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Mass found in my father's lung

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Hello- I have been reading these forums all week and just want to say how wonderful and reassuring it has been. To truly see you are not alone and what a great resource this forum is has been a breath of fresh air. On Tuesday my dad went into his pulmonologist for a routine visit, although for 4-5 days prior he has been experiencing shortness of breath and cough. My dad is overweight but active (hunting,fishing,taxidermy). He did smoke swisher sweet cigars but hasn't in 20 years. For 35 years he worked as an auto body man breathing in all kinds of crap and chemicals as well.  After some blood work and a chest xray, he was called back for a CT as they saw something in his left upper lobe. After the CT, we got the news they found a large mass (11 cm x 7 Cm X 3 cm I believe? looking back that appointment is a blur hearing all this news. My wife is a pathologist assistant and compared the size to the body of a rubber ducky). Multiple doctors have stated how it is likely cancer. On Thursday we met with another pulmonologist who would be conducting a bronchoscopy biopsy. This is scheduled for Christmas eve morning. Friday he had a pulmonary function test (which his numbers are better than last year), cardiology appointment, and PET scan. The days prior to the PET scan had been the most horrifying I have yet to experience. At work I was constantly having to run to the bathroom to cry and compose myself. On the PET scan, we were relieved to find the only thing to show "activity" was the mass and 2 lymph nodes "lit up" slightly extremely close to the mass. Nothing else found in either lung or the rest of his body. Although this is horrible news to find the mass, we are relieved it has not spread all over. Another concern however is that the tumor is putting pressure/around  the pulmonary artery and likely reducing flow, but they do not think it is "invading" or growing into it. Nothing is for sure though. I am very new to this disease, and have been trying to learn all I can. I am an intensive care burn nurse, but have little dealings with oncology.I know we will need the biopsy results to really know what we are dealing with and stage it. I am just hoping surgery will be an option. While its good it has not spread, is a mass that large operable? We all are eager to get the tests completed so we can start the fight. After the biopsy, we have his follow-up appointment on January 3rd. Thanks for all everyone does on this page and the resources you all make available.

Eddie

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Hi, Eddie, and welcome.

Sorry to hear about your dad's situation.  I suspect with a mass of that size that they will try to shrink the tumor with drug and/or radiation therapy before attempting surgery, if that is an option at that time.  I'm no expert, just going on what I've picked up here and in my reading.  

The good news is that recent advances in lung cancer treatment have resulted in some very effective treatments.  You'll know more after the biopsy, which will allow the doctors to create a treatment plan.  

So there's lots of reasons to feel hopeful.  The absence of indications of distant mets is a good thing.  

Glad you found us.

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Hi Eddie and welcome,

I would have said excactly what LexieCat said- but she said it first. It sounds like   the docs are doing all the right things for your dad at this poine. Please let us know what questions you have and how we can support you. Keep us posted.

Bridget O

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Eddie,

Welcome here.

I'm not a doctor but did have a very large mass removed by removing my entire right lung.  My diagnosis was non small cell, squamous cell, lung cancer.  I've lived nearly 15 years since my diagnosis on one lung and while I do have some residual treatment side effects, they are tolerable.

Lexie's suggestion about pre-surgical treatment to reduce the size of the tumor is one approach doctors might consider.  After biopsy, other approaches like treatment with conventional chemotherapy alone or in combination with radiation, targeted therapy or immunotherapy are other options. These may be given alone or prior to or after surgery as possible treatment approaches.  Thankfully, the recent emergence of new treatments in the form of precision radiation (IMRT, SBRT and IGRT), targeted therapy and immunotherapy have made even large tumors treatable.

You are right about a biopsy.  Pathology results to identify the type of cancer are the next step in determining a treatment approach.  The PET results are hopeful in terms of surgery in that there appear to be no distant mets.  Hold tight until the biopsy report is obtained then let us know and we'll field your questions.

Stay the course.

Tom

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Thank you guys for all the feedback! Biopsy is tomorrow morning and I am extremely hopeful. I’ll let you know what everything comes back as I’m sure I’ll have a million questions.  Hope you all have a great Christmas! Thanks again- Eddie 

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Hi Eddie, hope you are having a great Christmas.  I have a large mass also, 6.9cm x 6.3cm which totally freaked me out.  Unfortunately, I haven't had the PET yet so its pins and needles until Thursday.   That's great that there are not other hot spots on his PET!  It also gives me hope that even though mine is also large it may not have spread.  Hopefully your Dad can come through this with flying colors.  Hugs to you and keep posting.  I have found nobody laughs at stupid questions or when you just need to vent-these people are awesome.

