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Steph1235

PET Results & VATS

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Hi everyone, well I finally got my results back from PET and news was great!  No sign of "C" in any lymph nodes and the nodule did not have any uptake either.  My pulmonologist said it was good news but still wants me to have the nodule out.   I met with the Thoracic surgeon and he first thought that I could wait and see for another 3 months.  He made a comment about minimal growth and I asked him if he looked at the CT from December?  Turned out he only looked at the CT from May and August.  With the additionally data point from December he thought we should take it out.  A biopsy would be difficult as its right up against the lung wall so that would have a greater risk for lung collapse.   He indicated that he thought the nodule was maybe 30%-40% malignant...he also said he wouldn't be surprised if it was benign.   Anyway, after all this I am scheduled for VATS wedge on 9/16.   I am very very nervous but feel this is the best possible outcome I could of received and removing the nodule will provide me with further reassurance.  I just hope I'm doing the right thing.

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Steph,

If I was in your situation, I'd make exactly the same decision.

I had pre-surgical conventional radiation and chemotherapy to shrink my tumor and allow margins for surgery.  I had a very, very good response, so much so that the radiologist's note even questioned if I ever had a tumor.  That prompted a discussion about the need for surgery with my medical oncologist.  He said: "I want to picture your tumor on the examination table. When out of your body, what harm could it be." We went forward with surgery.

PET uptake is variable with small nodules.  Some display it, some don't and sometimes those that don't are malignant.  So I think you made a really good decision.  Now, start the pre-surgery checklist.

  • Buy a wedge pillow to elevate your thorax and help you sleep at home after surgery. Go to a mattress store and audition the pillow, but buy online for better pricing. 
  • Tell family and friends no visitors after surgery. The worst thing you want to do is pick up a bug that leads to a chest cold or pneumonia. Especially, no school aged children till after your sutures or staples are removed.
  • Get a script for lidocaine patches (Lindoderm 5%). They do a fine job of eliminating pain in the suture areas. You'll have small incisions with VATS but they might be painful.
  • You may be discharged with a chest tube installed. These are no big deal, read about them here. You won't feel any pain while it is placed because of surgical anesthesia and removal is a piece of cake. You may need to change dressings if you are sent home with one. Ask your ward nurse for a "basic load" of dressings.
  • You will most likely be up the day after surgery and encouraged to lap the ward.  Laps are good and enhance recovery. 
  • Your respiration therapist will introduce you to a spirometer.  It is a device with graduated tube and a ball.  You'll be encouraged to take deep breaths and blow into the spirometer and keep the ball at a constant level.  Every day the level will get higher.  First day will be painful but cooperate and graduate.
  • Bring your own slippers with rubber soles. The hospital socks with rubberized bottoms are horrible.

Others may have more checklist items to add. It has been a long timer since my surgeries.

Stay the course.

Tom 

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Hi Steph, I am in a similar situation to yours, they discovered a nodule after having a ct scan on New Year’s Eve last year looking for pneumonia! Little did I know how much my life would change after that. The worry is beyond anything I have ever experienced before, but I have learned after 4 ct scans, a pet scan, and a bronchoscopy with biopsy that the doctors just do not know enough yet about these nodules showing up on all of these scans! Glad you can do a wedge surgery, that is optimal and less invasive! Mine would be a large section of my left lung taken out due to the location of the nodule. I have had so many opinions about my situation, 2 Pulmonologists, 2 Thoracic surgeons, 3 different radiologists read my scans which showed no uptake on pet scan, no growth in 6 months, and no cancer anywhere, but......I guess even though thats good news, it could still change! Good luck to you with your surgery, I will be rooting for a great outcome for you.

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