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pancoast tumor


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Saw the local oncologist today, he said is inoperable because of bone involvement. I asked him if a pet scan is the next step, he said no for whatever reason I don't remember. He ordered a bone scan and a CT Scan for head, abdomen, and pelvis. My question for you all is, is this good enough to determine if the cancer has spread? Is a PET scan better, I don't know the difference. The original CT scan did show spinal, rib, and mediastinal invasion, and also supraclavicular adenopathy. My other question is, what is the difference between invasion and metastatis. Is it the same thing? If this doesn't make sense you must excuse my newbie ignorance!

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My plan followed a study being done at the time for the treatment of Pancoast tumors. I had chemo and daily radiation to shrink the tumor that made it operable, and then as planned had chemo after also. Most all here with Pancoast have treatment to shrink prior to surgery.

In general is your Mom in good health, good breathing capacity etc.

Donna G

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Hi Lisa,

based on your description the CT did show metastasis/spread to the spine and rib. These areas can be radiated if they are causing pain or discomfort. There is also a bone related medicine called Zometa which will definitely be part of the regimen and stregnthens the bones and can limit more bone spread. This is difficult news and I'm sorry, but remember there are a lot of people in similar straits who have pushed back hard on cancer and have been ticking a long for quite a while.

I have a guess that the invasion vs. spread distinction is that spread is where a new tumor pops up in a new location while invasion is where an existing tumor is basicallly pushing into a another part of that organ or area.

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My other question is, what is the difference between invasion and metastatis.


Sorry to hear about the CT scan results. I think the difference is simply the way the radiologist writes up the report. There appears to be no "standardized" terminology and I've seen all kinds of different verbiage in these reports. The cancer has gone into the middle section between the lungs (mediastinum). I don't know whether that is from the tumor in the lung invading through the wall of the lung or a completely separate growth. I'd ask the Doctor to clarify.

Some insurance companies balk about paying for a PET scan, although for initial work-ups, I thought they covered those. On the good side of the ledger, the moderately differentiated cell diagnosis is a positive which most people miss in the bigger picture. It means the cancer cells haven't become mutated beyond recognition and may be less aggressive. Let's hope so!

Never feel bad about asking any question here. That's what this board is all about. Good luck with the next steps in the process and I hope chemo or radiation can begin soon.


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I continue to be pessamistic (wrong spelling) about this "inoperable" situation with my Mom's pancoast tumor. I am seeking a second opinion from a surgeon, if a surgeon tells me it is inoperable, then I will believe it and go from there.

Now, as you can see in my signature, the oncologist only ordered a CT scan and bone scan, not a PET scan. My question is, if the CT scan said that the adrenal gland is suspicious for metastasis from the lung cancer, do doctors just assume that this is true? Or does a biopsy of the adrenal gland need to be done.

I am not going to the next oncologist appointment with my Mom, I wanted her to ask him this in case he says "it has spread to the adrenal gland".

Kasey, if you read this, we are still waiting to hear, all test results so far have been sent or are being sent today.

My Mom's pain is getting worse, she is on I believe 2 fentynal patches and I think vicodin every 4 hours. The pain begins again before the 4 hours is up. I told her to tell the doctor and try to get something else. What would be the next step for pain, maybe oxycontin or something?

Radiation and chemo is to begin next week.

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I don't know about adrenal glands, but Henks CT-scan said that his liver was 'suspicious for mets'. The PET scan didn't confirm this (he had both scans before dx) and the docs ordered some extra tests for the liver. They said it was important to know if the liver was involved, because the treatment would be different.

It's good to have a second opinion about surgery.

But even if it's inoperable, there still is hope. Henks dx was more than two years ago and he is doing well without surgery!

Henk was on oxycontin before the radiation. But after the radiation, the pain was gone.


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  • 2 weeks later...

I guess I have no questions like I usually do, all of my efforts to find the best way for my Mom to deal with this cancer are now turning out to be reactive only. My Mom , after starting radiation treatments, and before starting chemo, began feeling numb in her legs. She told one of her doctors and was sent home for the weekend and told to go to the hospital if it got worse. The next day she couldn't walk without falling down. Trip to ER via ambulance. MRI indicates spinal invasion much worse. Steroids given along with pain meds after being admitted into hospital. Three more radiations given, still cant move legs and basically numb from chest area down. Surgeon operates on spine to try to save my Mom from permanenet paralysis on 10/25/07. Hoping she can walk again, no improvement as of today.

She is terrified, but at least pain is now controlled better while in hospital. I am more concerned with that, everything has happened so fast and she is faced with so many things at once. Thanks for listening. Lisa

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