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Initial biopsy negative....now MD says it's positive? Help


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Ah man....went through NSCLC stage 3B with my dad nearly 5 years ago and now here we go again with my 68 y/o mom.

So a 1cm nodule in the middle right lobe was seen on the PET and chest CT (these were done for something else....she had no symptoms). On June 1st, she went in for a VATS procedure. The plan was to take out the nodule, do a frozen section while she was still in the OR and if it was positive for cancer, to take out the lobe. WELL...the initial good news was in the OR, the biopsy was negative....so they didn't take the lobe...closed her up. Today they took out her chest tube.....and the final pathology came back.

POSITIVE for darn cancer and now the lobe is still in there. The doctor says we will do "the watch and wait" doing regular CT scans...but I'm nervous. research shows improved survival rates with the lobe coming out. The surgeon doesn't disagree with me...but this would mean another surgery!,, My mom is not thrilled about another surgery and is leaning towards watch and wait.

I'm a nervous wreck and don't want her to make the wrong choice! Any thoughts?

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Teresa,

What an awful way to find out - and how sad that you have to be welcomed back to the site. Of course, I am not by any means an expert but I can share my thoughts based on your description. (I would also suggest that you ask the same thing over at cancergrace.org where an oncologist will respond from their perspective.)

You said the nodule was only 1 cm - which to me is relatively small. Although the pathology was positive for cancer you did not indicate if the "margins" were clear. If the surgeon cut the nodule out and included in the cut sufficient lung around the tumor then I think this might be considered something like a wedge. So I would think that the wait and see would be sound advice. If they got it all after your mom has healed and is rescanned nothing will show - if they didn't then they might consider going in again and your mom will know what to expect from the Vats surgery perspective (which I had done twice - so I agree with your mom - ouch!).

You have been there as a caregiver with your dad and it sounds like you know all the right things to be aware of - and you can always ask here. I'm sure others will weigh in on your question - in the mean time - I will keep you and your mom in my thoughts and prayers.

Annette

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Hi Teresa,

Lung cancer stinks! I hate this disease. But I understand where you are coming from. How absolutely frustrating that they were already in there, and could have taken the lobe and didn't. Urg!

Lung surgery is incredibly painful, so I don't blame her for not wanting another one. At the same time, it is always best if they can remove the lobe completely. My cancer is back in a new lobe, a new cancer. If it grows (3 month wait), he recommends immediate removal of the lobe. While I dread another surgery, I'm comforted by the knowledge that it is gone, and can't come back.

I like what Annette recommended too. Cancergrace is a good place to get an opinion too.

Judy in MI

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Our partnership woth GRACE, Dr jack west answers questions for us here.

You no loner have to leave this website. Just go to the ask the expert forum here and click on the link to ask the expert.

I hope they can help answer your questions.

Keep posting here and keep us updated.

Looking forward to your updates.

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Wow-that really stinks-recovering from surgery only to find out the biopsy was positive. I understand your anxiety about waiting to see and monitoring with scans, etc. That's a tough call, I would check with Dr. West.

Also need to consider your mom's recovery and getting strength back after this surgery. Could be a while before she's ready for another procedure.

I hope everything works out ok for her!

Cindy

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Oh Teresa, I'm so sorry about this. I'm hoping your Mom's situation follows Annette's scenario.

Thanks Katie, for letting us know we can access the oncologists on Cancergrace with questions. Very convenient especially for newcomers.

Judy in KW

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Thanks for all the tips. It was a wedge resection and although the margins were clear, they were on the smaller side. Also, not all the nodes were sampled...the few that were were negative, but nothing was taken from the hilar region (a popular place for adenocarcinoma to "hang out" and "hide from scans).

We will be going to see a popular surgeon at University of Chicago (Dr Mark Ferguson) as well as one at University of WIsconsin-Madison (AND following up with her original surgeon) ALL this week....hopefully with all of their knowledge and experience, we can make a decision.

My mom is doing great. QUite honestly, she was back to herself right when she got d/c'd from the hospital (a 3 night stay). She had a brain MRI because of the adenocarcinoma diagnosis and the risk of spreading...results are pending. She feels great, a little "sore", but full of energy and life. She has come around to the fact that additional surgery may be needed and does want the cancer out....but still is hopeful she won't need it.

Thanks again for your support and input!!!

I am also going to post on the cancergrace.org.

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  • 3 months later...

What could cause a cervical biopsy to look normal when it's not? I had a cervical biopsy done in February. I got it done because my pap smear indicated precancerous cells. When I got the biopsy done, it came back looking fine, but the doctors weren't convinced since the pap was so irregular. I'm going to get another one done next week.

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What could cause a cervical biopsy to look normal when it's not? I had a cervical biopsy done in February. I got it done because my pap smear indicated precancerous cells. When I got the biopsy done, it came back looking fine, but the doctors weren't convinced since the pap was so irregular. I'm going to get another one done next week.

Hi wahleena,

I'm afraid you've wandered onto a lung cancer support community, so we might not be very helpful in answering your medical question. I think you are doing a smart thing to get a second opinion, whether or not an additional biopsy is needed.

Sometimes a biopsy just doesn't happen to get cancer cells - they might not be everywhere, just in a limited area. This happens and a false negative report ensues. I don't know much about cervical cancer, but I imagine this could be the case here as well. However, if the pap smear showed precancerous cells - isn't it also possible there is no actual cancer developed? I've had precancerous skin biopsies and nothing more was required at those sites. I think asking the doctor for clarification is appropriate. Best of luck to you. I hope it is nothing!

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HI wahleena

TS is right- this is a lung cancer support forum.

However, I happen to be a 16 year cervical cancer survivor so I can help in anyway I can. my email address is kbrown@Lungevity.org

as far as the biopsy- definitely do it again. It could be they need a bigger sample but I wouldn't be satified unless a conization or LEEP procedure ensured all displaysia was removed and that was tested.

Good luck.

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  • 10 months later...

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