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Brand new diagnosis.


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I couldn't sleep and found this site!  I found out Friday (today is Sunday) that I have lung cancer.  I feel and have felt the 6-7 cm. mass in my left lung for awhile now.  I am told I have swollen lymph nodes found in the CT Scan last week Thursday.  I have not yet had the biopsy.  I have decided this weekend to change medical facilities to that of a teaching hospital here in Milwaukee.  I had a difficult time deciding to make this change before the biopsy as we are coming up on Thanksgiving week.  Should I change the appt. or keep it, and then change medical facilities after the biopsy?  Will a week matter?  How soon will the teaching hospital be able to get me in?  The more I research, the more frightened I become.  I try to get my thoughts off this new journey I'm about to begin, however, well, I am sure you all know!  I'm 59! I am married and have two lovely daughters and 8 beautiful grandchildren.  Everything has changed so quickly. 


I wanted to change doctor's even before I had my chest xray. The chest xray showed the mass.  It took almost two weeks to get the CT scan scheduled, which I finally had to call central scheduling and insist I get in.  So, I've lost some trust in the group I am working with. I was called on the same day as my diagnosis was given to be told how much the biopsy would cost and how much I need to pay.  Did I want to pay for this now, over the phone, or the day the biopsy was scheduled, which is this coming Wednesday, or, be billed.  I may be "old school", but, I couldn't believe they were calling me with this?  Is this the norm?


I feel time is running out, yet, I feel I'll get the best, proactive care by changing hospitals now.  But again, I don't want to loose time as the biopsy test is now scheduled for Wednesday, the day before Thanksgiving. 







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Of course your are unnerved.  I was almost undone by my surprise diagnosis!  But, even though it is cancer, you've got time to weigh options and consider alternatives.


That said, a biopsy is a pretty standard procedure.  It can be performed almost anywhere and there are a number of ways the procedure is performed.  Some are minimally invasive.  Once your biopsy is complete, the pathologist will examine the sample and determine the type of lung cancer.  This is most important because different types require unique treatment approaches.  However, another requirement is to stage your cancer.  This is done with additional scanning and two normally conducted tests you didn't mention are a bone scan and brain scan.  These are performed to determine the extent of disease in your body.  This is also important because it dictates treatment alternatives.  So there will likely be more testing ordered besides the biopsy before treatment can be designed and undertaken.


Take a moment and read about types of lung cancer here - http://www.lungevity.org/about-lung-cancer/lung-cancer-101/types-of-lung-cancer


Information about lung cancer staging is here - http://www.lungevity.org/about-lung-cancer/lung-cancer-101/lung-cancer-staging


If you have insurance, the payment discussion you mentioned seems most unusual.  If you don't have insurance, then pay at the time of service may not be unusual.  Is this the first time you've used the medical establishment that is scheduled to perform your Wednesday biopsy?  If so, this may be their standard billing practice for new patients.  It has been so long since I was a new patient and so many changes in payment have occurred since i was diagnosed so I can't say with any certainty what is the norm.


If it were me, I'd keep the biopsy appointment, then take the pathology report (OBTW - ensure you get a copy of the report) to your new treatment hospital.  Suggest you see a medical oncologist at your new hospital.  Normally, in lung cancer, the medical oncologist interprets the pathology report and designs treatment alternatives.  It is so very important to have confidence in the medical practitioners that treat you.  If you feel they don't care about you, then change the team.  You may be a patient, but a patient is a person, not a thing.  If your not treated with dignity and respect, find another place.


Have you asked your general practitioner for a recommended cancer treatment team?  


Stay the course.



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