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I could use a little help from my friends

Lisa O

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After some long delays, my mom had the second CT scan which still showed a 2 cm nodule and has now had a pet scan which did light up. The surgeon (The one who did my second surgery when the eight nodules were removed from the right lung) is fairly certain it is BAC but since my mom is a smoker, he is hesitant to do an open lung biopsy. He has requested that she go to Cornell for a needle biopsy.

Please share any experiences regarding needle biopsies with me. Also if anyone has any experiences with Cornell, I would apprecieate it. It is almost unbelievable. first, I had melanoma, then she had melanoma. Next, I had lung cancer, now she is being investigated for the same rare form of lung cancer.

I am having a rough time with this. She has a 2 cm nodule. I think she has a decent shot of beating this. She is very young - 62 - and energetic and beautiful. I am hoping the biopsy goes well for her. Has anyone had a needle biopsy who is willing to give me all the details. I had multifocal disease and we went straight for the open lung biopsies in my case.


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John had a needle biopsy. It was not painful but ached some later. It is like a hollow tube they go in, grab a piece, and send it down to pathology. They waited with the needle in his chest for the report in case they needed another piece.

Now you won't believe this...his mother has a tumor in her lung. She goes to the pulmonolgist tomorrow and will soon be having a biopsy also. We seem to be having similar experiences.

Good luck to your mom...hang in there.

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Hi Lisa,

So sorry.

I had a needle biopsy. I was hospitalized and they may or may not have given me a little dope.... hard to remember, I was in shock, anyway.

I do recall that it was not painful, per se. More like uncomfortable for just a couple seconds. The doctor (radiologist, I believe) used guided imagery and got the tissue that he needed on the first try. Afterwards, I was checked for pneumonthorax with a quick chest xray and then done. It didn't take long for the pathologist to review the slides to make a determination. (I was hospitalized, remember).. they were all working together on the premises as a team. So. Hardly any waiting or dicking around, which was good.

Tell her it doesn't hurt. Oh. He did put a little local in my back. No big deal.

Of course, please let us know how she does.

Cindi o'h

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I am so very sorry.

Besides the fact that your Mom is/was a smoker, is there any other reason why her physicians are reluctant to perform surgery to remove the nodule without "disturbing" it? Is her pulmonary function strong enough to tolerate the surgery? Everything I have ever read says that it is best to remove a suspected malignant tumor intact, with clear margins, and otherwise undisturbed. If I had known in the early days what I know now I would not have allowed them do a FNAB on me.

I have had 3 Fine Needle Aspiration Biopsies, and one transbronchial needle biopsy.

The first one was done in May of 1999, and resulted in the partial collapse of my lung. The results were inconclusive. This is common in FNAB, because such a tiny amount of material is removed from the lesion. It's also not uncommon for there to be a false negative. And often times the exact cell type is difficult to determine, again because there is such a small amount of tissue to exam.

My second FNAB was done 10 days after the first one. They used a larger needle, and this time were able to obtain an adequate specimen for pathologic exam. The results were positive for malignancy, but they had it listed as NSCLC-Large Cell. Wrong histology.

I had surgery 2 weeks later to remove the tumor(s). The one that had been FNAB ( that was supposed to be Large Cell) turned out to be Adenocarcinoma with BAC Features.

The third needle biopsy was a Transbronchial Needle biopsy, done from inside the lung into an exterior hilar lymph node. It was alleged to have been negative (could never get a copy of the path reports on that procedure), and was the reason why no one would do the pneumonectomy on the right lung when the only apparent cancer was that node. No "biopsy proven recurrence". In the subsequent pneumonectomy done almost two years later there was, indeed, tumor at the location of the hilar lymph node and on the inside of the lung at the site where the Transbrochial Needle biopsy was done., as well as several other places.

