saje Posted January 4, 2017 Posted January 4, 2017 In October I presented to the local ER with chest pain. A chest x-ray revealed a 1.1 mm spot on my right lung. I was told to schedule a CT scan within the week. I had been seeing a hematologist/oncologist once a year for a non-cancer related issue. The multitude of awards hanging on his walls state that he is one if the top oncologists in the country. I called his office & after obtaining & reviewing the x-ray he scheduled me for a CT scan & then a PET scan. He informed me that these scans confirmed an 11 mm nodule in my right lung. He stated that although the PET scan did not "light up," the nodule was spiculated & therefore caused him concern. He told me that I had two options to choose from. I could wait three months & have another scan, or I could have a needle biopsy. He said he would be comfortable with either choice. I thought it over & opted for the biopsy which was scheduled this morning at the hospital where he is on staff. The intake nurse explained that the procedure would take about an hour & a half & then I'd be in recovery for two hours unless my lung deflated at which point they'd assign me a room & keep me overnight. A little after 8:00 the radiation tech came to get me. He took me to a room with a CT machine & explained they'd do a CT to precisely locate the tumor & to see if there had been any changes since my prior scans. The biopsy surgeon & his assistant were there to assess the scan prior to the biopsy. The tech asked if I was familiar with the risks of the procedure. I told him that the oncologist had explained that there was a 1 in 10 chance of my lung deflating. He said "it's not quite that simple" & went on to explain that there's always a risk on infection although that is very rare, but the lung deflating really depended on where the nodule was located. Here's how I understand it. Your lungs are apparently made up of lobes. The left lung has two, the right lung has three These lobes are separated by fissures. If the nodule is located in a lobe, the chance of the lung deflating is doubtful or nonexistent, but if the nodule is on/in/under/close to a fissure, the lung deflating is pretty much a sure thing ... & if the lung deflates, they won't be able to do a biopsy. The tech left me lying on the bed of the CT machine in case he needed to repeat the scan. After about ten minutes, I was informed that my nodule is either on, in, under, or close to a fissure (I forget which), there was no way to safely access it, & the biopsy was being canceled. I was told a report was being sent to my oncologist & he would probably have me follow up with another CT in 3-6 months. The tech said I should get a call from the oncologist's office within a week. What is really strange is that he said the nodule has actually gotten smaller ... it was originally 8.7 mm but now it's 7.5 mm. I said "but I was told in November that it measured 11 mm" & the response was "the person measuring it at that time probably measured it differently." ??? Isn't there be a standard in the medical field that everyone uses for measuring nodules??? And where did this "original measurement" of 8.7 mm come from? The oncologist saw the report & x-ray taken in October. He ordered a CT & then a PET scan in November & confirmed an 11 mm nodule. What in the world??? The biopsy surgeon did say the nodule was "still spiculated" & added that it showed up "hot" on the PET scan. I am totally bewildered!!! I had expected some answers & now I have no idea what's going on : ( I am 63 years old & have never smoked nor have I hung around with people who smoked. I did grow up with a mother who was a heavy smoker for 70+ years. She died from small cell lung cancer. Any input regarding this puzzling situation would be greatly appreciated. Sent from Yahoo Mail on Android Michele 1 Quote
buzzy Posted January 5, 2017 Posted January 5, 2017 Saje, I certainly hope you find an answer soon and i will follow this thread with a huge interest since I'm just beginning my journey through the lung nodule jungle. I have a chest xray scheduled in two weeks to check on a 7mm nodule in one lung and a more concerning 13mm nodule in the other. I'm praying they are smaller like yours. The 7mm actually measured 6mm in July. When I questioned 1mm growth in it the GP and radiologist seemed to think 1mm wasn't a huge issue. Good luck to you. I hope you get positive answers. Quote
