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Just told I had a 1 cm spot on my lung


Pearl

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I'll "weigh in". Pearl, Your doctor may have a medical situation in her family, but that should not put your medical situation on hold. Another doctor or nurse practitioner should order the needle biopsy at the hospital they are associated with. It's an outpatient procedure done by an interventional radiologist. Or they should schedule you for a PET scan at the facility they work with for those, but only a biopsy can confirm cancer. If they refer you to a thoracic surgeon, they can order the biopsy. If it is cancer and operable, that's who would do it. This is when you need to advocate for yourself and tell them what you need. If it is positive, you wouldn't be going back to a pulmonologist anyway. You would work with the surgeon or radiational or medical oncologist depending what treatment is decided upon. I know it's awful to be stuck in the unknown and scared and confused...and it's a holiday weekend. My center is open tomorrow even though they're closed Tuesday, but calling tomorrow is worth a try. Definitely Wednesday. Then let us know where things stand. You need to know that something else is scheduled sooner than another office visit at the no of the month. We'll be thinking of you.

Cindy

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They did tell me I could see the nurse practitioner but I didn't think that was a good idea I thought seeing a doctor was best so they did offer for me to see the nurse practitioner


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I think what Cindy was suggesting is that the NP could order a referral for a biopsy or to a doctor who could order one.  No, the NP will not be able to diagnose you or perform the biopsy, but should be able to get you to someone who can.

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If I may, I would like to weigh on this topic with my own question. Please bear with me as there is some necessary backstory, although I will try to keep it short. I'm a five-year Stage IV colon cancer survivor so I have regular PET and CT scans and I've been NED for four years now. On 9/7/2016 I had a PET scan. There were no abnormalities noted in the report, but because of some equivocal results in my abdomen, we decided to redo the scan "in a few months." We did another scan on Feb. 23, 2017 and resolved the equivocal results in my abdomen and once more there was nothing reported in my lung. Because I complained of some chronic pain in my abdomen, the onc. decided to do another scan which was done last Thursday June 29. Again, there was no report of problems in my abdomen.

And, now we come to why I'm here. The radiologist referring to my lungs reported, "Stable irregular 1.0 cm nodule in the posterior right upper lobe is minimally metabolic with SUV max 1.6 with no additional nodules, infiltrates, effusions or metabolic lung findings." I haven't spoken with my oncologist yet, because the results are posted online in a "medical chart software program" that patients can access.

I'm wondering what your reaction to this finding of a "Stable irregular 1.0 cm nodule in the posterior right upper lobe is minimally metabolic with SUV max 1.6 with no additional nodules, infiltrates, effusions or metabolic lung findings" might be. I'm also wondering whether you all know if a radiologist can determine if a new finding, remember no nodules have ever been previously reported in my lung, is stable with just one data point. If, in fact, there was no nodule in my previous PET of Feb. 23 that means the nodule grew from 0 to 1 cm in four months which seems fast to me. Also, it's metabolically active but only minimally. I've read they really can't biopsy something so small safely and we might have to wait a while to see if it grows. Again, I would appreciate your thoughts in general and specifically whether we need to move fast to biopsy this nodule remembering it was found on PET with minimal FDG Avidity of SUV max of 1.6.

Also, I would appreciate any information on lung cancer survivorship that is more up-to-date than the published stats.

Thanks,

Rick

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Hi, Rick,

I'm brand new, myself, so I don't have any info or advice to offer.  I'm new to this forum, too, but in my experience on other forums it's usually a good idea to start a new thread of your own so your post gets the attention it deserves.  I'm sure somebody with knowledge/experience will be along soon.

Sending you hugs and support, though!

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Pearl,

Sorry I haven't been able to get back to you on your wait time.  Two practical ways to shorten the wait.  Your pulmonary medicine PA ought to be able to order a PET scan.  I'd try that avenue first.  Second, you might try securing an appointment with a medical oncologist.  Get your records including scans from your pulmonary physicians practice and take them to an oncology consultation.  Cancer is a medical oncologist domaine specialty and they ought to be able to advise if the tumor is able to be needle biopsied and if so arrange for a thoracic surgeon or interventional radiologist to perform the procedure.