Had the 4th one done about 2.5 months before the pneumonectomy. The tumor appears to "explode" shortly after the needle was inserted for the FNAB, at least according to the CT films that were being done at the time of the procedure. The physician who did the FNAB said only that there had been some problem with "...bleeding...".

The first FNAB was painful because other than a local used to numb my skin and some of the muscle tissue the rest of me was wide awake and feeling everything. The needle went in, my lung collapsed and my back went into spasms. Part of the pain was from the pneumothorax, part from the back muscles in spasm. I had to lie on my back for a few hours until the leak sealed. My lung never fully inflated after the first FNAB, but that wasn't really a big problem for me, because the docs removed that part of my lung in the first surgery.

I was not looking forward to the second time around, but that turned out to be much easier. My lung didn't collapse, and I didn't have any back spasms. It was uncomfortable, nothing more.

The Transbronchial Biopsy was done while having a bronchoscopy. I was unconscious.

The third FNAB was also done under sedation. I felt it when the doc was punching through the lung and tumor and when I moaned he increased the sedative. I don't remember any more pain after that.

This may be more than you wanted to know. But after all I've read on Fine Needle Aspiration Biopsy (PubMed articles) I believe the risks (1.seeding of malignant cells along the needle tract, 2. bleeding from the tumor within the lung, 3. False Negative Pathology, 4. Pneumothorax) outweigh the benefits, and if I had known early on what I know now I would not have agreed to it when first diagnosed. I fully admit that the fact that some of my tumors turned out to be cancerous colors my view on undergoing thoracic surgery when the nature of the tumor is unknown.

Lisa, your family is in my prayers every day. All of you.

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Hi Lisa: I am sorry about your mom. I had a lung needle biopsy for my first occurrence a year ago. Just yesterday, I had 2 more needle biopsies. One in my chest wall and one in a recurrent nodule at the remaining lobe of my left lung.

Yesterday, I checked in to the hospital at 8 in the morning. It was 10 am before the procedure started. I had to fill out forms and sign stuff first and get prepped. The procedure took longer than usual for me because, I had two needle biopsies yesterday. I was back in my holding area by 1130 or so. I slept for a while , had my xray, and slept some more. They let me go at 2 pm. It took 6 hours all told. I had to have a driver. I could not do any strenuous activity for 72 hours and not drive for 48 hours afterwards. I was advised not to sign any legal documents for 48 hours after.

An interventional radiologist performed the procedure using the ct scanning device to guide the needle insertion and tissue extraction. They gave me a local shot to numb me up at the insertion site. I also had an IV and was mildly sedated. I had to be responsive enough to follow the instructions on when to breathe and when to hold my breath. The main purpose of the IV was to help me be relaxed so that I could lay still. They stressed that regular even breathing was important so the the lung would always be in the same spot when the radiologist was ready to move the needle when I was holding my breath.

The needle may be inserted from the back or the side or the front, depending on where the nodule is. I was on my back when they did it to me. The radiologist will get a good sample and send it to the pathologist. There will be a 15 minute wait with the needle still in while the pathologist determines if he has enough sample. If it is found malgnant right away, that will be the end of the procedure. If it cannot be immediately established that there is a malignancy, the pathologist will ask for another sample. The radiologist will move the needle to a slightly different area at a slightly different angle rather than making a new insertion and get a second sample. Then, it is sent to the pathologist again. I don't think they would come back for a third try. They never did with me. but I had them come back for seconds a year ago and yesterday.

There is a danger of getting a pneumothorax (collasped lung). I had one a year ago, but not yesterday. They will take an xray soon after the procedure to see if your lung is ok. If it has collasped, the usual practice is to insert a chest tube to drain the air trapped between your chest wall and the lung and keep you overnight in the hospital for observation. When I had my collasped lung, they put a chest tube in me and I went home. the next day I came back and they took it out after establishing it was back to normal with an xray.

I am feeling a little bit sore today. the soreness goes away after a couple of days.

