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Kooper59

Hurry up and wait

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Hello everyone,

I am a 59 year old male who has been abusing his lungs in every manner possibly for about three decades. Not surprisingly I have what my pulmonologist calls "end stage" lung disease.

To make a long story short I have had a number of CT studies of my chest done as a result of my illness. The most recent one revealed a 1.6 x 1.9 cm spiculated nodule in my left upper lobe. The report says "concerning for malignancy" and suggests a biopsy. My pulmonologist ordered a PET/CT study. The PET/CT results verify the nodule which the report says is "suspicious for malignancy" with a maximum SUV of 2.3 and also suggests a biopsy. This nodule was not noted on a CT of my chest three months ago.

I have made an appointment at Moffitt Cancer Center in Tampa for July 10th.

My pulmologist wants to do a biopsy via bronchoscopy which is scheduled for July 17th which is the earliest date available.

I have been reading almost non-stop. I am in the camp that believes a needle biopsy is probably not 100% safe and am wondering about a liquid biopsy.

I turn 60 on July 13th. Go ME!

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Kooper,

Welcome here.

There are always risks with invasive medical procedures; I wouldn't view a needle biopsy as unsafe. A liquid biopsy is a valid technique if you have edema (fluid buildup in air sacs of the lung) but if the edema site or sites are small, they can be just as challenging to access as a small nodules (yours is small).  Moreover, you've told us that you pulmonologist ordered a bronchoscopy biopsy and this is not as invasive as a needle biopsy.  I've had perhaps a dozen bronchoscope procedures and they involve light anesthesia and recovery is quick after a couple of days of a sore throat. 

While a solitary spiculated nodule is a finding of concern, your SUV level of 2.3 does not necessarily indicate metastatic disease. SUVs at 2 or below are considered normal. Above 2 is suspect but this uptake can be explained by other causes (inflammation). The metastatic level 4 and above is the definitive level of concern for metastatic disease. Moreover, I've had many scans where nodules appear and disappear and the appearance does not necessary indicate lung cancer.  Here is my go to resource that explains lung nodules and possible causes. So you are kind of in the middle and I hope your forthcoming biopsy rules out lung cancer.

In case it does not, then you might pass the time reading in to our disease.  This is a good place to start.

Stay the course.

Tom

 

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Welcome Kooper,

I am a newbie and also had the bronchoscopy.  It was no big deal.  I didn't even get a sore throat.  It was day surgery and home that night. It was waiting on the pathology report and the referral to the first oncologist appointment that took 2 weeks that was nerve wracking for me.  Hang in there and keep us posted.

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