Introduction...3.5 cm Right Lower Lobe mass

[KM_NRP]

Hello everyone,

Glad I some how stumbled across this site.  I'm a 53 year old female.  Never smoked, no family history, etc.  I did have a moderate case of Covid in May 2020.  I have received both vaccines (I'm a paramedic) with the 2nd on 2/05/21.  On 2/15/21, I went for my annual physical for my career.  Every 3 or 5 years a routine chest X-ray is done.  Mine noted a 3 cm mass.  Had a CT which showed suspicious and said to follow up with more test.  Saw a pulmonologist Wednesday who says it looks like cancer but ordered a PET scan then biopsy type following PET scan results.  Edges were a little rough. Single mass, slight enlarged lymph node (pulmonologist didn't seem real convenience on the lymph node due to clarity of the images)

I did have a course of steroids for my asthma but it was well controlled.  Normally well controlled.  

I have been trying to find anything on Covid related masses but coming up dry.  IF, this is a covid thing, its still very early to see many cases of this type yet, hence the lack of information.  

Any information anyone would like to share, I'd appreciate.  

 

Thanks

~K

[LexieCat]

I haven't heard of COVID-related masses, which isn't to say they don't exist. 3 cm is large enough to be concerned about, though. The PET-CT and biopsy, if possible, will tell you a lot more. 

[GaryG]

Hi and welcome. I am very surprised that the pulmonologist thinks it is cancer just from looking at a CT scan. As Lexi said, for now your best bet is to wait for the PT and biopsy results to find out. Waiting is difficult but there are no alternatives to the tests even if someone had the same experience with Covid-19.

[Mamma Om]

Hello K. Sorry to hear of your mass. I have heard of women turning up with breast "lumps" following COVID, revealed at routine mammograms. I don't think they were cancerous, though. I didn't follow up with the findings. I also am surprised that the pulmonologist would say "Cancer" without a PET and/or a biopsy. I know from experience that the appearance of a nodule or mass can indicate the state of it, but only a biopsy can say for sure what it is. I had a small nodule in my right lower lobe at age 75, had surgery to remove the lobe, and the pathologist found a 2nd tumor in there, and it was even a different kind of cancer. Luckily, though, removing the lobe and the cancers was all the treatment I needed. Unfortunately, there is another 2+ centimeter nodule in the middle lobe, called a spiculated, ground glass appearance that the doctors are watching with CT scans, but I finally have the Ins. OK for a PET/CT. I am allergic to the CT contrast medium so that makes it harder to see. I have also had breast cancer twice and thyroid cancer, but here I am!! Best wishes, have the tests you need, and know that we are still learning about COVID and its effects. I hope your mass is just an anomaly and clears up. Mamma-Om

[TJM]

Welcome. 3 cm is a pretty good sized little bugger. With the lymph nodes I would be pretty suspicious.

So. Cancer or not, you are learning the first lesson of the cancer struggle, hurry up and wait.

Keep us informed.

Peace 

Tom

[Tom Galli]

K,

Welcome here.

Can COVID cause residual nodules? I wouldn't know but pulmonary nodules form for a lot of reasons and most are not cancer. Here is my go to resource for explaining why? After 17 years surviving lung cancer, my CT scans still show nodules. Mine appear, disappear, get larger and smaller, and I track them with a spread sheet to preserve my sanity.

Here is information about your PET scan that might help you understand the process and how results are characterized. This is a good place to pose your questions after you get your PET results. I do hope your nodule is of the "phantom" variety.

Stay the course.

Tom

[LouT]

K,

Welcome to our forum.  A 3cm growth is concerning, but all of us here have learned the lesson of waiting for all tests to be done before we go down one road or another.  So please read the info that Tom mentions (it's very good) and come back here with any questions you have also, make it a point to do a few things:

1.  Write down questions you have for the doctor as we can often forget them when we are nervous.

2.  Stay away from Dr. Google, there is little help there and even many of the stats are outdated because they run on 5-year averages and don't show the present rates for recovery, survival and such.  Stick with your medical team and what you'll read and learn here.

