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Don M

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    SHADOW ON XRAY

    in GENERAL

    Posted

    Hi Barb. They don't really know what it is for sure, but there is something there. It is either scar tissue or it could be a nodule. The size of it could be importnat. If it is less than 8 mm, I think they would probabaly monitor it to see if it grows. If it is around 12 mm they could do a PET scan to see if it has increased metabolism, and indicator of malignacy (infection too). In my case, I had a 9mm something in August 2004. In Jan 2005 it grew to 12 mm and was big enough to do a PET scan. A CT scan a few weeks ago more positively identified it as a nodule and the PET scan showed uptake. So, if it is still small, wait and see should be ok.

    UPDATE

    in GENERAL

    Posted

    Karen: I ma praying for Dave and you and Faith. Let the miracle happen. I think it is cool that the oncologist is on board with you, pulling for that miracle.

    Chest wall needle biopsy and lung needle biopsy 2-16-05

    in NSCLC GROUP

    Posted

    Thanks for your support and responses everyone.

    I saw my surgeon today and it took me about 2 minutes to decide to have an operation. The data that we have now does not prove or disprove cancer. The next step would be to open me up and do a complete biopsy. There is an unknown mass at the chest wall. It showed uptake. It is not shaped like a tumor. It may be just inflamed scar tissue. The first thing they will do is to check out my chest wall. If there is a malignancy at my chest, the operation will end. I will be restaged (stage III I think) because the cancer will have left my lungs. It will be inoperable once it gets in the chest wall.

    So, if the chest wall and other sites (outside the lung) prove no cancer at the time of the operation, the surgeon will do a wedge resection of the tumor. If the tumor is malignant, I will have the rest of my lung removed and I will ask for adjuvant chemo.

    I think it is probably all benign, but I am not going to bet my life on it. I want the operation to put the matter to rest.

    If the insurence clears it, in time, I will hae the operation this Friday. Otherwise, I will have to wait a week longer. I hope it is this Friday.

    It will be a full thoractomy because I probably have too much scar tissue to use the scope effectively. the surgeon says it is like looking through a kelp forest if there is a lot of scar tissue.

    At least I know pretty much what to suspect this time.

    Don M

    new to this.

    in INTRODUCE YOURSELF!

    Posted

    Hi Carole and welcome. I hope the scan show the chemo whacked your husband's tumors. More than a few of us, myself included, have had to deal with depression relative to this disease. I got a Rx for lexapro from my oncologist and it has helped me.

    Chest wall needle biopsy and lung needle biopsy 2-16-05

    in NSCLC GROUP

    Posted

    Last Wednesday I had 2 needle biopsies done to follow up on a 2-7-05 PET scan.

    The PET scan had shown uptake and a fill-in oncologist advised me to forget surgery and go on chemo since I had uptake at the chest wall, at a new nodule and near the right hilum. I went to see the surgeon the following Friday who said that uptake on a PET scan does not prove cancer. The surgeon referred me to an interventional radiologist to do the needle biopsy. I also talked to the pulmonologist that day, and his opinion on the upake at the right hilar area is that it is negligible and not worth considering. If there was cancer there it would be from a lymph node, and none showed up in the CT scan.

    After I arrived at the hospital for the biopsy, I spoke to the radiologist and he said that he would like to also do a biopsy of the nodule if the preliminary pathology showed no malignancy in my chest wall. I told him I liked that idea just fine.

    The chest wall showed no malignancy on preliminary testing, so they also did a needle biopsy of the nodule.

    I got a copy of the report on Friday.

    Below is an excerpt from the pathology report:

    SPECIMEN SOURCE (from requisition):

    A. LLL (LEFT LOWER LOBE) LUNG BIOPSY

    B. LEFT CHEST WALL MASS

    INTRAPROCEDURAL EVALUATION:

    A. Nondiagnostic JMO

    B. Nondiagnostic sample ROW

    GROSS DESCRIPTION.

    Two sets of slides and two PreservCyt vials containing fluid specimens are received. Each slide and fluid container is labeled with the patient's name, "Miniken, Donald."

    Part A. Five fixed and five air-dried slides are received, In addition, a PreservCyt vial containing 20 ml of slightly cloudy fluid is received, from which one thin layer prep and one cell block are made.

    Part B. Five fixed and five air-dried slides are received. In addition, a PreservCyt, vial labeled with "L chest wall” is received. The vial contains two tan-red biopsy cores in cloudy tan fluid, from which one thin layer prep and one cell block are made.

