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josie1961

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I had a Ct guided lung biopsy last week and have been diagnosed with adenocarcinoma in situ.  The surgeon plans to resect the nodule laparoscopically.  Have any of you had this procedure?  if so, what was the recovery time?  What should I expect?  Prognosis?  At this time, there is no plan for chemo or radiation post procedure. Does that sound like routine protocol? 

I have been told the likelihood that this would spread or metastasize is minimal but I read that often times adenocarcinoma does spread.  Is metastasis dependent upon the Stage of the cancer?  

Any information on this topic/diagnosis would be helpful.  Thank you

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Hello Josie.  Welcome.  You have a lot of good questions.  The stage you are diagnosed is only a description of its location . I was Stage 3 B Lung Cancer which meant I had no distant spread but my tumor was pressing on the lining on the lung and on nerves going down my right arm.  I was diagnosed in Dec. 1997.  I had chemo and radiation because on the late stage. It shrunk the tumor and I then was able to have surgery, the old fashion was on breaking ribs to get into the chest to get the tumor. After I had more chemo. 

It is wonderful the advances they have made with laparoscopic surgery, much less traumatic.  If your tumor is small, has not spread they will follow up with more CT's to be sure it has not returned.  If you really are worried I would get the surgery and follow up with a second opinion regarding the follow up chemo.

Keep us posted on how it goes. 

Donna G

 

 

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Thank you Donna!  Congrats on your recovery of breast cancer!  I am sure that was a terrifying time for you not to mention painful.   I certainly hope to be cancer free 19 years post cancer!  

I didn't realize in situ referenced location.  thank you! I have a general doctor at Cooper Clinic in Dallas that I go to for a yearly physical.  They have been following several  Ground Glass Density nodules in both lungs since 2010.  This one particular one has grown slowly but consistently for the past 6 years and is now at a size that they thought it was safe to biopsy.  It is close to the exterior vs. center, of the right upper lobe but difficult to reach because of the ribs hiding the nodule during biopsy.  My doctor has referred me to a cardio-thoracic surgeon to remove the nodule.  I have not seen an oncologist and no one has mentioned me seeing an oncologist.  Sounds like I may need to schedule an appointment with one. 

Can they know if the cancer has spread with a biopsy? before they get inside and remove it? or without a PET scan? 

Sorry, I know I have tons of questions but your knowledge is appreciated. 

Thanks again, 

 

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Your prognosis sounds pretty good to me. I was diagnosed with stage 4 adenocarcinoma of the lung which only means the cancer had spread from its original location. I tested positive for a gene mutation and have been on an oral targeted therapy drug for 17 months now with no growth or spread of the disease. If you have questions the best person to ask would be your doctor/surgeon. Good luck to you.

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Josie,

Welcome here.  You have a lot of questions.  Let's get to them.

"In situ" is Latin for on site or in the same place.  In terms of cancer, it means the tumor has not spread - a good thing.  

Ground Glass Density (or Ground Glass Opacity) Nodules, from what I've read, are a diagnostic challenge.  Thankfully, your doctors have accumulated a history because of your annual physical examination. Again, from what I've read, when one changes size it is common for doctors to order a biopsy.  If located in a difficult area, removal of the entire opacity is something I've also read about and following removal, a biopsy is performed.  From what you've reported, you had a CT guided biopsy already (assume it was the Ground Glass Opacity) and adenocarcinoma is diagnosed.  If this is so, I'd be consulting with an oncologist.  

A single biopsy does not reveal if cancer has spread.  Generally scans are used for this function - a CT scan that you've had or a PET scan are used to determine if your cancer has spread to other areas.

I hope these answers are helpful.  More questions?  Ask away.

Stay the course.

Tom

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Thank you Tom.  I really appreciate the answers you have provided and I will try to get an appointment with an oncologist scheduled.  We discovered several nodules in both lungs in 2010 and have been having follow up CT scans since then.  This one nodule has grown slowing and consistently, it is non-solid with a solid center.  I had the biopsy last week and plan to have surgery in September.  I have no idea what to expect for recovery. length of time? pain? will I need assistance during recovery?  Certainly, I hope it has not spread and they get "clear" margins upon resection.  I want to be informed but I the research can be scary.  It seems many people with adenocarcinoma have had it metastasize  or come back in the lung or elsewhere.  I guess I will know more after surgery. 

Am I correct in thinking you have had lung cancer?  I hope you are cancer free.  It is so kind of you to offer support to a newbie. I really take comfort from those who are unfortunately, experienced.  

Hope you have a great day! 

 

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Josie,

I am a 12 year, well almost 13 year, survivor with late stage diagnosed non-small cell, squamous cell, lung cancer.  I had conventional radiation and chemotherapy (taxol and carboplatin) first line treatment after a 2004 diagnosis to shrink my in situ tumor in the main stem bronchus of my right lung.  Then my right lung was removed using a thoracotomy procedure.  Unfortunately, I had post surgical complications that required 3 more operations to correct.

Then the cancer spread to my left (now only) lung and I had a total of two years chemotherapy treatment, again with taxol and carboplatin, although my last series of infusions was hardened by the oral chemotherapy drug Tarceva.  Still my cancer returned.  What finally caused my no evidence of disease or NED was stereotactic (CyberKnife) radiation to my left lung.