3.  Keep your mind in the present, until you have a diagnosis don't make any conclusions.  Once you have a diagnosis make sure you learn all you can about it, how it was concluded and (if needed) what treatments yield the best results for any condition you may have.

Good luck with your tests and please keep us posted.

Lou

[KM_NRP]

Thank you so much Lou.  That is great advice.  I have been reading Tom information as a resource. 

Dr. Google...and WebMD....the nemesis to all patients over their healthcare professionals.  

Currently, still waiting on a PET scan time but should be Thursday now.  The hospital / insurance pathway for preauthorization got unlinked somewhere.  I had to call insurance this am, who said they hospital called about preauthorization and they were told how to do it.  However, the insurance says they received no request from them.  

Therefore, I suspect I should have some results on Friday, 3/5.  I'll be back to update then.  

Thank you to everyone for their information, support and great advice.  Some of it I know, but need to be told by someone else to get it in my head!

~K

[LexieCat]

One other suggestion--everyone is different about this but I prefer to make sure I don't see scan reports before the doc has a chance to discuss/explain them. I've had several instances where the oncologist or other doctor disagreed with the radiologist's take on it, and if I'd read the report on my own I would have been freaking out a bit. Plus PET-CT results are often not definitive, and you need for a doctor to explain the significance of the results.

Just my experience--YMMV.

[Judy M2]

Exactly what @LexieCatsays!  My oncologist doesn't even post the scan reports to the patient portal until he has discussed them with me first. 

[Jesse L.]

To be honest I've never actually seen even one scan of me yet...and I think after deliberation I prefer it that way. What do I know what those scans say? I'll just leave it up to the professionals to inerpret... That's their job along with knowledgeably informing a patient and laying out the best plan of attack.

My only problem with this is when the team waits seemingly like forever to tell a person what the scans indicate. Scansxiety is a real thing!! I told my Oncologist that yesterday and she was taken aback as to the relevance of the term. All I can think is what do these Dr.'s think that we are thinking? 

Of courose we want to know as soon as possible...sheesh!!

[Judy M2]

@Jesse L., I've never seen one of my scans either, only the radiologist's report, and I really need my oncologist to interpret all the mumbo jumbo. I usually have to wait several days, and up to a week, to get my PET scan results. The report isn't posted to the patient portal until my oncologist reviews it with me. So I have learned to be a patient patient. 

[Jesse L.]

All I ever really got so far was from the Dr. In radiology quickly explaining the TNM and the corresponding numbers 1 to 3 that go with those letters. Direct from my Tumor Board I was told that I was a T1 N2 M0. From her perspective that was good in that it showed a very treatable disease.

And so far so good through seemingly endless scans no other masses found anywhere. 

That dosen't mean that I'm not freaking out though... cancer has been depicted as such a killer for so long that how can I but think they're looking to stamp me with an expiration date...soon. To be honest my first thoughts were to acquire an estate plan and I even went so far as to buy a headstone and burial plots for both me and the significant other as well. 

Then again maybe those are things I should have done long ago... After all I am 64 already and just living gets Dicier the older a person gets...

[TJM]

I'll be contrary to the consensus of the group here. I LOVE that they must post the results in the patient portals immediately now.  If the mumbo jumbo is to hard to understand just read the impression, it's like the summary.

I just had a scan on Monday, the results were posted by the time I got back home. Good results which saved me a lot of anxiety waiting for my appointment with my Onc. Even if it had been a bad result I, personally, want to know ASAP

 I always ask if they saw anything when the scan is done and they always tell me they cant discuss.

Peace

Tom

[LexieCat]

 

1 hour ago, Jesse L. said:

To be honest my first thoughts were to acquire an estate plan and I even went so far as to buy a headstone and burial plots for both me and the significant other as well. 

Then again maybe those are things I should have done long ago... After all I am 64 already and just living gets Dicier the older a person gets...