A biopsy will result in the definitive answer - cancer or no cancer and have the additional benefit of disclosing type for treatment plan purposes.

Stay the course.

Tom

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Pearl,

To clarify, could the cancer center in your area schedule a PET scan?  Sure.  In fact, because they likely have significant scan facilities, you may be able to reduce your wait time for scan.  I'd still maintain contact with your pulmonologist's PA and see if she can arrange a PET scan at your area cancer center.

When your doctors return from vacation, they may have scan results to discuss with you.

Stay the course.

Tom

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Oh, trust me, I TOTALLY get that.  All *I* know is that my nodule is "probably" cancer--I won't know anything for sure until surgery on Monday.  So I'm sort of trying to get the most useful info I can without getting ahead of myself.  I know right now it looks encouraging--it doesn't APPEAR from the PET scan that there has been any spread, but I won't know what I'm even dealing with until Monday.  So I'm trying not to get too far into the weeds on scarier scenarios that I may never have to contend with.  That's a sure-fire recipe for freaking myself out for no reason. 

Hang in there--remember, at this point anything that's there is SMALL.

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Ok update doctors office just called they have moved my appointment up to next Friday and have two offices on high alert to get me sooner I guess they have looked at scans and feel I need to been seen sooner


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Well, that's good news--persistence pays off.  I can tell you once I saw my pulmonologist, it took only a few days to see the surgeon for the consult and get the PET scan (and same day results).  This way you get the ball rolling sooner rather than later.  

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I know what you mean--I've been pumping myself up and staying busy and positive and all that the past couple of weeks.  My surgery is Monday, and yesterday I started feeling what I've come to identify as anxiety.  Shallow, constricted breathing, mainly.  It's not true shortness of breath, because when I am really concentrating on something else, I breathe normally.  I've been trying to do some of the yoga breathing I've learned, but I'm out of practice.  Uncertainty with something like this is hard to deal with.  I always feel like if I KNOW what's going on, I can deal with it.  I gotta hand it to folks like Tom and others here who have been dealing with various levels of uncertainty for years and years.  Sounds like you never REALLY get used to it, though people do find ways to cope with it.  

One thing that helped me this past week or so was taking care of a bunch of stuff I'd been putting off, just knowing that I'd feel better coming home from the hospital, whether with good news or less-good news, if I got it done.  And it really has kept me distracted, and given me fewer things to worry about.  Clearing the decks, so to speak.  If you've got some stuff you've been meaning to get done, now's not a bad time to tackle them.

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Ok so today is the day I go see the lung doctor and I know I need to buy the fear keeps me not wanting to go I will go because it's what's best but I didn't sleep well last night and my nerves are shot this morning and it's just to set up testing I'm sure does the stress level ever settle down inside you with all this or can I just assume to be a basket case through it all?


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Ok need some personal advice
I am taking care of 8 step grandchildren and have 3 biological grandchildren that my children are raising so here is where I'm confused
The day I was told in the er that I had the spot and it was probably cancer I cried when the doctor left my husband of 7 years says I don't know why your crying you know what it is now deal with it he made my first appointment but didn't show up for it with me the other day when they called me to move my appointment up and talk a little with me I called him crying and he said I don't know why you are worried or crying I said I have kids to think about he said if something happens to me him and the kids would be fine it was like a slap in the face to me ive tried talking to him about the lung cancer and he just shuts me down and don't want to talk about it am I wrong for feeling like there is no care or support from him?


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My Ct scans from 2015 2016 2017 where looking for blood clots I had a heart attack when I was 25 and 27 and a blood clot through my lungs in my 30's then a blood clot through my heart in my late 30's which I'm blessed to be here so when I have chest tightness or shortness of breathe they Ct scan my lungs for blood clots and check my heart that is how they found the spot this time


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