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cancer in the lympnodes???

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Well they finally found the primary source of mom's cancer, they found it in the lympnodes near the lungs. Orginally they found brain mets and not much on the CT/PET, but from the biposy of one of the brain tumors they said it was probablly lung cancer. They did a broncoscpy?? test on Monday and took some lympnodes, the pathology results show that mom's primary spot to be in the lympnodes of the lung. Its hard for me to find out if this is good or bad without upsetting mom or my stepdad too much b/c i live so far away from mom and i get everything second hand. When i look on the internet sites it just seems all so bad...can someone please tell me what this means?

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Have you asked the doctor what this means. Have they given you any info about it? I guess there are different part of the lung that cancer can grow. Some are worst than other I don't remember which. How far away is your mom from you? I saw you live in central Mass my mom used to go to Mass General great doctors there. Also you can do some research on the web so you will understand better.

I will pray for you and your mom!

Take care


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Vassar, again, I'm just so sorry you have found yourself on this road.

I'm not a doctor.

It is my understanding that the brain mets really are the most immediate issue.

Spotting the primary is certainly a key piece of info, but I don't know if that changes the depth of the situation (whether the primary is a lung or a lung lymphnode primary). Maybe someone else may set me straight on that.

Regardless I am praying for good things to happen for your mom.

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This may help you out some. You can also call onc and se if he will release info to you being a Family member. worth a shot. Read this it may help clarify things;

The stages of lung cancerThis page tells you about the stages of lung cancer. You can scroll down the page to read all the information here. Or you can use these links to go straight down to sections on

About staging for lung cancer

The stages of non-small cell lung cancer

The stages of small cell lung cancer

Pleural effusion

About staging for lung cancer

The stage of a cancer tells the doctor how far a cancer has spread. It is important because treatment is often decided according to the stage of a cancer. All staging for cancer includes information on the size of the tumour, whether there is cancer in the lymph nodes and whether the cancer has spread anywhere else.

There are different staging systems for cancer. You are most likely to be told the number stage of your cancer. This is a system that groups lung cancers into one of 4 groups, stages 1 to 4, depending on how far the cancer has progressed. As this system has developed, it has become a little more complicated. Stages 1 to 3 are now divided into subgroups. There is information below about the number stages of non small cell lung cancer.

Staging for small cell lung cancer can be even simpler with only two stages - limited diseaes and extensive disease. There is more about these two stages of small cell lung cancer below.

Between themselves, doctors most often use the TNM staging system. This is quite detailed and can tell the doctor the size of the primary cancer, whether it has spread to lymph nodes and whether it has spread anywhere else in the body. There is more about the TNM stages of lung cancer in this section of CancerHelp UK.

The stages of non-small cell cancer

Non-small cell cancer can be divided into four stages

Stage I

This means the cancer is localised. There is no cancer in any lymph nodes.

Stage 1 can be divided into 1A and 1B. Stage 1A means the tumour is small (3cm or less across). Stage 1B means the cancer is larger or that it is growing in the main airway of the lung (the main bronchus). Stage 1B includes cancers that have grown into the inner covering of the lung or caused a partial collapse of the affected lung.

Stage 2

Stage 2 is divided into stages 2A and 2B. Stage 2A means the cancer is small, but has spread to the lymph nodes closest to the affected lung.

Stage 2B can mean one of two things

The cancer in the lung is larger than 3cm across and there is cancer in the lymph nodes nearest the affected lung or

There is no cancer in the lymph nodes but the cancer has grown into the chest wall, the outer covering of the lung, the muscle at the bottom of the chest cavity (the diaphragm) or the outer covering of the heart.

Stage 3 is divided into stages 3A and 3B. 3A can mean one of two things. There is cancer in nodes further away from the affected lung, but still on the same side of the chest. Or there is cancer only in lymph nodes nearest to the affected lung but the cancer has also spread to either the chest wall or the covering of the lung (pleura) or the middle of the chest (mediastinum).

3B cancer means one of 4 things

There is cancer spread to nodes on the other side of the chest or to nodes above either collarbone

There is more than one tumour in the affected lobe of your lung

The tumour has grown into another major structure in your chest, which could be the heart, the windpipe, the gullet (oesophagus) or a main blood vessel

There is a fluid collection around your lung that contains cancer cells (a malignant pleural effusion)

Stage 4 means the cancer has spread to another lobe of the lung from where it started or to another part of your body, for example the liver or bones.

