Update on Growing Nodule - 1288562

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ellen24
Update on Growing Nodule - 1288562

Hi Everyone,
I hope everyone is having a lovely Friday evening. I just got back with my husband for his first consultation with a thoracic surgeon. I am confused. The surgeon seems to want to go radical. It was a bit more than even I expected. For a 1.4 cm nodule he suggested to take out the whole mid right lobe lung. I think that is a bit much without knowing if it is cancer or not.

We are schedule for another consult with another doctor from Columbia next week. We are awaiting an appointment at Sloan. Feedback would be much appreciated.

JimC
Hi ellen,

Hi ellen,

I would agree with your concern, especially in light of your husband's compromised lung function. However, there are limitations of assessing a situation online from limited information, so it's good that you are getting a second and third opinion, as some surgeons are more anxious to perform surgery just because they can (give them a hammer, and everything looks like a nail). But there may be factors such as the location and appearance of the nodule on scans that make surgery the favored option.

I hope you have a good meeting at Columbia next week.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

ellen24
Hi Jim,

Hi Jim,

Thanks, the one thing that came out of the session with the surgeon was that my husband finally accepted that this is a serious situation. I realize from his point of view that he wants to downplay it but he knows the facts.

What would be some of the issues he would face having a the middle lobe removed rather than a small wedge? If we agree to go with the surgeon who wants to take the middle lobe out would that give my husband a better chance of not having the cancer pop up again. Sort like a pre-emptive strike?

Lots of questions for the next surgeon to answer.

catdander
Ellen,

Ellen,

Removing the middle lobe of the right lung will remove both healthy and non healthy tissue. Losing healthy lung tissue causes loss of lung function.
The procedure itself is risky. VATS is less invasive so less risky than an open thoracotomy. A pulmonologist does a lung functions test to judge whether a person is healthy enough to withstand surgery itself and withstand the loss of healthy lung tissue.

Over all losing lung is dangerous enough not to remove any without a good reason.

A question I would have for the surgeon is his/her experience with thoracotomies, a dedicated thoracic surgeon. Not all hospitals have them but Sloan will. This should be a routine surgery for the surgeon. A surgeon that does mostly heart surgery or general surgery doesn't routinely do lung surgery and doesn't have the experience to deliver the best outcomes.
Another question for the surgeon who suggested taking the whole lobe. Why take the whole lobe before testing to see if the mass is benign or malignant? That can be done during surgery so the decision can be made during surgery.

I hope ya'll find the best answers. Seeing several surgeons is certainly a good thing.

All best,
Janine

catdander
Ellen,

Ellen,

Removing the middle lobe of the right lung will remove both healthy and non healthy tissue. Losing healthy lung tissue causes loss of lung function.
The procedure itself is risky. VATS is less invasive so less risky than an open thoracotomy. A pulmonologist does a lung functions test to judge whether a person is healthy enough to withstand surgery itself and withstand the loss of healthy lung tissue.

Over all losing lung is dangerous enough not to remove any without a good reason.

A question I would have for the surgeon is about his/her experience with thoracotomies, a dedicated thoracic surgeon. Not all hospitals have them but Sloan will. This should be a routine surgery for the surgeon. A surgeon that does mostly heart surgery or general surgery doesn't routinely do lung surgery and doesn't have the experience to deliver the best outcomes.
Another question for the surgeon who suggested taking the whole lobe. Why take the whole lobe before testing to see if the mass is benign or malignant? Testing a sample of the mass can be done during surgery so the decision can be made during surgery.

I hope ya'll find the best answers. Seeing several surgeons is certainly a good thing.

All best,
Janine