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Interventional radiology CT-guided biopsy of lesion


Irka

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I've just learned that I'm to have an interventional radiology CT-guided biopsy of a lesion in my upper right lung.  It would be great to hear from others who've had this procedure.  Also, is this as reliable in determining malignancy as having an endoscopic bronchoscopy ultrasound to obtain tissue for biopsy?

Thanks in advance.

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Hi, Irka,

The method of obtaining a sample for biopsy really depends on the size/location of the tumor/nodule.  Tom was just saying that the pain/recovery time from a needle biopsy is way less unpleasant than from  a bronchoscopy (which can give you a sore throat for a week).  (I never had any biopsy.)  To the best of my knowledge, though, as long as they can grab a sample sufficient to examine, taking it one way is as reliable as another.  

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Thank you, LexieCat!  Doc's office is trying to schedule it close to where I live, which should help.  I really am in a tizzy (understatement) because house is topsy-turvy with clothing & boxes everywhere & I'm not getting anything done for the move.  Just frustrated & must settle down!

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Hi Irka,

I had the same procedure in my lower right lung while I was inpatient for pneumonia.  The medical team placed me under “conscious sedation” aka really good drugs.  It went pretty quickly. I was monitored in recovery for about 2 hours & discharged home.  I had no pain or complications.  There was a slight discomfort that went away with some Advil.   The site was only covered with a band-aid. 

Drink lots of water the before the procedure & right after as you might get constipated. I needed one dose of Miralax the next day.  

Hopefully the procedure goes well for you.  

Michelle

PS our packing rule is when I’m doubt, throw it out.  Keep chipping away! 

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Hi Michelle,

Thank you for reassuring me by relating your own experience.  If I may ask, were they able to do a successful biopsy as a result?  That's one of my concerns since I read sometimes it has to be redone.  That won't happen in my case, I hope.

I won't find out until tomorrow when it will take place.

You're so right about the "when in doubt, throw it out."

Irka

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When my nodules first started to grow & change it was noticed during an annual CT scan monitoring them. I had a needle guided biopsy to determine it was cancer and then a bronchoscopy and a medianoscopy to check lymph nodes. I guess everyone's experiences are different; for me the bronchoscopy was the easiest of the three.

When you have the needle biopsy, you'll probably get some light sedatives & numbing injections. Afterwards you'll need to stay in the bed for 2 hours, then get an x-ray to make sure you don't have any air pockets in your lungs. If you do have air, they will wait and x-ray again in another 1 -2 hours to make sure its going away or at least not getting any worse. A band aid is all that is needed to cover the site. Do plan on taking it easy the next day or two. Ask your doctor prior to this appointment about biomarker testing. If they can do this, there is a required minimum amount of tissue required for this testing. The first time I had this, I went to work the following day; I did take an extra day off after the 2nd one.

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Hi Irka 

Yes- no problem with any of the tissue samples- they took a total of six.  My tumor was right near the surface of my back.  

Shelkay is right about the X-ray.  I forgot about that.  They did the X-ray in the recovery room & the radiologist read it on the spot.  

The biopsy was not hard- I couldn’t stand the brain MRI.  I got some Valium for that.

Michelle

 

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Thank you, Shelkay & Michelle!  Tomorrow, I expect to find out when mine will be scheduled.  Friday at the earliest, probably Monday, which actually would be better.  Our son & 26-year old grandson are arriving Friday morning to help us.  They'll also take some furniture & kitchen stuff for the grandson's new apartment.  They plan to leave early Monday.

Well, I just have to try & settle down & do whatever I need to when the time comes.

It's exhausting, frustrating, & plain no fun!

Thanks so much for the support.

Irka

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Irka, I had both procedures and like Lexi said the needle biopsy was a lot easier. I hope you get it scheduled soon. 

Take Care

 

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Thanks for sharing this important information.  Since I didn't get a call-back today, I'm assuming it won't be scheduled until Monday at the earliest.  The waiting is hard. . .

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Irka, I also had the CT-guided biopsy a couple of years ago. I didn't feel anything - just a thump against my sternum. I, too, was sent home with just a bandaid on this hole in my chest!  The pathologist was in the room during the procedure and he confirmed it was cancer, but performed additional testing to confirm it was a recurrence of my primary cancer and not something new.  The same radiologist also placed my  port on the same day.  Keep us posted. 

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Happy you had such a good experience.  The medical facility was be outstanding to have the pathologist present to confirm it was a recurrence & not something new.  And to have the port inserted the same time!  So, I wish you every success with the treatment.

My biopsy procedure was a bit tricky.  Quite small "target" near lung lining right middle lobe, had to go around rib, & could do only one "run" -- in & out.  But she said she believed she got enough for the biopsy, not sure about biomarker test.  In my case, the procedure was painful, but I withstood it!  Won't get biopsy results until middle of next week.  Because we're moving to PA from MD Apr 8-9, I have to get established with a new oncologist there.  So I'm eager to get the results; that onc won't even make an appointment with me until he reviews my biopsy!  But I'm doing o.k. & will feel even better tomorrow!

Thanks very much for thinking of me.

