Talk Cancer

Question:

Thanks for your time. I realize just how valuable time is to many that are here. I am a 41 year old who was recently diagnosed with a tumor in my right lung, the size of a pea. No other testing or broncoscopy has been done yet, possibly next week. I am getting a second look to see what may be recommended. Obviously I am scared and confused as I have never smoked in my life and never worked in an asbestos environment. I know stranger things have happened (Andy Kauffman, etc) and the origins of many tumors are unknown. I am feeling somewhat lucky that if it does turn out to be malignant that it was discovered early enough to possibly cure. Even if I have to lose part or all of my right lung. I was wondering if anyone else was in a similar condition and what may be available for information I could use. The tumor was detected after I slipped and hurt my back and 2 ct scans were done (1 with/1 without dye). The funny part is I fought not to do the ct’s because I had no insurance and tried saving $. The emergency room Dr. insisted on both, and I may owe him my life. I wish all the best for everyone here, and thank you for any direction you may have. Dane

Response:

I am a 41 year old who was recently diagnosed with a tumor in my right lung, the size of a pea.

I’m not quite sure, where the nodule is. In the lung or in the pleura? Thats make a difference because management is different. If it is pleural, then i would consider taking a biopsy. If it is in the lung, the i would recommend a mediastinoscopy, to see if lymphnodes are involved. If there is no lymph node involvement, then operation will be the next step. This would be the case of a so called T1 N0 M0 Tumorm which is potentialy curable. T1 means a small tumor, N0 means abscence of lymph node involvement an M0 means the absence of metastases. In this case, i would not recomment watchfull waiting. That means that ct woul be repeated in 3 mounths, to see wether the volume of the nodule has changed. A small increase in volume may not be appreciated, for on the ct you see the diameter not the volume. The diameter increase from 1 cm to 1,3 cm and you have double volume. So an incease in volume of 50% can easily be missed. If you then wait another 3 mounths, you have considerable chance of lymph node involvement. A curable treatment with long survival is not possible then. A needle or core biopsy of a lung nodule ist not easy to take. There is a chance that a representative specimen can’t be taken, so you van only be sure if you have a positive specimen. If it is negative, you still don’t know wether it is benigne or just have missed the malignant cells. Hope this helps Mared

Response:

I am a 41 year old who was recently diagnosed with a tumor in my right lung, the size of a pea. I’m not quite sure, where the nodule is. In the lung or in the pleura? Thats make a difference because management is different.

not certain at this point, all I have is info that it is a pleural nodule. Dr. at emergency room told me not "disapear" for 6 years without following-up. Obviously that won’t happen. I have 2 sons ( 1 and 3) and a wife and would do anything to spend life with them (at least the rest of this life!) If it is pleural, then i would consider taking a biopsy.

can this be done during a bronchoscopy ? If it is in – Hide quoted text — Show quoted text – the lung, the i would recommend a mediastinoscopy, to see if lymphnodes are involved. If there is no lymph node involvement, then operation will be the next step. This would be the case of a so called T1 N0 M0 Tumorm which is potentialy curable. T1 means a small tumor, N0 means abscence of lymph node involvement an M0 means the absence of metastases. In this case, i would not recomment watchfull waiting. That means that ct woul be repeated in 3 mounths, to see wether the volume of the nodule has changed. A small increase in volume may not be appreciated, for on the ct you see the diameter not the volume. The diameter increase from 1 cm to 1,3 cm and you have double volume. So an incease in volume of 50% can easily be missed. If you then wait another 3 mounths, you have considerable chance of lymph node involvement. A curable treatment with long survival is not possible then.

I thank you so much for this help. Is there any chance that a "nodule" can be something other than cancer? I know a good Dr. will help much (I go Monday) with these questions, but I value the opinions and knowledge that exists here in the newsgroup as well. I am looking for positive hope while being realistic. Dane (heading to church tonight!) Hope this helps Mared

– "He is no fool who gives up what he cannot keep To gain what he cannot lose"

Response:

If it is pleural, then i would consider taking a biopsy. can this be done during a bronchoscopy ?

No. The Pleura is too far away. A Biopsy of the pleura can be taken through the skin. It looks a little bit strange to me, that bronchoscopy is the firs step in evaluating a pleural nodule. This is usually done in the case of a pulmonary nodule. I thank you so much for this help. Is there any chance that a "nodule" can be something other than cancer?

Since you don’t have any risk factors (no smoking and no asbest exposition) you have a good chance that it is not cancer. There are many other possiblities. But a malignant cause msut be excluded and you will only know for sure after you have the biopsy results. All the best to you and to your family. Mared

Response:

Hi welcome to the NG. You have come to the right place for info. My mother age 63 has lung cancer. I can take you through the bronch. You will be given a sedative. You won’t be out completely at first. The doctor will go in with a scope that has a camera attached. He will be able to see your vocal cords and then he will proceed down the bronchioles. If he sees anything he will do what is called a brushing. He will gather approx. 40 to 80cc of tissue to be examined by the pathologists. This will intern give them what they are looking for and treatment. I was in with my mom because I am a nurse. The doctor told me what it was before the path report. They are doing a bronch on you because they suspect what ever to be in the bronchial. The only thing the doctor does not know is what type it is. There are 3 types small cell (oat cell) that is what my mom has. NSCLC( Non small cell) and Large cell. I read up on it before her bronch. Hers is located in the right Karina which is an archway in the bronchial tube. It is inoperable. 2 cm. to high. Sometimes the path reports can be inconclusive on the first brushing. They got her’s on the second. You ask the doctor after the procedure that you want to speak to him when you are awake. Ask him what or if he did a biopsy. He knows, they do them enough to know. You don’t have to play the week long waiting game. Path reports get back to the dr. in 3 days typed. 24hrs for a preliminary finding. Good luck, if you want to ask me anything email me. Please inform us of anything. I am not trying to scare you. What I have told is any nursing book. I think people should be informed. This is why you are here.       Debbie

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