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family history 3 gen., have mediastinal nodes enlarged


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I was recently having swallowing pain,dysphea, and general feeling of pressure in sternum. CT w/contrast of neck revealed "mediastineal enlarged nodes and mild distinctness of superior mediastinum."

It was recommeded that I follow up with lung CT w/contrast. Normally, I wouldnt be that concerned but we have 3 generations (mom, grandfather and great-grandmother who died from lung cancer, my mom has non-small cell carcinoma and is two years in remission) I am 55 years old and have never smoked, I am a avid exerciser and am not overweight. My question is if lung CT comeback with only a "mild looking issue" should I still request further tests? My concern is that I have had Valley fever  years ago (I live in Arizona) and this sometimes leaves beningn lesions, but there's no way to tell from CT scan alone whether it's cancer, RIGHT???????  I am quite scared and must wait 2 weeks before my crappy Ambetter insurance will ALLOW the scan. Hopefully, you all out there can offer me some sound advice.

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I'd say you need to wait and see what the results of the scan are.  I was following my lung nodules and when one got larger and developed a spiculated appearance, my pulmonologist was reasonably sure it was cancerous.  It's often impossible to biopsy very small nodules.  In that case, it often makes sense to follow them, as the docs did with mine, to see whether they change over time.  

It's possible your genetics predispose you to lung cancer, but genetics isn't necessarily destiny.  There is a lot that isn't known about why some people get lung cancer and others don't.

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I agree with LexieCant in suggesting you wait until you wee what the scan results are before you decide what to do next. An experienced pulmonolgist can tell a lot from a CT scan. I had a small nodule that grew slowly. It was found in a routine surveillance CT scan that was done to watch for metastases from a prior non-lung cancer.  I also hd some other stuff in my lungs (can't remembr how it was described technically). Those had been there  unchanged as long as I's been having CTS.  One of my pulmonologist's first questionss where I grew up; It was the Central Valley in California. The doctor was pretty sure that the "other stuff" was scarring from Valley Fever. I'd never been diagnosed with it but it's endemic  in the valley it was named for. The pulmonologist also told me that the new, growing nodule looked like a cancer because of it's shape, ane that it looked like a primary lung cancer rather than a metastasis from another cancer. The nodule didn't light up on the PET scan at all, which can happen with small slow-growing cancers. Mine couldn't be biopsied without surgery due to its location. I had a lobectomy and sure enough it was an adenocarcinoma, atage 1a. So they can tell a lot by looking at the CT.

BTW, I'm well and feeling fine almost 2 years later.

Bridget O

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