Hey, I updated my will and other info, myself, as soon as I was diagnosed. The way I look at it, I'd sooner do all that crap while I'm feeling good (and I'm the same age as you are--65 later this summer) than worry about it/struggle with it when I'm feeling sick. It makes me feel better, actually--like I'm controlling what I can. A bunch of things I no longer have to worry about. Worst case scenario, I live to be a hundred and spend all my money having fun in the meantime.  

[Judy M2]

I had all of my estate planning done in 2015, after I moved to CA. That included a power of attorney, health care advance directive, trust and will. So when I was diagnosed in 2019, I did not have any extra work to do. I have already selected a hospice provider (my palliative care team is part of the same organization) and a nursing home, should I need them. I'm not being morbid, just prepared.

[LouT]

Jesse,

Like you, I prefer to let my doctor read the results and tell me what he sees.  My problem is that one time I read the results early and was sure I'd be dead in a month.  After unsuccessfully trying to control his laughter, my doctor told me that I was stable, NED and misunderstanding most of what was written there.  So, I stay educated on the disease and treatments, but don't read my own scans.  That's not so different as singers or movie stars that never read their reviews.  So, we're in good company. 

Lou

[LexieCat]

LOL, Lou, I gotta remember that one--like reading my own reviews. Yeah, some things are just plain dangerous to one's mental health!

[KM_NRP]

Thank you all.  I had a Bronco Biopsy done and just got the results.  It is Adenocarcinoma.  The mass and one of the two lymph nodes were positive the other lymph node was "good".   Need my brain MRI and consult with Thoracic Surgeon and Oncology.  I am in good health and 53.  Fingers crossed; the surgeon can and will be able to successfully remove all the bad stuff.  

[LexieCat]

Hi, KM,

Sorry about the diagnosis but glad to hear things are moving along. What did the PET CT scan show? Since you have a couple of positive lymph nodes, there's a good chance you'll be getting adjuvant chemo after surgery (assuming you have surgery). 

Thanks for your work as a paramedic. I'm a retired prosecutor and have always appreciated the good work you folks do taking care of victims of violence.

[LouT]

KM,

Now you're coming to the part where you'll have a defined battle plan.  Once you know the approach there are many of us here that can share our experiences with you and that can help you go through your journey more easily.  Please stay in touch and ask us any questions you have.

Lou

[KM_NRP]

15 hours ago, LexieCat said:

Hi, KM,

Sorry about the diagnosis but glad to hear things are moving along. What did the PET CT scan show? Since you have a couple of positive lymph nodes, there's a good chance you'll be getting adjuvant chemo after surgery (assuming you have surgery). 

Thanks for your work as a paramedic. I'm a retired prosecutor and have always appreciated the good work you folks do taking care of victims of violence.

LexiCat, 

Thank you. PET scan only lit up on the mass and 2 lymph nodes that were biopsied.  Hence why I hope they can and will do surgery before it spreads. 

Retired prosecutor.... Tough job! But great that I'm sure doing that you made a real difference. 

[LexieCat]

Great--that's more good news. You should come through this without much difficulty. The surgery is actually pretty easy--most people get VATS, which is laparascopic. Three tiny incisions and most people go home within a couple of days at most. I was out for dinner and a concert with friends two weeks later.

And for me, the chemo wasn't too bad. I didn't have chemo till my recurrence (I was Stage 1b first time around with no lymph nodes). I'm now Stage IV, so I'll be on maintenance therapy (chemo/immunotherapy) indefinitely, but the initial chemo had relatively mild side effects (mostly fatigue and brain fog). Yeah, unfortunately lung cancer sometimes recurs so you will want to stay on top of your followup scans, so if that does happen you can jump right on it. 

Keep us posted!

[LouT]

KM,

If your medical team decides that surgery is the approach then you should take a look at some Tips and Tricks on how to prepare, get through and recover from thoracic surgery.  It can be found here.

Lou  

[KM_NRP]

Thank you Lou