Appointments scheduled

[JerseyRose]

I finally have my first PET CT scan scheduled for August 17th, followed by appointments with another Pulmonologist and Oncologist on August 24 and 26th respectively. I saw my first Pulmonologist last week and he is sending me for a TB test and breathing tests, which I’ll be getting before my PET CT scan. I also had to wear a finger oxygen level sensor overnight and take a 6 minute walk in his office to check my pulmonary function. The fact that I don’t have a car and have to rely on the senior bus service to get to my appointments means I have to schedule everything around the times the bus gets into towns and returns to my home. That why I’m waiting so long for everything.  At least I was really happy with the first Pulmonologist I saw. He was so nice and friendly and took the time to answer all my questions. He kept telling me that what is showing up on my CT scan doesn’t necessarily mean I have lung cancer, which helped me feel a little more relaxed.. He also told me that depending on what my PET CT scans shows , I may need to have a Bronchoscopy next.  I’ll be so glad when this waiting game is over and I get a diagnosis. Then I can focus on doing whatever the doctors recommend and go with the flow.  

[JerseyRose]

I also had a question to ask. If my CT scan report shows different types of nodules in both of my lungs and describes them as cancerous areas, wouldn’t that automatically mean I have stage 4 lung cancer if those areas later  light up on my PET Scan?  I was reading somewhere on line that cancer in both lungs is automatically stage 4 ,whether or not it traveled to other areas of the body. 

[LexieCat]

I don't believe they will stage you without a biopsy. PET CT areas that light up indicate hyper metabolic activity, which is highly suggestive of cancer, but I believe a biopsy is needed to confirm. 

While the spiculated nodule is something that might be cancerous (spiculation is a common indicator), the other nodules in your other lung might be nothing at all. Lots of people have nodules that are scar tissue or inflammation or something, which never turn into cancer. 

With any luck, yours might turn out to be a single probably-cancerous nodule that might be treatable with surgery. 

[LexieCat]

Just one other thought. The fact that you're being sent for pulmonary function tests suggests your doctor thinks you might be a candidate for surgery. They need to see whether your lung capacity is such that you can tolerate surgery and having a portion of your lung removed. If your capacity is insufficient they won't do surgery. Surgery is an option only for early-stage cancers. So my bet is that he is focused on that one large, spiculated nodule and not assuming that the others are cancerous. The PET scan will show whether any others are suspicious, but by getting the PFT now, you'll be better positioned to have surgery if that's feasible. 

[JerseyRose]

Thank you for that information Lexie. I hadn’t really considered what you mentioned. It all makes sense to me now , because the next doctor I see I was told is an Interventional Pulmonologist, who works closely with a Thoracic Surgeon at my local Cancer Institute. I got a call from someone in the office saying  this new doctor wanted to see me after my appointment was set up with the Oncologist in the same cancer center. 

[LexieCat]

Yup, that was the protocol followed when I was being evaluated three years ago. At that time, the focus was on a single nodule that had grown since the one-year-previous scan, which was also spiculated. When they did the PET CT, that was the only thing that lit up. The other nodules had been around for a while, and it's only recently that one of mine grew and then the PET CT had numerous glowing areas, suggesting it has metastasized. 

Not everyone has recurrences. So first things first is to find out what's going on with you NOW. Hopefully it's that one nodule and you can have what is really a pretty simple procedure. I was back to work and going out with friends two weeks after my surgery.

[LouT]

JerseyRose,

Lexie has already hit on all the salient points for you so please listen to what she has to say.  Don't get ahead of your medical team; it will only serve to make you anxious and have you guessing about things you (or we) never studied like the doctors have.  You'll get through this and we'll be here for support.

Lou