Surgery with no biopsy and surgeon questions - 1270441

newgrl4
Posts:2

42 year old healthy woman. 2cm nodule in lower right lobe centrallly located. Mayo didnt biopsy due to difficult location and high odds of lung collapse and possible hemorhage as they suspect a carcinoid. Pet did not light up and i feel healthy and great. Passed lung tests over and above. They didnt see any fat or calcifications but my local radiologist saw densities of -30 to 200. They said location and the fact that its so round and smooth makes them think carcinoid. They want me to rmeove it..said even if biopsy came back neg there is still a chance it could be cancer. I have RSD/chronic regional pain syndrome. Spent many years in suicidal pain. Its under control but worried surgery could flare it all up. Its hard to commit to losing a lobe of my lung when they arent positive of what it is. Met a girl there who had the same story..wouldnt biopsy said 99.9% sure carcinoid turns out it was a hamartoma benign. She is suffereing from subcuntaneous air leak and looks like someone beat her with a baseball bat. How does one go about getting a second opinion and what would be a good place to go? Or is mayo the best. How do i know if my surgoen is good? He is in his 60s and has been doing it for 20 years but i think he does lung and cardio. Does anyone ahve any thoughts on any of this? Thanks!

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Reply # - July 9, 2015, 07:56 PM

catdander
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Hi newgirl, I commented on your other post but wanted to add that you may want to talk to your doctors about a wait and watch approach to see if the nodule grows. If so a surgery can be done at that time. If you have surgery the surgeon can biopsy during surgery and if it isn't cancerous the surgeon can close without losing lung tissue which should be easier from which to recover. If it doesn't grow then nothing may need to be done even if it is cancer. That is something you can speak to your surgeon about.

Reply # - July 10, 2015, 11:55 AM

newgrl4
Posts: 2

thanks for your comment. the lung dr said that a watch and see approach isnt the best because both hamartomas and carcinoids grow at a slow rate so he doesnt think that would help clarify what i have. If they biopsied during surgery wouldnt i already be cut open and ribs apart so still basically be already having the surgery..it would just benefit by not losing the lobe? I think they think since its 2 cm that anything that size should come out. But their not the ones losing a lobe at 42 years old and most likely dealing with rsd pain for years to come because of it. PS they said they do bronchoscopy right before the lung surgery...what does that mean? is that a biopsy or just checking down my throat for other cancer?

Reply # - July 11, 2015, 09:47 AM

JimC
Posts: 2753

Hi newgrl4,

The bronchoscopy is an effort to reach the nodule with the scope and obtain tissue from it, which could then be biopsied. Whether the results would change the surgical plan is an open question.

I would just emphasize that whether this is a carcinoid or lung cancer, your chances of cure are greatly improved by acting quickly, since the nodule has been discovered at such a relatively small size. Although I understand your concern about losing a lobe at such a young age, you have a chance at cure that many who are diagnosed at a later stage wish they'd had, and it would be unfortunate if you did not take advantage of it.

As Tom pointed out with his link to Dr. West's post, radiation may be an option that could be considered. If you would like a second opinion, the best choice would be at a teaching hospital affiliated with a good medical school.

Good luck.

JimC
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