Biopsy results

[JerseyRose]

Last week, I had a CT guided needle biopsy done at the hospital and it wasn’t nearly as bad as I imagined it would be. Actually the only thing that hurt a little was the injection that I got containing the local anesthetic. Everything else was a piece of cake. Well, after waiting a week, my Interventional Pulmonologist called me today to let me know that my test results came back positive for an adenocarcinoma. The doctor didn’t tell me much other than saying I need to make an appointment with my oncologist to determine if she wants me to get radiation treatments or lung surgery. He also recommended that I get another PET Scan to see if my lung nodule has increased in size since my last scan on August 17th. ( it was previously 1.5 cm) Now I’m really confused because I thought surgery was my only option for Stage I lung cancer. I I sure hope I can get some answers to my questions real soon because not having a game plan is really testing my patience. 

[Tom Galli]

I happy your biopsy was an easy procedure. While surgery is the preferred method for treating a stage 1 diagnosis, sometimes tumor location complicates surgery. Precision radiation can be as effective as surgery. I’d have a consultation with a thoracic surgeon and radiation oncologist. Let your medical oncologist act as team captain and explain the surgeon and radiation oncologist treatment opinion. I’d also ask your medical oncologist about sending biopsy samples for follow on laboratory testing to learn if your lung cancer can be treated with targeted therapy. But, some insurance does not cover this procedure for low stage diagnosis. I’d ask anyway. 

Stay the course. 

Tom

[LouT]

Rose,

I think Tom gave you the best advice.  Treatment can be different for what "appears" to be the same symptoms, but have underlying differences.  Stay calm and ask all the questions about why a certain course is best for you and if any other course is also possible.  Hang in there and stay strong.

Lou

[LexieCat]

Yup, ditto what Tom said. Before surgery they will also want to do pulmonary function tests, to be sure you can continue to breathe well with part of a lung missing. There are other options like radiation to treat tumors if surgery isn't a good option.

The waiting for test results, follow-up, etc., is the worst part for all of us. But remember, it's important to nail the RIGHT treatment for the best result, so gotta go through the drill. 

I'd be very surprised if they order another PET scan at this point--they are incredibly expensive and insurance doesn't pay for them to check for growth of the tumor. You had one not that long ago. I'd bet you'll get a CT scan--those are perfectly adequate to determine the size of the nodule. If there were no signs of metastasis when you had the first PET and your nodule is as small as it is, I doubt another one is necessary at this point. I got a PET-CT back in 2017 before my surgery, and another when my Stage IV was diagnosed this year--in all that time in between I never had another PET. I was told they do them only when there are signs of progression or a change in treatment is being considered.

Keep us posted!

[Judy M2]

JerseyRose, please ask if your biopsy is being sent for biomarker testing. This can take a couple of weeks, so your patience may be stretched a little more. I just saw that targeted therapy (for treatable gene mutations) is being approved for early stage lung cancer. This is quite a breakthrough. In any event, let us know how your team suggests you proceed. Good luck to you.