saje Posted January 5, 2017 Author Posted January 5, 2017 Thank you buzzy. I also hope I get some input on this. I think it was quite thoughtless of your GP & radiologist to say that your 1 mm increase in size wasn't a huge issue. Perhaps they were just trying to alleviate your fears for now, but to respond to you so glibly was uncalled for. Why are they following up by just doing another chest x-ray rather than a CT scan? I think you might want to consider making an appointmwnt to see an oncologist who would order a CT & then a PET scan if need be. I will also pray that your nodules will be smaller. I am baffled about my size discrepancy. How can one person say I have a 1.1 mm nodule, then the next person tell me it's 11 mm, & then another person look at that report & say it was originally 8.7 mm. Makes me wonder whose report that third party was looking at! And then to tell me that the edges are spiculated, it showed up hot on the PET scan, & then to glibly add that it's not reachable & nothing can be done so go back home ... I am quite outraged. I have a followup appointment with the oncologist next week which I hope they aren't thinking of canceling, & I will insist on an explanation ... but I am hoping that someone here can perhaps be of help before then. Mally 1 Quote
MaryTD777 Posted January 6, 2017 Posted January 6, 2017 Hi there, I am wondering if there was a misunderstanding because I can't imagine anyone looking at a CT scan and claiming a measurement of 1.1mm. 1.1cm is the same as 11mm so THAT would make perfect sense. Just as Buzzy heard that a 1mm difference is virtually nothing, looking deep inside someone using "slices" of a picture that can be taken every 2/3 or 3/5 of some measurement apart, it's virtually impossible to be that precise. Keep in mind I am just a patient too. Whatever those numbers are, you also have to take into consideration where exactly on your person the machine starts shooting. That could easily allow for a small difference of a mm or 2. 10 mm = 1 cm. 2.54 something cm = 1 inch. That means that there are about 25 and a half mms in 1 inch. Now do you see how easy it is for John to measure 6mm on his machine and Jake to get 7mm on his machine a month or 3 later? Add to that the fact that the test measurements can begin a half a mm or so apart from each other on your person EVEN if done by the same man on the same machine. Now that the size of a mm & a cm are clear, I am very confused by the rest of your numbers changing Saje. I am more confused by the in or between the lobes thing. I have spoken to dozens of people and never heard that one before. I find it confusing that the doctor who sent you for the biopsy wouldn't have told you that it looks like your lesion is between the lobes & that it might be inaccessible as such. Mine was at the tippy top of the lung so I guess it couldn't get further from a lobe delineation point than that! If he says that being near the fissures shouldn't have stopped your biopsy, then you need to have him find you someone who thinks like he does! Perhaps no matter what all of these numbers may or may not be, you need to have a serious talk with the first doctor and have him recommend you to a pulmonary oncologist or perhaps a cancer center (always my preference) so you can make sure WTH is what!!I really wish I could have been of some help!! I had a terribly long day and am afraid that even if I could have helped my babbling would have left you confused anyway. Please let us know what comes of all of this!! I will cross my fingers that things are shrinking because that's what benign lesions do!!Take care, Mary Sent from my SM-N920V using Tapatalk buzzy and Mally 2 Quote
MaryTD777 Posted January 6, 2017 Posted January 6, 2017 Oh, and a very important detail for both of you. As much as 60 % of new lung cancer diagnoses are in non smokers, both ex & never smokers. As a matter of fact, the fastest growing group of lung cancer patients is young women, mid 20s - 30s who are otherwise perfectly healthy and even outdoorsy. Runners, climbers mothers who focus only on their rosy checked cherub like children in the yard. The only thing one needs to get lung cancer is lungs. Sent from my SM-N920V using Tapatalk LaurenH 1 Quote
MaryTD777 Posted January 6, 2017 Posted January 6, 2017 Please imagine an ampersand between climbers & mothers. Toldja I was tired!Sent from my SM-N920V using Tapatalk Mally 1 Quote
MaryTD777 Posted January 6, 2017 Posted January 6, 2017 Oh, and a very important detail for both of you. As much as 60 % of new lung cancer diagnoses are in non smokers, both ex & never smokers. As a matter of fact, the fastest growing group of lung cancer patients is young women, mid 20s - 30s who are otherwise perfectly healthy and even outdoorsy. Runners, climbers & mothers who focus only on their rosy cheeked cherub like children in the yard. The only thing one needs to get lung cancer is lungs. Sent from my SM-N920V using TapatalkSent from my SM-N920V using Tapatalk Mally 1 Quote
Tom Galli Posted January 15, 2017 Posted January 15, 2017 Saje, Welcome here. Agree completely with Mary's explanation of size variance and small differences in tumor size from radiologist to radiologist. Also note and agree with her about the need to get some straight answers from your medical team concerning performing a needle biopsy. While there are risks, they are small. Strange that your doc declined to perform one. A collapsed lung is easily dealt with in a medical setting. Let us know how further discussions go with your medical team. Stay the course. Tom MaryTD777 and Mally 2 Quote
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