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Thank you everyone for the support. Yesterday we met with the oncologist and the biopsies came back as non small squamous cell. Preliminary results of mri are good so it’s look like he will be stage 3. Good news is lymph nodes on right are negative. One node very close to the tumor came back as “suspicious”. Tomorrow they are going over my dads case in a tumor board with the entire team and come up with a definite plan. It seemed like they are leaning towards no surgery yet and chemo and radiation. They mentioned doing a couple rounds of chemo 3 weeks apart then start targeted radiation. Hoping to shrink it down. I really want them to do the surgery and cut it out, but as you mentioned they may want to get it smaller first which makes sense. On Thursday we will learn a lot more. Next week Monday will meet with radiologist and get a port and likely start chemo by end of next week. At what point would you suggest to get a second opinion though? So far we are impressed with all the docs and medical staff and have been treated exceptionally well. My dad most definitely feels very comfortable at his hospital. We do however have many large university hospitals close to us living in a large city (Chicago). Thanks again for everything! Hopefully have a good plan Thursday that is aggressive to go after it. 

Eddie 

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Eddie,

I am glad to hear that you dad has a tentative treatment plan in place. Your dad can pursue a 2nd opinion at any time, even while he is undergoing treatment. Many people do this to have piece of mind that they are making the best decision for them. My mom did not have a 2nd opinion because her initial treatment was very straight forward - lobectomy with follow up chemo and radiation- that was really the only options then and was what we wanted (mainly the surgery). 

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Hi Eddie, If your dad continues to be comfortable at his hospital and you're both impressed by the medical staff, probably  he doesn't need a second opinion at this time.  As Steff said, he could decide at any time to get another opiion. Here's my second opinion story. My lung cancer was discovered very early and my treatment plan (surgery) seemed very cut and dried and so no reason for a second opinion. I did have a prior non-lung cancer that was stage 3. I had surgery urgently and then my case went to a tumor board. There was agreement that concurrent chemo and radiation should be the plan and we went with that, There was one member of the tumor board who thought I should have addtional chemo. The cancer I had was a rare type and there was no standard treatment. My medical oncologist thought I did not need the additional chemo and I wasn't comfortable with her reasoning. I went for a second opinion at  the medical center assoiated with the local medical school and sought out a doctor who had experience with my kind of cancer. She recommended specific addititonal chemo. I told my original oncologist that  I wanted to follow that recommendation and she agreed to do the treatment. I was glad I did, because now, almost 8 years later I  have no evidence of disease. It was a rare and aggressive cancer with a poor prognosis. 

So it's really a matter of what you're comfortable with. The better informed you are the better decisions you can make.

Best of luck to you and your dad

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I agree with Bridget--if you feel comfortable and confident with the doctors he has now, a second opinion probably isn't necessary.  Her example of a situation where it would be called for is a good one--aggressive cancer, a specialist with experience with that type.  Your Dad's cancer is fairly common and treatment should be pretty straightforward, with adjustments to be made once his response is assessed.  Chances are that a second opinion would echo this one in terms of first-line treatment.  If he isn't responding to treatment, that might be the time for a second opinion.  But totally up to you/him--as noted, you can seek one at any time.

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Eddie,

I agree with both Bridget and Lexie. From your post, I glean a well thought out treatment plan that should produce results.  I had pre-surgical conventional radiation and chemotherapy but my diagnosis was well before the emergence of precision radiation as a lung cancer treatment method.  The targeted or precision radiation is the treatment that likely saved my life.  It should have a dramatic effect on his tumor and the chemo will stop propagation of cancer cells in the blood stream. Surgery remains in play and therefore I would be satisfied with this course of treatment and would feel no need to seek a second opinion.  

Stay the course.

Tom 

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Thanks everyone! Yea so after meeting yesterday- plan remains chemo and radiation in order to shrink the large left side tumor and hope for the possibility of surgery. Only change is to include radiation on lymph node on right side even though the biopsy was negative. Docs say rather be safe than sorry cause it worries them which we agree with.  Doctor said goal is to achieve NED so that gives us more hope. Now he will get chemo once a week and radiation daily, with hopes to start that right away as well.  Monday he will have radiologist appointment to “map” him out along with an informative intro to chemo meeting. Thursday he should also get a port and Monday January 14 start treatment. Can’t complain too much as basically within a month of onset of symptoms he’s receiving treatment. Once we find out the names of chemo drugs I’m sure I’ll have a number of more questions for you all. God bless you all and thanks so  Much for the information,advice, and words of encouragement. 

Eddie 

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Eddie,

Sounds Iike you are ready to go.  Glad to here your are getting a port.  That will eliminate assault of the veins.  

Stay the course.

Tom

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Last year the found four modules in my lungs. The reports states Ascending aorta 4 cm unchanged. Arch 2.8 cm diameter descending aorta 2.7 There are two new irregular destiny in both lower lobes. The lower lobe is 17 x 12 classified. The last not on the report says there new irregular densities in the lower lung.. I’m scheduled for another ct in three week. I just had one a week ago!!!! 

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