New to this forum, appreciated any advice or help - 1253046

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mickey61
New to this forum, appreciated any advice or help - 1253046

Hi all started in December 2012, asked Dr for ct lung cancer screening test, he agreed and off we went. came back with comparison to Feb 2011 ct scan came back as a slighty irregular 0.9 x 0.1cm soft tissue mass in upper right lung suspicious for neoplasm. Then refers to it a 1CM, suspicious for neoplasm. No mention of calcified or non-calcified, called it a mass but it is my understanding anything under 3cm is a nodule, Dr called and then consulted with thoracic dr who he said seemed unimpressed but would probably ask for another ct scan in a month. Dr checked lungs clear, no cough, back pain but always had that. go to thoracic Dr 1-25 and he ask 50 million questions, then says because of smoking hx thank god you had this ct scan. next step is pet scan, another ct scan of chest and pulmonary function test and then onto needle biopsy. Ok I do have and have had emphysemic bullae more on the upper right so I am very very worried about the needle biopsy as I am 61 do not have good lungs as you can see, and every single webpage and hospital site refers to DO NOT do a needle biopsy on any patient that has emphysemic bullae and it or it says it should NOT be performed and the NOT is always capped and it even says that on there own hospital website, so why would this Thoracic Dr put me in this position with ct needle biopsy? I am thinking for sure my lung will collapse and the nurse said when I go to the hospital they will put pain meds and twilight sleep into an IV, now I'm really worried because just the thought of waking up in pain not being able to breathe because my lung collapsed and I can find no one on any forums who said they did this before the procedure. Generally thCan anyone help with this please, I'm putting off this needle biopsy until I get answers. I am going for the pet scan along with the ct scan and the pulmonary test, they stressed I had to have that before the ct needle thing (the pulmonary test).

Any opinions would be appreciated.

mickey61
Reply To: New to this forum, appreciated any advice or help

Also want to add I have no support, husband can't deal with it, actually walk out the door and told me he is not going to deal with it, I better get off my tush and get over it. Taking care of an elderly mom and have no one else to turn to. Really concerned about the needle biopsy, ask Dr if finding are small could he do Vats and get rid of it, he said they are many options but after seeing me wants all this done in two weeks. More worried about this needle biopsy then anything else right now. Thanks

Dr West
Reply To: New to this forum, appreciated any advice or help

Mickey,

I'm sorry that I don't have an easy answer for you. The forms are written as legal CYA documents that are meant to be conservative, but in real life, it's necessary for the doctors to determine the balance of risk of doing something vs. the risk of not doing something. It sounds as if the doctor has judged that the risk is greater for not doing this evaluation.

Many people here have undergone a needle biopsy. It's true that it's not risk-free, but many people undergoing a needle biopsy don't have perfect lungs -- you won't be the first. And yes, it's possible that there could be a small or large amount of lung collapse -- that can happen in people who don't have significant emphysema, but it's something that is a known, accepted risk that can be almost always be managed effectively.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

catdander
Reply To: New to this forum, appreciated any advice or help

If your not convinced that you need the biopsy perhaps a second opinion would help. It sounds as though they are preparing for the possibility of a lung collapse with the extra meds. I'd ask. By the time you wake up if you had a collapsed lung it would be stabilized by the time you woke up. I'm just theorizing though.

mickey61
Reply To: New to this forum, appreciated any advice or help

Thank you both.

For Dr West, the only determination so far is the ct scan which showed the nodule, have not had the Pet scan, having that this week nor have I had the pulmonary test. Wouldn't it be advisable waiting for the pet to determine the risk, he also order another ct scan of chest along with the pet. He just gave me this order, pet, pulmonary function and then needle biopsy. Being an oncologist is that size nodule 0.9 x0.1, slight irregular, soft tissue mass, no mention of calcified or not have guided you in that direction. He did take blood work and an ekg, he did a physical exam, briefly, neck, heart and lungs, did say lungs were clear, have no idea what he was looking for, looked at my fingernails and my ankles. Oh in my mouth which he mention I had some broken teeth (they were not really broken just root canaled and filled over instead caping in the back of my mouth) and some problems going on in my upper right teeth all of which I knew about because they have been hurting for some time. Dr google and I know that Dr google can be very misleading. Is it the smoking hx that guided him? I'm looking for the worse and praying for a miracle. Should I voice my concerns to him in hopes of getting an answer, I know that the only way to know is a biopsy, but I was hoping more for skipping a biopsy and doing a Vats to get it out fi I could, then doing the biopsy. As you can see I'm very axious, stressed and worried, cried alot, but from what I have read everywhere its better to get it out, no good comes of anything that should not be there.

I appreciate your time. Thank you so very much.
Mickey

mickey61
Reply To: New to this forum, appreciated any advice or help

Also one more question, 1cm is not small my Dr says its small but lots of people have 1cm, but not big I guess, what are the chances they will get it with one shot or will it be several, it is in my URL. thanks again!!!!

also Bronchoscopy versus Needle Biopsy, think I would take the first one because you are completely out and the chances of lung collapsing is not as big.

Mickey

cards7up
Reply To: New to this forum, appreciated any advice or help

Most doctors dont' do a biopsy until they see a PET report and you have your pulmonary testing. So if this surgeon seems to be pushing before these are done, then find another surgeon. I don't know of anyone that is completely knocked out for a bronchoscopy. In your case, the biopsy might be easier for you with a bronch vs a needle. Take care, Judy

mickey61
Reply To: New to this forum, appreciated any advice or help

Thank you for your reply, surgeon said pet, then pulmonary, then biopsy all in two weeks, pet this wed, pulmonary friday morning. his coordinator did say I had to have the pulmonary before the biopsy. I'm sure he is not looking at any of these test one by one. He just said first we do a pet, then we do a pulmonary test then a needle biopsy. I thought it was also weird that he would order all three. I'm going to make sure someone looks at the first two before the needle biopsy, I am going to have the pet and the pulmonary sent to my GP also so he can look at it. I am also going to ask him about or have his coordinator ask him about the needle biopsy and my concerns. they have not call me to schedule yet (the needle biopsy). thanks again for responding.

Dr West
Reply To: New to this forum, appreciated any advice or help

Mickey,

We really want to get a biopsy any time we see a lung nodule growing over time, especially if it's over 5 mm. One cm isn't big -- it's actually pretty small -- but it's definitely big enough that in a smoker, seeing a nodule growing to 1 cm makes us concerned enough to want to get a biopsy to clarify what it represents. And even if a PET scan doesn't light up there, that doesn't mean it isn't a cancer, so it's helpful if it lights up a lot, but it's not completely reassuring even if it doesn't.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education