PET scan Lingo

[2weimies]

Question what is teh differnce betwen saying saying something is a nodule? as opposed to what? A Mass? , growth, tumor??Cancer?? Just curious to know when something goes from being a "nodule" to something worse...any ideas???

[Andrea]

I find the word nodule to be a generic term and it can mean a mass, a growth, etc. I am not sure what the medical definitions are, but like my dad had lung nodules, some were cancer, some were not. I think nodule can be used interchangably with mass, etc (at least slang wise)

[DrWest]

People don't tend to use the terms very precisely, but a nodule is actually defined as a lesion that is less than 3 cm, and larger than that is a mass. But people generally use "nodule", "mass", "lesion" and "cancer" more or less interchangeably, at least if cancer has been diagnosed.

[2weimies]

I think I was grasping for hope and at straws.My appt with the surgeon is this saturday and I am getting really freaked out. Keep thinking there is some mistake maybe another scan will show its all gone... Dare I ask for another one? what questions should I ask?

I feel fine and have no symtpoms.I am a non smoker ( although my DH of 20 years smmokes) Huge family history of cancer .... BUT I simply cannot even fantom that I could have lung cancer . This is so not real to me..I am trying to figure out if teh PET and CAT scan could havebeen wrong.If there is another test I could take. Less invasive something ... why surgery?? Seems so drastic.I have read about everyone and the hope for a cure is surgery.If only I knew for certain....I am clinging to a hope that its all a mistake . The queen of De-nial here.

Thanks for responding you seem to be such a life line here.I appreciate being able to be so open and frank with a doctor..usually I am freaking out.Can you tell I am a basketcase now??

[recce101]

[2weimies] I feel fine and have no symptoms...I simply cannot even fathom that I could have lung cancer.

I know exactly what you mean. That's the problem with lung cancer, and why so many cases are not diagnosed or even suspected until they're rather advanced.

The combination of CT scan and PET scan is probably as good as it gets for noninvasive evaluation. But even that is not 100% definitive (things other than cancer can result in similar scans), so a biopsy is generally required for an actual diagnosis of cancer. You didn't say where the nodule is or if there's more than one, but during your consultation Saturday the surgeon should lay out the various possibilities for you. If your condition is potentially operable (a good thing!) he/she may be able to start with a minimally invasive procedure (via scope) to obtain a tissue sample for immediate analysis, then if cancer is confirmed (and while you're still "under"), proceed to the next step.

You should be straightforward with the surgeon and express your concerns openly -- remember that he works for you, not the other way around! And be equally open during your preop consultation with the anesthesiologist, a very important member of your surgical team.

Please let us know how your Saturday session goes, and give us some details on your situation, preferably in a "profile" to save you some repetitive typing each time you post.

Best wishes and Aloha,

Ned

[2weimies]

Thanks.I am trying to figure out how to do a profile where I can list everything.,Can you tell I'm not a computer wiz? LOL I hope this works....

I have only one nodule found on CAT scan and then it lite up with moderate uptake on PET scan ( but larger ) in the 2 weeks since the hospital scan. It will be about a month after the PET scan that I am scheduled for surgery and based on what his nurse has said to me he tries to do things less invasively ,and progresses depending on biopsy results. The nodule is in the upper right lobe I think closer to my arm pit side of my chest...so a bronchoscopy would probably not be helpful at all. I am trying to get together an intelligent list of questions cause my mind is totally lost in those situations.

Thanks again !

[DrWest]

It may be possible to undergo a CT-guided biopsy instead of a full-fledged surgery. You're right that the nodules that are further out toward the chest wall tend not to be accessible by bronchoscopy, but many of the ones toward the periphery are accessible via a CT-guided needle biopsy from outside. Some are too small or are in a location where it may not be approachable or are too dangerous because of important blood vessels nearby or just the wrong angle with bones in the way, so sometimes surgery is the best or only way to really get a diagnosis.

You can always ask for another CT, but with a CT and a PET scan, it sounds like the level of concern is high enough that they'd recommend a definitive answer, which I can certainly understand. I think most medical teams would recommend getting a tissue diagnosis based on what you've said.

And no, I don't think you're a basket-case. It's appropriate to be anxious, but just take it a step at a time, get some answers, and you'll work out a plan with the docs.

-Dr. West