The scans and tests you have done should give your doctor some idea of the stage of your cancer. But it may not be possible to be completely sure until you have had an operation. In most cases however the tests described in Diagnosing Lung Cancer are enough for your doctor to tell the stage.

The stages of small cell lung cancer

The TNM staging of small cell lung cancer is the same as for non-small cell lung cancer. But in practice, small cell lung cancers are often divided into just two groups. This is because small cell lung cancer often spreads quite early on. Even if the doctor cannot see any spread on your scans, it is likely that some cancer cells will have broken away and travelled through the bloodstream or lymphatic system. To be safe, doctors often prefer to treat small cell lung cancers as if they have spread, whether they can see any secondary cancer or not.

The two stages of small cell lung cancers are

Limited disease means cancer that can only be seen in one lung, in nearby lymph nodes or in fluid around the lung (pleural effusion)

Extensive disease means cancer that has spread outside the lung to the chest or to other parts of the body

Surgery is not usually used to treat small cell cancer, except in very early cases. Your doctor will probably suggest chemotherapy with or without radiotherapy. The scans and tests you have done at first will be used later to see how well you are responding to treatment.

Pleural effusion

A pleural effusion is fluid between the membranes covering the outside of the lungs - the pleura. The fluid takes up space and makes it impossible for the lung to expand fully when you breathe. If there is a lot of fluid, it can make you very breathless.

The fluid has to be checked for cancer cells. If it does have cancer cells, it is called a malignant pleural effusion and will affect the stage of your cancer. Occasionally, someone with lung cancer has fluid around the lung but the fluid doesn't contain cancer cells. If there are no cancer cells, it doesn't count towards your lung cancer stage.

In small cell lung cancer, pleural effusion containing cancer cells, but with no other signs of cancer spread is often classified as limited disease. But not all doctors agree on this. Some think that a pleural effusion may be better grouped as extensive disease.

In non small cell lung cancer, pleural effusion containing cancer cells means your cancer is considered to be at least stage 3B.

Your doctor will decide which stage you are by taking a number of different factors into account and pleural effusion is just one of these.

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As everyone has said before, I'm no doctor...

However, I DO know about brain mets as I've walked that road with my mother a couple times already. As Nick said, they tend to be the more immediate "problem" and there are different options depending on the size of the tumor(s) and location that can be used. We've had a lot of luck with stereotactic radio surgery (SRS) and/or Gamma Knife.

Generally, if the cancer has metastisized to the brain and the primary is lung...it's going to be staged at IV...however, there is HOPE even at that staging. Mom was told she'd never see a year...and we're 18 months in (almost)!! And she's doing well!!

Much love and many prayers...

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I am not a Dr either but I believe Missy and Nick are correct. The brain met is the most immediate issue.

There is a drug call Temodar (temozolomide) that is sometimes used for brain mets. I am not sure if it still in clinical trials or approved.

There are other "radio sensitizers" that are being used for brain mets. You can research or ask the Dr about these if you wish

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I spoke to my mom last night and asked her if I can call the Dr, she said she didn't want me to call b/c it would be too much of a bother and to just ask my stepdad the info I told her OK. (I didn't tell her this but:I didn't know if i was going to respect her wishes or not.) So then she had my stepdad call me back after we got off the phone to ask me why i wanted to talk to the doctor and i told him what i wanted to ask the doctor about, and that I wanted mom to get a 2nd opinion up closer to me either at Mass General or Dana Faber and/or Sloan Kittery in NY anyway, mom cried and was very upset and said she doesn't want a 2nd opinion b/c she believes the Drs that are treating her in Miami will heal her, and if she gets a 2nd opinion it would be like saying that the doctors she has now are wrong and they can't cure her and she is going to die. So now I made her upset and and cry which i feel horrible about. She also was adament that I not talk to her doctors, and anything i have to find out I can do so through either her or my stepdad. Mom dosen't like to hear negative things and usually when my stepdad talks to the dr she is with him, and I want mom to have a postive attitude. So i just feel so confused and like a terible daugter, I don't want to upset my mom any more by pushing her for a 2nd opinion but at the same time I feel like the doctors down in Miami have almost written her off. Other than making yet another plane reservation to go down there and visit her (which i just did) I don't know what else to do.

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Don't feel bad. You are just trying to help your mom. And I am sure she is really scared. A second opinion is always a must. I had cancer and if it wasn't for my second opinion I probably wont be here writing to you.

At Mass General I can recommend Dr. Fidias. He is a great guy. At Dana Dr. Lynch. Can you try to talk to your stepdad and see if he can talk your mom into a second opinion.Take care


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