So to your questions: What to expect after surgery?  It depends on the type of surgery (thoracotomy, lobectomy or video assisted thoracic surgery (VATS).  A thoracotomy is most invasive and pain and recovery are longest with this type.  Still my pain from my first thoracotomy was not that bad because I had a morphine injector hooked to my IV line and was encouraged to activate it whenever I felt pain.  After my first surgery, I was discharged to home after about 5 days.

I needed assistance after recovery.  My mobility was limited.  I couldn't bend over and pick things up and my dressings needed to be changed every day.  But, if you have a minimally invasive lobectomy or VATS, you might not feel much discomfort but I bet you'll need some in home assistance.  I'd plan on it.

Researching lung cancer is scary.  But knowledge is power and if you learn about your disease you'll be a better self-advocate able to ask your treatment team "terribly preceptive questions" about alternate treatment means and side-effects.  Here is the best place to start your education: https://www.lungevity.org/about-lung-cancer/lung-cancer-101

More questions?  Ask away.

Stay the course.

Tom

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Wow, Tom, sounds like you have really been through it.  I am sorry for your complications but so happy you are disease free!  My mom had squamous cell carcinoma of the lung in 2006.  Her tumor was in operable. She received Chemo and radiation that bought her time but she died 8 months post diagnosis.  It is a scary time.  I try not to think about it all the time but it is hard not too.  I want to be informed and that requires research!  I did speak to an oncologist today and I think in my situation as we understand it today, chemo and radiation is not the standard of care for my stage of cancer.  I hope that hold true after surgery, I think, I certainly want to reduce the chance of reoccurrence if possible.

I really appreciate you sharing your experience and information.  Thank you for sharing the link, I will continue my research there!  

Thank you again.  I will hope for your continued NED state!    

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  • 1 month later...

Hi Josie. I am also a newcomer.  I had the upper right lung removed in August using the VATS method.  I only spent 2 nights in hospital and went home without oxygen. I had 3 incisions where bandages were changed daily, and I had pain in particular the first week or so.  I could not bend over for at least 2-3 weeks.  My husband fixed food, I wasn't eating much initially, and then I'd go back to bed. My daughter helped me in the shower because my balance was unsteady for the first week.

Recovery takes time.  I started feeling more like myself around week 4 post surgery. 

Hope this helps.

MaryR11

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Thank you MaryR.  Congrats on your recovery!  I hope your margins were clear and your are now a Lung Cancer Survivor!  Please let me know. I would love to heart about your experience, diagnosis to surgery! 

I actually had my surgery last Tuesday, so I am one week post-op.  My experience was very much the same as yours.  However, I did not have an entire lobe removed but a wedge resection of the lower portion of the upper right lobe.   I have three incisions and went home after two nights.  I have had pain but nothing Tylenol and Ibuprofen can't handle at this point.  The pain was considerably less once the chest tube was removed on Thursday after Tuesday's surgery.  I do understand about bending over and now squat now instead!  Today is the first day that I have really felt almost back to normal but still have discomfort with lack of energy.  The mornings are the most difficult and most uncomfortable to get deep breaths.  However, after I do my breathing exercises, I feel better.  I compare it to stretching a muscle, it hurts when you are stretching but feels so much better after.  I am considered a lung cancer survivor!!  and I am so relieved and thrilled and feel so blessed!  

Thank you so much for sharing your experience with me!  I hope Lung cancer is in your past!  

Have a great evening and continue to improve! 

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Josie thank you so much for your update.  Great News.  The new way of doing surgery is  so much easier to cope with and recover from.

Glad they were able to use this for you!  All margins clear, more great news!  Want you to keep that good news coming.

 

Donna G

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  • 2 weeks later...
I had a Ct guided lung biopsy last week and have been diagnosed with adenocarcinoma in situ.  The surgeon plans to resect the nodule laparoscopically.  Have any of you had this procedure?  if so, what was the recovery time?  What should I expect?  Prognosis?  At this time, there is no plan for chemo or radiation post procedure. Does that sound like routine protocol? 

I have been told the likelihood that this would spread or metastasize is minimal but I read that often times adenocarcinoma does spread.  Is metastasis dependent upon the Stage of the cancer?  

Any information on this topic/diagnosis would be helpful.  Thank you


Hi Josie ,
New to the group , and am only 4 weeks post surgery . My experience was a Bronchoscopy to tattoo the tumor so the surgeon could . .visualize it . Then he did a VATS . Video assisted thoracoscopy ,and mediostinal lymph node dissection and biopsy . I didn't have a biopsy prior to the surgery ,my tumor was small and they were concerned about getting it with a needle. While I was asleep they sent it to pathology . The surgeon had told me if it was cancer he would remove the right upper lobe . It was adeno carcinoma and they did a lobectomy . Mine was Stage 1a , margins and lymph nodes were clear . The oncologist said I didn't need chemo or radiation , but I 'm to have a CT scan every 6 months for 2 years .
I asked for physical therapy they came to the house for 3 weeks for endurance . My insurance won't pay for the facility that has the only pulmonary rehab . Outpatient . So I will be going to a conditioning program . My big problem is shortness of breath and fatigue . I am a pretty bad asthmatic as well . But they say the best thing is walking and use the incentive spirometer . I hope My experience helped some


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