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Paranoid


Irwin1

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Ok. Because I needed a CPAP machine due to my weight I went to my pulmanary doctor. He have me an overnight sleep study which verified my need for CPAP which I knew that I needed for years. He also gave me a PFT which was normal. He also had me get a chest x-ray at the local hospital which was normal. The X-ray was done in the middle of April. Before I received my CPAP machine I ended up on May 20 in the ER with pneumonia and a mass that the CT scan measured more than 4cm large. I asked my pulmonary doctor why the mass didn't show up in my x-ray. He said that sometimes they don't show up in the X-ray. But we are not talking about a small nodule. We are talking a large mass. 

   Now the pneumonia healed in a weak and now I have absolutely no symptoms.

   I can't help to say it but sometimes I feel somewhat paranoid. I changed my medical insurance advantage plan to a group that pretty much have a monopoly in my county. But 2years ago I was having hip pain and an orthopedic surgeon told me I needed double hip replacement. I told my PCP that I needed a referral to the orthopedic surgeon who was a hip specialist. Now I asked the first orthopedic on a scale of one to ten ten being the worst. He told me I was 7. When I finally went to the orthopedic surgeon specialist that was to do the surgery he told me that he couldn't operate on my hips because basically I had a very mild case of arthritis. At the same time the other orthopedic was giving me cortisone injections into both hips at $1500 a shot.

    Now since I am in this huge medical group I am suddenly feeling like I am in an invented mess again because I have 0 symptoms. 

    Is it possible to have a large mass without symptoms and have the mass be missed by a routine chest x-ray.

   Wow. Am I paranoid now. Just writing about my hip experience makes me relive it. My hips have long been better for 2years. I'm really scared right now

 

One last thing. When I took the PET scan the mass was reported as 4cm which was smaller than the CT scans at the hospital. My wife and I asked why and the oncologist said that the PET scan was not as accurate at measuring size as the CT scan. My wife noticed that the 4cm was smaller so she obviously knows the original size.

 

 

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Hi Irwin-

You’ve really articulated why it’s so difficult to diagnose lung cancer.  There are often no symptoms. Tumors are sneaky and can hide in chest x-rays if there is “ground glass opacity”.  It looks like snow on the CT scan. 

I had one of those sneaky tumors which was 3cm. My lungs sounded clear, I had two chest X-rays with a diagnosis of atypical pneumonia, and an indeterminate chest CT.  My pulmonary function was normal, However my oxygen dropped to 90%. No one was looking for a cancer diagnosis. In fact I was discharged from the hospital on Pepcid AC as the attending physician thought my cough was GERD. 

My diagnosis was only confirmed by the CT guided biopsy and bio-marker testing. 

 

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Yes it is possible to have a 4 cm mass with no other symptoms.  Lung cancer is elusive and often doesn’t show any symptoms until it is larger and has spread.  It is also possible to have missed it on an X-ray.  This photo was posted to a Facebook group I’m in.  I thought it showed what details the different scans could show pretty well.  

54BA8532-58E3-420A-9D12-1E3F6680734B.jpeg

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Again the pros have come to my rescue. As I previously made known in a post, I have OCD. I can overthink anything until smoke starts coming out of my ears. It was a good attribute for my career. But it is not such a good thing in other things.

    Thanks for rescuing me again!!!

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I suppose I did have a symptom. I live in Central Florida and stay inside most of the time. Why in the heck would I end up in the ER with pneumonia? 

    I had a needle biopsy ( while I was awake grrrr) and although it definitely called no cancer written by the pathologist in the report, it did confirm the pneumonia. 

    So a surprise case of pneumonia is definitely weird

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Irwin,

You asked why a mass would appear to be a different size on a PET scan vice a CT scan. The CT that accompanies a PET is not accurate enough alone to support a diagnosis. It’s purpose is to providr rough order of magnitude sizing and location information while the radioactive tagged glucose does the diagnostic work. You may find words to this effect on the radiologist PET diagnostic report. 

Stay the course. 

Tom

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Irwin, Pneumonia happens, like other things. Consider walking pneumonia and people who don’t even know they have it!!! When you are feeling antsy, slow deep breaths and try to hum in you head. That will scare those evil, paranoia thoughts away!!! I hope you are better soon.

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18 hours ago, Tom Galli said:

Irwin,

You asked why a mass would appear to be a different size on a PET scan vice a CT scan. The CT that accompanies a PET is not accurate enough alone to support a diagnosis. It’s purpose is to providr rough order of magnitude sizing and location information while the radioactive tagged glucose does the diagnostic work. You may find words to this effect on the radiologist PET diagnostic report. 

Stay the course. 

Tom

I have been using my phone to post but the browser is causing malfunctions so I may have to pull my laptop out of the closet.

     Thanks Tom. The knowledge that you poccess is really a blessing to me. Upon reading the first post of this thread at this point there is no reason to trust my oncologist yet. As I have said I worked in the path lab in a busy hospital in N. Miami and when it comes to actual samples from a living person I can catch a doctor making mistakes. But I know nothing about radiology and it appears that you do!

   I can tell you how my oncologist operates when handling what the patient knows. When he visited me the one time in the hospital we had yet to get the results from the needle biopsy. At this point he told me that at this point it could be anything such as a fungal infection. This had me thinking very positively and relieved me of my anxiety. What he didn't tell me was the odds that it could be a benign tumor or malignancy. So in a way I feel like he likes to relieve the patient walking a fine line of false hope.

     When the biopsy results came in he called me at home and said that the results were inconclusive and that I needed a PET scan. But then he started giving me reasons why I should be positive about the report. I hadn't read the report myself calling the needle biopsy myself which clearly said that it was not cancerous but was consistent with pneumonia.

    He then started to build me up by listing the common symptoms of LC and telling me that I didn't have any of them. He also told me that sometimes infections show up like masses on the CT scan. This is also true.

     So I became confused and asked him if he was giving me a good report. For some reason I don't remember his answer. I felt like he should give up oncology and work for President Trump's press secretary.

     Anyway thanks for the info. I have to go get the dust off of my laptop!

 

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