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81 year old dad diagnosed with 10cm Mass recently


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Hi,
My 81 year old dad just got diagnosed with 10cm lung mass and pulmonary nodules. 
He is also a COPD patient who went every 3 months for chest x-rays and on the last chest x-ray he was told about the 10cm lung mass and pulmonary nodules. We were shocked as just 3 months ago, his chest X-ray was clear. How can a mass grow 10cm in 3 months?  We are beyond disbelief? So far they have done a needle biopsy and CT scan. Bone scan is clear. They have sent him home to wait for the biopsy results which are sent out to Mayo Clinic for 2nd opinion. They are saying it takes 2-3 weeks for Mayo Clinic to get back. 
Is this how it goes normally the process once they see a lung mass?  We are so lost and currently are managing his Shortness of breath with inhalers and nebuilzers as he is also a COPD patient. Please let us know if we need to be doing something we are not doing . Oncology office says wait for results. Is this normal process? Thanks 

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Hi, Nav, and welcome.

Yep, normal procedure. It's important to get all the diagnostic testing done before any treatment begins, because the wrong treatment can be not only ineffective, but actually harmful. It sounds as if they are being appropriately thorough. You will know more when they are able to identify the exact type of lung cancer he has. You want to be sure they send out his tissue samples for molecular testing--it sounds like that's what they are doing but you want to make sure. If he has one of a few specific mutations, his cancer might be treatable with targeted therapy (a pill) rather than chemo. 10 cm IS pretty fast to have developed in 3 months. Hopefully they can get a handle on a treatment that will get this under control.

Glad you found us--this is a great place for information and support.

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Nav,

I'm very sorry to learn of your father's diagnosis. About 30 days before my diagnosis, I had an x-ray for broken ribs. My GP and I both looked at the film (film in those days) and noted broken ribs. Nothing else was seen. A month later, after coughing up blood in an emergency room, the doctor showed me an x-ray with a 7cm by 2.5cm tumor completely blocking the main stem bronchus of my right lung. So can tumors grow fast? Perhaps but I believe the truth is growth plus limitations of x-rays to detect lung tumors.

On the biopsy wait, these days there are 2 types of testing performed for lung cancer. A pathologist's histology examination and a follow on laboratory test to check for tumor mutations. The results of the former diagnose the type of lung cancer and this diagnosis ought to be documented now in your dad's medical records. The latter check for the presence of certain biomarkers that might dictate the type of treatment given to your dad. A 2 to 3 week turn-around on biomarker testing sounds about right.

Is this a normal process? Yes except you ought to know the type of lung cancer your dad has right now. We understand lost! We've all been there. I do hope biomarker testing results in a treatment plan that arrests your dad's lung cancer.

Stay the course.

Tom 

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It took 2 weeks for my biomarker test to come back. Biopsy was much quicker. This is when waiting is the hardest, but it's essential to first determine whether there are any targetable mutations so a proper treatment plan can be created. For now, using an inhaler and nebulizer will help alleviate the SoB. 

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Hi Nav and welcome! I don't have much to add to what other members have posted. One thing I do want to clarify, since it can be confusing. One poster referred to molecular testing and others to biomarker testing. These are the same thing. It is testing for mutations in the actual tumor itself, based on a tissue sample from the biopsy. It can also be called tumor genetics. Biomarker is the most common name. There may be specific targeted therapies depending on the biomarkers. There is also a recently develped form of biomarker testing sometimes called liquid biopsy, based on blood. 

This is not the same as the genetic testing for inherited risk of specific cancers, which is often called germline testing, but sometimes just called genetic testing . This kind of mutation is found in all the cells of the body, not just in tumor cells.  The inherited mutations many people are familiar with are BRCA mutations which increase risk of breast and some other cancers.  These tests are done on blood or saliva. 

I hope this is clear. It took me a while to figure it out!  Let us know if you have other questions and how we can support you.

Best wishes to your father.

Bridget O

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