copd and lung cancer

[Kathy2]

Hello, I have recently had a Pet scan that was positive for 2.3 cm in left upper lung. I have severe copd and my pulmonolgist referred me to see cardiac thoracic surgeon tomorrow. He told me there is no way that a surgeon will touch me given my lung capacity. He said a "negative does not mean a negative on a biopsy."  So what direction am I supposed to turn? I realize the seriousness if I have a lobectomy or a wedge thoracectomy. (correct terminology?) Should I have been referred to see oncologist? Doesn't the nodule need to be biopsied some how? It has grown in few chest xray and Ct in last few months. So we don't need to watch any longer especially since it did have hot spot on Pet Scan. Please answer any of my questions or share your story. Anything will help.

[Steff]

Welcome Kathy,

In regard to "positive" PET scans, best practice is to follow up with additional testing to get a definite answer of cancer or not cancer.  Biopsies are the best way to do this.  There are several different types of biopsies, some less invasive than others.  If a more invasive biopsy is not an option, perhaps a less invasive one will be.  Some people forgo the biopsy and go straight to a wedge resection, lobectomy etc.  I don't know why some do this other than the nodule/mass is in a spot that cannot be safely biopsied (I'm sure there are other reasons as well).  My mom's pulmonologist has done all of her biopsies.  I would be sure to follow up at your next meeting and ask about a biopsy as an option.  My mom also has COPD, not too severe, but it limits her lung capacity.  Luckily her surgeon did not worry about that and did a lobectomy, which turned out fine.  Depending on how things go with the surgeon, I would suggest getting a second opinion if he/she says surgery is not an option.  My mom has had several different surgeons for several different non-cancer related things.  We've been told that even though she has health issues that make her a higher surgical risk (COPD being one of them), she still is a surgical candidate.  If we are denied a necessary surgery, we should seek a second opinion from a different surgeon.  If we receive two "NO's", then we would accept that surgery is not an option.  Hope this helps a bit.

Take Care,

Steff

[LexieCat]

Hi there, and welcome.

Cyberknife surgery (a form of radiation therapy) is often recommended when someone is not a candidate for lobectomy or other conventional surgery.  The doctors won't perform a surgery that may put you at an unacceptable level of risk.  I think I'd check into that, if I were you.  

A biopsy still might be essential, though, to determine the type of cancer so the most effective treatment can be used.

[Kathy2]

Thank you for your replies!! I do really appreciate you! My Pulmonologist said as far as a biopsy that”a negative does not necessarily mean a negative. “ he used his computer mouse to demonstrate with an ink pen telling me if they biopsy this side then maybe they will get negative cells. So I was just kind of left in the dark. My cops is severe and have very low lung capacity. So I don’t want the worst outcome of surgery, at the same time just wonder where to go if it never gets biopsed. I have never heard of the cyberknife surgery!  so I appreciate that and will take it to my doctor. Thanks!!

[BridgetO]

Hi Kathy and welcome!. I like the suggtions that Steff and LexieCat have given. A second opinion might be helpful. Also note that Cyberknife is a type of Stereotactic Body Radiotherapy (SBRT). The various names can get confusing.