xrays

[bes]

Does anyone know why a lung mass would not show on x-rays.  My husband had numerous x-rays taken in the last several years and nothing showed up his pulmonary Dr. decided to get a CT scan due to a 9mm nodule they saw and then that's when they discovered not only the mass(it's abutting the pleura and down to the 5th rib) but a 2CM speculated nodule and pleura nodules in the upper and lower right lung.  I looked online but could not find anything,  I know it doesn't change the diagnosis but I'm upset to think that we thought we were being proactive in our health care and I guess we weren't.  My husband had been complaining of right rib pain for about 2yrs.

[Shoosy1]

Hi Bes-

I'm sorry for your husband's missed diagnosis. My husband too had been going to hospital since November of last year and we have lost count of the number of CT scans and xrays. NO ONE found his 7 mm mass that is now in his chest wall and rib until mid August. My husband and I are both new here too, out of sad necessity, but everyone here has been ver supportive and kind. We found out from our new oncologist last week that he is not a candidate for surgery as there would be too much tissue loss, and it would kill him. Radiation isn't an option at this point either, why I don't know. The doctor told us this is incurable, but treatable. So we are only left with chemo. He starts his first cycle on 10/9. We meet again with the oncologist this coming Friday to go over stuff, and hopefully to find out the genetic marker tests. Perhaps he will be a candidate for Keydtuda or Optiva or Immunotherapy. We just have to keep faith in our superb team of medical professionals, in our ability to stay strong fight and in God's grace.  

In the meantime I have purchased 2 books regarding cancer and supportive adjunctive therapies and practices such as radically changing his diet, clearing out our  house of all synthetic and chemical cleaners, soaps etc.

Most days I find it hard to breathe (my own anxiety) on the way home from work, but at least I will be focusing on the positive now and forcibly keeping negative thoughts away from my panicked brain. I know my husband needs me to stay level-headed, which I normally am. He needs me to be just as strong as he is, and we will get through this, no matter what. 

We both have been totally blind-sided by this diagnosis, but it is what it is, and we will FIGHT this beast. Just keep breathing......and notice that your husband doesn't have an expiration date stamped on his forhead!  I have made a joke of this, and will peek at hubby's bottom.......NOPE- not there today! Or look at the soles of his fee!-----nope, not there today either!  It focuses our attention to LIVE today and to keep breathing and moving and loving each other. 

Peace and  love to you all.....HOLD on Bes!

Shoo2

[BridgetO]

Hi bes,

I don't know why an x-ray wouldn't show a mass or nodule. I looked at Lungevity Lung Cancer 101 under Imaging and it says that x-rays sometimes miss small lung cancers. It doesn't say why.  Here's the link: https://www.lungevity.org/for-patients-caregivers/lung-cancer-101/diagnosing-lung-cancer/imaging-tests.

Also, bes and Shoo2,  Have you been on the main Lungevity Site? There is a Caregiver Resource  Center there that may have something helpful for you: https://www.lungevity.org/for-patients-caregivers/caregiver-resource-center

Bridget O

[bes]

I asked the oncologist and he told us that when a nodule or mass is located on the chest wall and near the ribs sometimes it can be difficult to diagnose and my husband has severe COPD.  I would think that would be right if the nodules/mass were small but these were not.

[Steff]

Bes-

It's not all that uncommon for lung cancer masses or nodules to be "hidden" on xrays because there are so many different things they can hide behind.  CT's do a much better job at helping docs see them.  My mom is a great example - her "1 year all clear" chest xray looked "normal". After continued shortness of breath, her new pulmonary doc began reviewing scans and xrays. He saw something on her "all clear" chest xray. They decided to take a better look and found cancer behind her trachea that was closing off 70% of her airway.  A CT shows it better, but it is still really hard to see even then.  We were truly angry for a long time and are probably still a bit angry that it had been missed for over a year and 3 follow-up chest xrays.  But all we could do was get over it and move-on so we could deal with her treatment and recovery.  Luckily, her cancer supposedly has not spread, so we are grateful, but not everyone is that lucky.  All that I can say going forward, is to continue to push for answers should a new symptom arise and there has not been an explanation for it - and don't always accept the "It's just chemo/radiation/other treatment side effects" answer because it's not always due to side effects.  My mom recently spent 2 weeks in the hospital because of pneumonia and a pleural effusion in which they drained over 2 liters - this was also missed by a chest xray.  My mom used to be nervous about "crying wolf" but we are to the point that her health is way more important than worrying if we are pestering her docs.  What I've learned from all of this is to always ask questions and should you have other questions after your appointments, contact your docs and ask them.  

