Lobectomy Without Biopsy?

[Curt]

I am a 42 year old none/never smoker.  I do have a family history of cancer.  My father passed away of NSCLC at age 59, we had smokeD early in life but hadn’t smoked in over 20 years.  Two of his six sisters also had lung cancer.  I had my gallbladder removed last spring and they saw a 8mm nodule on my upper right lobe.  I went for follow up CT and PET scans. Neither were conclusive.  I just had a six month follow up CT done.  They said the nodule hasn’t grown but that they are concerned about the spiculated edges and are recommending removing my upper right lobe.  They said that the nodule was too small to biopsy.  Has anyone ever had a lobectomy without a biopsy or signs of the nodule growing?   If so did it turn out to br malignant?  I know that quick decisions at early stages can make a big difference but I’m struggling with removing a third of my lung without knowing for sure it’s cancer.     

[LexieCat]

Hi, Curt, and welcome.

I had my upper left lobe (which had a spiculated nodule about 9 mm in size) removed without a biopsy.  It had grown slightly from prior scan--not a lot--but my surgeon said it was sufficiently suspicious that even with a negative biopsy he'd recommend getting it out of there.  It WAS cancer, but the early surgery meant I didn't have to have any further treatment (other than periodic scans to make sure everything stays good).

FWIW, my surgery was a year and a half ago, my recovery was VERY quick, and I've noticed no permanent effects on my breathing.  If your lungs are otherwise in good shape, you have plenty of lung capacity left after removal of one lobe.

[Curt]

Thank you Lexi. I really appreciate the reply and hearing from someone else who’s confronted this.  How quick was a very quick recovery?  I’ve read four - eight weeks and then I’ve read two weeks.  I am active but also 40 lbs overweight.  I tend to be the get me out of this bed type, which sometime has me pushing things too quickly.  I have three young kids, my youngest just turned six and am self employed.  I’m concerned I won’t be able to fulfill my obligations to both if I have this surgery.  

[LexieCat]

I was out with friends to a dinner and a concert two weeks after surgery, and I was back to work right after that (desk job).  You'll be sore for a while, but the more you move, the quicker you'll get back to normal.  I had to avoid heavy lifting for a few weeks, but no other restrictions on my activity.  

I had VATS (which is laparoscopic--robotic surgery is similar).  If "open" surgery is required, recovery may be longer (and more painful).

I was honestly shocked by how little pain I experienced.  I've had a few abdominal surgeries in my life, all of which were more painful than this was.

[BridgetO]

Hi Curt, I had my lower right lobe removed 2 years ago without a biopsy. A small nodule was discovered in a routine surveillance CT for an unrelated cancer. I had  a rescan in 3 months and it had grown very slightly. They were unable to biopsy it due to its location. I had a PET scan and nothing lit up. The nodule looked to the docs like a primary lung cancer because of its shape (spiculated and ground glass appearance). It didn't look to them like a metastasis from my other cancer. I agreed to a VATs lobectomy and the nodule turned out to be an adenocarcinoma, stage 1a. My recovery was about like LexieCats. How soon you'd be able to return to work would depend on the kind of work you do. Desk job, fairly fast; physical job, longer. 

If I were in your position (no growth in 8mm nodule), I'd be inclined to get a second opinion about surgery with no biopsy. VATs lobectomy is generally fairly easy as surgeries go, but it's still surgery and general anesthesia has its risks. Also, some people have difficult recoveries, chronic pain in incisions and other complications. It's rare,, but it does happen. If a second opinion was for surgery now, I'd be more inclined to go for it. 

Best of luck and well wishes,

Bridget O

[Curt]

Thank you for responding Bridget.  It’s really helpful to hear how others have dealt with this and the outcomes they’ve experienced.  My father had adenosarcoma but It was not diagnosed until stage 4.  I am going to Sloan Kettering on Monday, yes Christmas Eve, for a second opinion.  My instinct is just to get it removed.  I’d rather be upset a about doing it and finding out it wasn’t cancer than not doing it and find out it was.  At least I’ll know.  

[LaurenH]

Hi, Curt,

Welcome to the forums. I'm glad to see that you've already connected with LexieCat and BridgetO. We hope your appointment goes well and that you get the information you need to feel confident about making a decision. Please keep us posted!

With gratitude,

Lauren
--
Digital Community Manager
LUNGevity Foundation

[Curt]

Thank you Lauren.  I really appreciate this forum.  It helps to be in touch with others having similar struggles.