My husband, aged 58, began complaining 2 weeks ago about pain in his shoulder, which continued to get worse and then about a week ago I noticed an apricot sized lump just under his scapula on the same side where the pain is. He went to our GP who referred him to an ortho who took a neck xray and diagnosed him with a pinched nerve and put him on methylprednisolone. Since that time, the pain has increased and also goes from shoulder to down his arm, elbow, top of hand and just tonight under his arm. I have been searching the internet with his symptoms, and as it appears others before me have, I keep running across pancoast syndrome/tumor. My husband has never been a cigarette smoker, but smoked something else in the 70's. His father was a smoker and passed away of lung cancer in his 50's.
He is barely sleeping at night as he cannot lay down on his back or side due to the pain. He tries to sleep sitting up. He also cradles his right arm in his left arm to try to take the pressure off of his right shoulder. I keep seeing how the best prognosis relates to early diagnosis and also that so many people are misdiagnosed by their orthos sometimes for months!!
I am a 12 year survivor of nonhogkins lymphoma, and understand the necessity of early diagnosis. I am thinking I should call my oncologist and ask his opinion tomorrow. My husband called the ortho today and told them how much pain he is in. They made an appointment for him the day after tomorrow first thing in the morning. I told him to make sure they xray his shoulder AND his chest. Are we doing all we should?
P.S. We also called our Gen Practitioner who is on vacation until 7/6. Thanks for any info and guidance you can provide.
Reply # - June 30, 2015, 08:52 AM
Hi dgel and welcome to Grace.
Hi dgel and welcome to Grace. I'm so sorry your husband is having such pain.
I'd first like to say that there are many other reasons for shoulder pain yet people online and off seem to gravitate toward the worst most unlikely diagnosis possible. Doctors have to look for the most obvious. Though I must admit your husband's pain does sound suspicious at least to someone whose husband had a pancoast tumor. An x ray isn't a very good way to look for problems especially cancer. A CT scan is hundreds of times more useful. An ortho is also likely to want to look at his shoulder with an MRI because it sees the structures in the area.
It's not likely you'll be able to speak with an oncologist, they most usually only provide care to those already with a cancer diagnosis.
Your husband's GP or ortho are the best bet for authorizing a CT. Whether or not a tumor it sounds as if he has an acute problem and care should move on quickly but sometimes it takes a little push from the patient or loved one to move it on.
A note about how pancoasts are usually diagnosed. An ortho is usually the first doctor to help because these symptom are usually caused by an orthopedic problem. So it may be worth asking the ortho for more comprehensive scanning such as CT.
I hope all works out well and without cancer.
Janine
Reply # - June 30, 2015, 10:12 AM
Hello Janine. Thank you for
Hello Janine. Thank you for your reply. I actually had a brief conversation with my oncologist today who suggested I go to the ortho appointment tomorrow with my husband so that I can express my concerns. My husband is also on board with that so that is the plan. I am hopeful he will do a chest and shoulder x-ray, and perhaps a ct and maybe that will put us on track to find the issue.
Thanks for your advice and your insight and congrats--I see in your signature that your husband is NED as of 2/15!
Wish us luck tomorrow!! Thanks again!
Diane