    MICROSCOPIC DESCRIPTION:

    A, B. Twenty-two smears and two cell blocks are reviewed. The smears demonstrate blood and infrequent benign cells. No malignant cells are seen. One of the cell blocks has blood and skeletal muscle without evidence for malignancy.

    FINAL Diagnosis:

    A, .B. "Left lower lobe of lung": nondiagnostic.

    So, all I know for sure is that I have a nodule and some kind of mass at my chest wall.

    The PET scan is marginal for indicating malignancy. The biopsy found no malignancy. I know that does not necessarily mean there is nothing there. Needle biopsies are not reliable for negative results. But, I think that they got some good tissue samples in pathology.

    I like the part in the pathology report where they use words like "benign cells" and "no malignant cells are seen". I have a history of a benign tumor at the very same site in that lobe. You might think a benign history would be an important factor to consider, but the fill-in oncologist was thinking lung cancer history I guess.

    Well, anyway, I think the PET scan is more wishy-washy, in terms of interpretation, than the needle biopsy, in this case. I remember that I asked the fill-in onc what he thought about the probability that I had cancer again, and he said it was 90% certain. Right now, my un-expert opinion is that there is a 90% chance I don’t have a recurrence.

    So, what do I do now? Well, tomorrow, I have an appointment to discuss the biopsy results and whatever else with my surgeon. He will probably present me with options. I am going to go ahead and guess.

    1.Wait and see. No surgery now. Continue to monitor with ct and pet scans.

    2.Open me up and do a full biopsy of the suspect sites.

    a. If a malignancy is found at the chest wall area end the

    operation and go on chemo.

    b. If no malignancy is found at the chest wall, test lymph nodes

    at my mediastinal and right hilar areas. If these areas show

    malignancy, end the operation and go on chemo.

    c. If no malignancy is found at sites outside my lung, remove

    the nodule and test it for malignancy.

    1. If the nodule is malignant, remove the rest of my lung.

    Do follow-up chemo.

    2. If the nodule is not malignant, end the operation and don’t do

    chemo.

    I wonder what the surgeon will say.

    Don M

    Bad News

    in GENERAL

    Posted

    David : enjoy the circus. I will pray for you . There is always another step. You say what's next with this disease a lot I guess.

    "yo David, b---ch slap dis disease"

    it's A Pity Party and You're ALL invited!!!

    in GENERAL

    Posted

    Hey Fay, I don't have a long list of war wounds at my signature like a lot of folks do, but what the heck sign me up to for a little "pity on" this weekend. Monday I have a appointment with my surgeon and it will be time to get back to work.

    But serioulsly, sometimes I think it is perfectly ok to give myself a mental hug. I tell myself, there there it will be ok, like I was talking to my inner child.

    I have a drum and a harmonica, will that be good enough? And is a tartan like a spirit guide or somthing?

    Don M

    New at this and scared gg

    in INTRODUCE YOURSELF!

    Posted

    Hi June: welcome.

    I am sorry to hear that your lc came back. All of us early stagers here remain hopeful that we will have beaten it after 2 years, but I guess there are no guarantees.

    I may be facing the possibility of a recurrence at one year after sugery, possibly into my chest wall, and so I know how you must feel. For me, I don't really know for sure yet, but I know I would be very dissapointed, depressed and eventually afraid I suppose if a recurrence to a higher stage for sure happened.

    but... there are lots of people here who can listen to you and me and cheer us on.

    It is good to hear that your treatment is going well. Before you know it, you will be outa Eugene and down in San Diego to be with your family.

    Hopefully the radiation will make your tumor small enough so that you can have an operation. If the cancer has not left your lung, I think they would do something like that.

    I go through Eugene every now and then when I am on the road for job assignments.

    I am a first time grandpa. His name is Keaton Joseph.

    Hang in there June.

    Don M

    I've been told to stop whining by PM

    in GENERAL

    Posted

    Beth: I have been reading your posts and know that if I had to go through what you have endured, I would have a hard time maintaining. I might even whine. I have had it easy compared to you. Besides, this site's purpose is to garner support from one another and if we just suffer in silence, grin and bear it or whatever, what is the point of the site? We would all be a bunch of silent stoics just mumbling I'm ok, happy to be here nonsense to one another.

    Anyway, I suspect that the guy who pm'd you may regret his message. It sounds a little impulsive.

    And, I think you may be on to something with the fungus thing. Look into that some more.

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