[Brenda Morelock]

So sorry your husband's cancer was missed. The same thing happened to my husband years back. He started complaining with chest pain & because he had open heart surgery 6 months prior the doctors were focused on his heart & nothing else. He continued to have chest pain on & off. He then started with a horrible take your breath away cough. Ten months later they decided to do CXR due to his symptoms. CXR revealed pneumonia for which he was treated with 2 rounds of antibiotics. When it didn't clear they proceeded with further testing-so a year later he was diagnosed with sclc. He was able to take radiation treatments & then chemo. Sadly he passed away 2 1/2 years later. My prayers are with you & your husband. Treatment options are so much better now so don't give up hope. Ironically I began with congestion & cough right after Christmas last year. I was diagnosed with sinus infection & bronchitis. Continued with congestion & cough-then was diagnosed with pneumonia. I had 3 rounds of antibiotics. Pneumonia never cleared & I was sent for CT scan. This showed a nodule highly suspicious for malignancy. Then to pulmonologist & had bronchoscopy which revealed I had nsclc. Finally had upper right lobe removed May 31. Doing fairly well now. So yes sometimes nodules & masses don't show on all CXR. I have been on both sides of the fence caregiver & patient- Many prayers for healing of your husband & grace for you both as you start on this journey.

[Tom Galli]

Bes,

I was x-rayed about a month before my lung cancer diagnosis.  The x-ray clearly showed two broken ribs.  Not shown was a 7.5 cm (3") long, 1.3 cm (1/2") wide tumor in the main stem bronchus of my right lung. Tumors in soft, diffuse tissue, like the lung are difficult to find using x-ray technology.  Sometimes they don't show with CT scan technology.  This is but one reason early diagnosis of lung cancer is so difficult.  But an unresolved chronic rib pain complaint should have raised an alarm. Doctors do the best they can with the tools at hand and lung cancer remains devilishly difficult to diagnose even with enhanced scanning technology.

So your next step is continued diagnosis.  Your husband may have further scans of the body and brain to determine if the cancer is confined to his chest.  The results of these procedures yield a stage of lung cancer.  This explains lung cancer staging.  Once staged, the type of lung cancer needs to be determined before a treatment plan can be devised.  Here is information on lung cancer types.  Type determination is often made using a needle biopsy; sometimes tumor samples suitable for pathology examination can be obtained using a rigid or flexible bronchoscope.  An interventional radiologist generally performs a needle biopsy, although thoracic surgeons also perform this procedure.  Thoracic surgeons or pulmonologists perform bronchoscope procedures. Tissue samples from either device are examined by a pathologist to determine the type of lung cancer.  The size and shape of biopsy cell tissue allow determination of the type of lung cancer.

Here is a resource you may find useful as you and your husband move forward toward treatment.  You'll have questions and this is a good place to ask.

Stay the course.

Tom

 

 

[bes]

Thanks so much for all the replies and resources I have found a place that really cares. I don't feel so alone in this battle knowing I can share with others. My husband has already had a needle biopsy with a diagnosis of Squamous cell lung cancer either a stage 3 or 4; we are waiting appointment for a Pet scan to see where it has spread and an appointment was made for the radiologist.  So if all goes as planned we should know the extent on the 17th when we meet again with our oncologist. The hardest part is yet to come we need to tell his adult children

 

[Tom Galli]

Bes,

Understand Squamous cell stage III or IV.  My type was also non-small cell squamous cell lung cancer so we share a type.  My stage was debatable between stage IIIA or B at diagnosis. With metastasis to my remaining lung after a pneumonectomy, I was stage IV, no debate. 

Telling my daughter was indeed difficult but she was very helpful once informed.  Waiting for results and just waiting between treatments for me was the hard part.

Stay the course.

Tom

[bes]

Husband has pet scan scheduled for this Tuesday but I am seeing things that don't seem right but since I have no knowledge everything worries me and of course he won't call the Dr. or let me call for him.  We have second appointment with oncologist on the 17th.  In the last few days his appetite has changed and I noticed the other night his right ankle/foot were very swollen. I don't know what signs to look for and I am worried he will go downhill fast--these changes have been since this past Friday and we do not know where the cancer has spread.  They gave him Tramadol for pain and the reaction to that was terrible, itching, vomiting, unstable balance--he quit taking it a few days ago and most of the symptoms have disappeared expect the balance.  Could all these things be the cancer spreading quickly.  I am the type of person who has to know what to prepare for and I have to know everything--don't want to be in the dark.

[BridgetO]

Hi bes,

I know how scary it can be when symptoms come on or get worse suddenly. In my several cancer journeys I've been through that and my symptoms were nowhere near as serious as your husband's. Since he's not wanting you to talk to the doctor, you're in a difficult spot. Hang in there--hopefully you'll have a better idea of the situation afther you meet with the oncologist on the 17th.