Irka

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20 minutes ago, Irka said:

Happy you had such a good experience.  The medical facility was be outstanding to have the pathologist present to confirm it was a recurrence & not something new.  And to have the port inserted the same time!  So, I wish you every success with the treatment.

My biopsy procedure was a bit tricky.  Quite small "target" near lung lining right middle lobe, had to go around rib, & could do only one "run" -- in & out.  But she said she believed she got enough for the biopsy, not sure about biomarker test.  In my case, the procedure was painful, but I withstood it!  Won't get biopsy results until middle of next week.  Because we're moving to PA from MD Apr 8-9, I have to get established with a new oncologist there.  So I'm eager to get the results; that onc won't even make an appointment with me until he reviews my biopsy!  But I'm doing o.k. & will feel even better tomorrow!

Thanks very much for thinking of me.

Irka

🙏🤞🏻sending positive thoughts. 

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I’m not sure where in PA you are moving but I’ve had family treated at U Penn.  They have been happy with them.  

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We're moving to Lititz PA just 10 miles N of Lancaster PA.  We've learned of a great cancer facility, the Ann B. Barshinger Cancer Institute.  It's part of Penn Lancaster General Health -- many of the doctors are from U of Penn.  I'm optimistic that I'll get connected with good doctors there & my needs (as well as my husband's) will be met!  Hoping you're doing well,

Irka

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My 3/20/19 biopsy was unsuccessful -- result, non-diagnostic.  I'm in a Catch-22 situation of sorts.  I have to figure out how to get an appointment with a thoracic surgeon at the Penn Medicine Lancaster General Health Ann B. Barshinger Cancer Institute (quite a mouthful of words there).  They require biopsy results faxed to them, but I have no biopsy results!

I'll have to find a way around this!

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Well, that's disappointing, isn't it?

I'd suggest maybe starting fresh with a pulmonologist, and have that doctor refer you for whatever diagnostic procedures are appropriate.  My surgeon had no problem operating based on just my CT scan without any biopsy, but I think that was partly because they were all part of the same team at the same cancer center.  It could be that they will recommend an alternative biopsy or that you go straight to surgery.  The way my surgery was done, they removed the nodule first and examined it before proceeding with the lobectomy.  You're moving in just a little over a week, so maybe it would be easiest to try to set up an appointment with a pulmonologist now.

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That's precisely what I'm doing now.  I've been in touch with an oncology nurse navigator at the Penn Medicine Lancaster General Health Ann B. Barshinger Cancer Institute.  She's  already begun the process to get me an appointment.  Likely, I will start out by seeing a thoracic surgeon within a matter of days after we move!  With information & encouragement I've gotten here & from the Lung Cancer Foundation's particularly significant input, I am relieved to say I now am on the path to obtaining the treatment I need. I know it's going to be a tough road ahead but I also know there are many folks I can count on for help.  Thanks a million to all of you who are responding to my postings!

Irka

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Hi Irka-

Thanks for the update.  That’s a total bummer!  It’s great that you’ve connected with the nurse navigator.  He/She will be your new best friend!  It’s one of the benefits of cancer center “membership”. (Remember those old American Express commercials??  Membership has benefits!  😂).  

The nurse navigator will also be useful in helping you get settled into the new community too. Ask who your social worker will be & get an appointment scheduled. The social worker can help put together your wellness programs.  Typically there are things like yoga, Tai Chi & nutrition programs offered for FREE to all patients & their care givers. Breast cancer gets most of the resources so I’ve been able to piggy back on their programs. The breast cancer ladies have adopted me. It’s a great way to meet new awesome people. 

Try not to worry too much about the biopsy- it happens quite a bit & the medical team will have a plan.  

The frustrating part is all the waiting!  It does take at least 6-8 weeks to get a treatment plan together. I’m the interim you can unpack & pitch the stuff that you now wonder how it made its way into the new place. 😉

Michelle

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Hi Michelle,

Your post is so uplifting!  Your suggestions are very important as well.  I didn't realize there are so many resources waiting for me.  My oncology nurse navigator has already been in touch with me by phone & email.  By the time we move in I'll have an appointment lined up, probably with a thoracic surgeon!

I absolutely hate packing even for short trips never mind moving after nearly 40 years in the same house.  So I must force myself to stop thinking about all I have to do and just do it!

Thanks for your warm & heartening response.

Irka (aka Irene)

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We’re all in this together!  There are lots of resources that the docs & nurses don’t know about.  (Including Free housecleaning during chemo). The social workers are the key to uncovering this stuff as well as other patients in the community.  I went to some of the support groups offered (non lung -general cancer) & got all types of great tips from other long term cancer survivors.  

Be assertive in asking for whatever you need- no matter how small. 

I count my blessings every day. I’ve met some really wonderful people at the cancer center (way better than the now former toxic waste work colleagues). 

Don’t be surprised if there isn’t a lung cancer support group.  I go to this fancy pancy NCI which to my surprise they didn’t have one.  So I made one up with my social worker.  You can ask to crash another support group. 

Once my wellness programs were organized I refer to it as my spa life: Wednesday Thai Chi, Thursday-acupuncture & Friday is restorative yoga.   Next up on my list is lymph massage! 

You may as well consider taking advantage of some programs while you’re in the interminable waiting period & getting a break from the unpacking! 

Michelle 

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