I have read that lung needle biopsies are very reliable when there is a positive result and unreliable when there is a negative result. If they don't find any cancer, it may be written up as "inconclusive" by the pathologist. Then, the beat goes on.

It usually takes 2 days after the day of the procedure for the pathologist to do a complete report. If your mom has the procedure done on a Monday, her doctor should have the report on Thursday.

I hope the best for you and your mom.

Don M

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Hi Lisa,

My husband had one done and did not feel any pain. They gave him a chest Xray afterward to make sure a lung did not collapse. It didn't and he went home. Was a little sore for a day but that was it.

Good luck,

And Don good luck with yours too, let us know the results.


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Lisa and Fay: I asked my oncologist about the possibility of seeding cancer cells along the needle tack and he said it is very rare for lung cancer to do this. Also, there are 2 studys that I came across that say it is a rare event. The other risks are more frequent. Surgery itself is no small risk.

http://www.ncbi.nlm.nih.gov/entrez/quer ... s=12754041


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Dear Lisa,

So sorry all this is happening, but you're right. Your mother has a good chance since it's small -- hope she'll stop smoking now!

Len had a needle biopsy after his xray and ct scan; the procedure itself wasn't painful but his lung collapsed when they withdrew the needle. The radiologist said that he may have breathed while this was happening and that may have caused the collapse. At any rate, he ended up in the hospital for a whole week before his surgery the next Monday while they attempted to reinflate the lung. They were going to let him go home until the surgery IF the lung reinflated but it refused to cooperate, even after the inserted a wider tube in an effort to get it to go back up. Guess when it reinflated? The morning of his surgery....

So just tell her to be sure to hold her breath when they tell her to -- she shouldn't have any problem otherwise.

When you say Cornell, which hospital (now that they're in a consortium, it's hard to tell). I was in New York Hospital for my two kids but that, of course, was way back in the Middle Ages. A friend of mine was there for melanoma a few years ago and received excellent treatment -- he's thriving now.


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I'm no help with the needle biopsy....my surgeon said he wouldn't do one...they are too dangerous, false negatives, it had to come out anyway. So, I'm with Fay on this one, but I've seen a lot of other cases here where they did a needle biopsy and everything was fine.

I was a smoker and tolerated the surgery really well. I hope that if your mom does have a tumor that needs to come out, it goes well. 2cm is still in the stage 1 range, and that would be the best of bad news.

You are in my thoughts.


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I guess I had what you are talking about. They put a needle into the lung and got something and then told me later about the cancer I had. I already knew I had cancer but they added in the other details. It didn't take long and I don't remember any pain.

My lung did collapse some and the pulmonary doctor checked me into the hospital in case anything went wrong from that. He is a very cautious doctor and didn't want to add anything else on top of what I had. Got out on Sunday or Monday and started chemo that Wed. before Thanksgiving. Marion

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As usual, this group has been so informative and supportive. Thank you. She is scheduled to go to Cornell on March 7. The procedure is set for March 8. I did pass along all of the information, warnings and all. She discussed them with her surgeon and opted to go forward. I will keep you posted. Thank you so much for sharing your information and experiences and thanks mostly for the support.

Ry, I will keep John and his mom in my prayers as well. Don, I hope all is well with your recent procedure too.

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Lisa I am a day late here. I did not even know what was happening to me. I remember lay on my back and they marked the spot. Anesthia took care of the rest. What I do remember tho is having to lay on my stomach for three hours. Would not let me speak a word. I am sure your mom will do fine. Hope this helps.

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Oh no, Lisa.....I'm so sorry to read this about your mom. I have no knowledge of anything other than the needle biopsy on my liver this past Tuesday. By yesterday, finally I wasn't so sore at the site. The procedure was a piece of cake, but then it wasn't the lung where there is more risk, it appears.

Please know I'll keep your mom in my most positive thoughts and hope she gets some good news next month. This must be making you crazy...but you know we're here whenever you need to vent or unload.

Keeping all good thoughts.....

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