Bridget O

[Tom Galli]

Bes,

Appetite challenges are normally experienced while receiving chemotherapy so a decline in appetite before treatment is not likely related to cancer.  It may be stress.  I've never heard of foot and ankle swelling as symptoms related to lung cancer before treatment.  So I think something else medically is going on.

Your husband is likely allergic to Tramadol.  I had the same type of reaction to the first narcotic pain prescription I received.  A telephone call to my general practitioner's office yielded a different prescription that works without the adverse symptoms you describe.

I don't think anything you've described is related to your husband's cancer spreading quickly.  I hope the results of the scheduled PET scan are helpful.

Stay the course.

Tom

[bes]

Thanks so much for the quick response it has helped ; my hubby says I am a "helicopter" wife--I guess that explains it. It's hard not to be we have been together 28yrs and he has battled severe COPD since 2004. So that in itself has it's ups and downs but nothing like this. Just dealing with all the test and doctors is tiring for both of us.   

[LaurenH]

Hi, bes,

Your husband is lucky to have his own personal helicopter! This is a tough disease and I'm sure he is very grateful for your support. I'm glad you've connected with so many of our members already and have gotten answers to some of your questions. Please feel free to keep exploring the discussion boards and blogs and join in the conversations when you're ready. I am also happy to help you find more information and support resources through LUNGevity, so do not hesitate to message me. We'll be thinking of you and your husband this week. Please let us know how the appointment goes on Tuesday!

With gratitude,

Lauren
--
Digital Community Manager
LUNGevity Foundation

[bes]

 Dr. visit went well yesterday and we were able to view the pet scan.  The dr. is suggesting starting off with radiation treatments first for pain relief--(we see that dr. tomorrow)and when that is completed to start a once a week chemo treatment.  A ct scan will be taken after a few months to see any changes and if things progress well he will be on maintenance chemo--once a month.  He told us that the cancer is confined to the one lung and has not spread to any other organs or lymph nodes--he said that was good news; the bad news was there is not only the mass next to the ribs/lining area but 2 other nodules one 2cm and one much smaller--he is hoping the chemo with shrink those--we will return to the oncologist in 3wks to discuss the chemo treatments.  I am hoping the radiation helps with the pain as the medication is making him sleep all the time.

[Tom Galli]

Bes,

Ok -- now we have a treatment plan.  Radiation will indeed help with the pain.  It should mostly eliminate it.  My radiation experience, side effect wise, was almost nothing for the first two weeks.  Then in week 3, I started to develop a dry, non productive cough and an irritated throat.  I'd get a supply of Halls cough drops that were very helpful.  My radiation oncologist also prescribed a pretty potent cough syrup that helped.  In weeks four through six, weakness started to settle in.  I was very tired, lacked energy, and spent a lot of time in bed.  Radiation is the inverse of March.  It comes in like a lamb and leaves like a lion. 

Did you learn the type of chemo the doctor is suggesting?  Telling us the names of the drugs may help forum members advise of side effect mitigation strategies.

Let us know how he is doing.

Stay the course.

Tom

[BridgetO]

Hi bes,

I'm glad to hear you finally got some information and that your husband has a treatment plan. Hang in there!  Let us know what we can do to support you.

Bridget  O

[bes]

Had meeting today with radiologist and she suggested 2 wks of radiation for pain relief.  I did find out more info today the tumor is located on the lining and into the ribs but from the back area not the front as I thought.  She told us that in her best guess my husband has a 1yr to live with treatment less without--he asked..  She said there could be other areas of cancer in the body but too tiny to show up.  They are treating the mass only because if they tried to treat the other nodules it would do too much damage to the lungs.  I'm trying to be optimistic but I'm not feeling it today sorry.  By the time all appointments are set up it will be at least 2wks before treatments start.

[BridgetO]

Hi bes, 

I'm sorry to hear about your husband's prognosis. However, It's just that, a prognosis, an opinion. We never know what's going to happen with this disease. That said, it's an infoormed opinion, so we have to consider it seriously. Has your husband thought about seeking a second opinion? I did, not on my lung cancer, but on my earlier advanced cervical cancer and found it helpful in making treatment decisions.  

BTW, my mother had radiation for pain relief for metastatic breast cancer that had spread to her spine. It was very effective in relieving her pain. 

You and your husband will be in my thoughts.

Bridget O

[bes]

Today has not been a good day I thought the pet scan we had done included the brain--it didn't and now he is being scheduled for a brain scan--another worry.

And my husband trying to be the jokester today during  dinner out said "well this time next year I won't be here"--I lost it and started crying in the restaurant--I blaming

this on the Vicodin he takes--what else could it be.  It's been of those days--

[Tom Galli]

Bes,

Unfortunately, "one of those days" is an all too common experience for folks on this forum.  We understand.

Stay the course.

Tom