Need some words of comfort please....

[lukejames]

3.31.2022

Hey everyone.  I just saw my main Doctor today and I after a chest CT scan a yesterday and this is what they found.  I see a lung specialist soon, but I sure would like someone to help me understand what all of this/below means.  I am very scared and worried.  I am 61 years old, weight 253 lbs, 5' 10" tall, never smoke anything ever, but I have worked in some dusty chemical in the air factories and still am the last 18 years.  My parents passed away a few years ago with really bad lungs.  Please help.  Thank you.

TECHNIQUE: CT scan was performed through the chest without intravenous administration of contrast.

FINDINGS:

LUNGS: 15 x 9 mm irregular spiculated bilobed nodule in the posterolateral right upper lobe series 4 image 39. A couple of new 3 mm pulmonary nodules in the left lower lobe for example on images 123 and 136. New 3 mm posterior medial right lower lobe nodule image 115. Few additional tiny 2 mm micronodules also noted bilaterally. Couple of small areas of scarring in the right upper lobe for example on images 21 and 23, similar to previous.

PLEURA: No pleural effusion or pneumothorax.

MEDIASTINUM AND HILA: There is new mediastinal and right hilar lymphadenopathy. For example, 12 mm short axis mediastinal lymph node immediately anterior to the right mainstem bronchus series 3 image 61. 10 mm short axis right hilar lymph node image 66. Mild atherosclerosis.

CHEST WALL: Multilevel bridging anterior endplate spurs in the spine.

UPPER ABDOMEN: Hepatic steatosis. Nodular thickening left adrenal gland, nonspecific. Atherosclerosis.

IMPRESSION:
1. 15 x 9 mm irregular spiculated bilobed nodule in the posterolateral right upper lobe highly concerning for malignancy until proven otherwise. Finding correlates to the chest x-ray abnormality reported on 3/5/2022. Recommend biopsy.
2. Few new pulmonary nodules bilaterally measuring up to 3 mm in size, nonspecific. Short interval follow-up recommended.
3. New mild mediastinal and right hilar lymphadenopathy.
4. See other findings above.

NOTE: An individualized dose reduction technique was for the above procedure, including automated exposure control

 

[BridgetO]

Hi Luke and welcome! I'm glad you found us. It's good that you had this CT and that you're seeing a lung specialist. Based on what's in your report, you've got some abnormalities in and around your lungs, but without further testing, there's no way to know if you have lung cancer. If a person does have lung cancer, the earlier it's found the easier it is to treat.  It's a very scary time you're in and it's normal to be scared. Here's how I would interpret your report. 

Most nodules found in lungs aren't cancer. They can be infections, inflammation, or scar tissue, for exampleThe 15x9 mm nodule is smallish.  "Spiculated" means it spiky or star shaped and nodules of this shape are suspicious for cancer. As the radiologist says, it needs a biopsy. There are several ways to do this, depending on size and location of the nodule. Some can be done with a needle through the chest wall and some with a bronchoscope, a device that goes down your bronchial tube. My nodule couldn't be done that way and had to be biopsied surgically. Those little 3mm nodules are probably too small to biopsy and need to be watched.

Lymphadenopathy means something doesn't look right in some of your lymph nodes. Mediastinal are in the mediastinum. the space between the two lungs and hilar are in the area  near the middle of the lung where the bronchial tubes and blood vessels go in. They may want to biopsy some of those, too. The rest of your findings probably don't relate to lungs. 

Of course you're scared! We've all been through this Being a non-smoker reduces your risk of lung cancer, but anybody can get it, smoker or not. Dusty factories could be a factor,  but might also be a cause of some other problem in your lungs.  No way to know any of this until you have a biopsy.

 My nodule, which was just a tiny bit smaller than yours, turned out to be cancer. I had a lobectomy (removal or the lower 3rd of my right lung. They took out and biopsied a whole lot of lymph nodes, which weren't cancerous. The surgery was done by VATS (video assisted, done through 3 small incisions) and was pretty easy as far as surgeries go. I didn't need further treatment.  My surgery was in 2016 and I've had no evidence of cancer since. 

Hang in there, Luke. Ask us any questions you may have and let us know how we can support you.

Bridget O

 

[lukejames]

Bridget, thank you so much for your reply, it means allot.  I'm just starting this journey that I don't want to take but knowing that someone like you is there is a Godsend.  I will let you all know what is going on next.  Thank you.  

[LouT]

Luke,

Bridget has give you a lot of very good information.  Before we go any further let's see what the diagnostic process finds.  The diagnostic process can be a very stressful time to go through.  Here is some good information on the diagnostic process to help you navigate it and make it an easier process for you.  It can be found here.

Once you have a diagnosis, and if you need us, we'll be here to support you through this.

Lou

.

[lukejames]

Thank you so much Lou, I see my "lung doctor" today.

[Justin1970]

Hi luke these are scary times but you really will get some great help from this site, most of us go through this stage but once we get a clearer picture of it all I'm sure you will start the journey of fighting this please stay as strong and as positive as possible, I wish you all the best for good results 

Many thanks Justin 

[lukejames]

Thank you Justin, I appreciate it.

[lukejames]

4.5.22

 

Hey everyone, I had my first PET scan yesterday and I got these test results below just now.  Im not sure, but it looks like I have lung cancer.  This is what I have scheduled on 4.7.22:

MONARCH - Monarch robotic bronchoscopy with biopsy, .

Performed by Benjamin Jason Seides, MD

EBUS - Linear probe EBUS with biopsy, REBUS - Radial probe EBUS with biopsy, FLEX - Flexible bronchoscopy with biopsies, Percepta/Veracyte Genomic testing.

 

These are the results from the PET scan today:

TECHNIQUE: A series of overlapping emission images were obtained. The area imaged spanned from the orbits to the mid thighs. A low-dose CT was performed for attenuation correction purposes. 15.5 mCi F-18 fluorodeoxyglucose (FDG), IV. Uptake time 50 minutes. Blood glucose 109 mg/dL.

FINDINGS:

HEAD AND NECK:
There is physiologic uptake in the head and neck. No hypermetabolic cervical lymphadenopathy is identified.

CHEST:
There is hypermetabolic right paratracheal lymphadenopathy within SUV max of 3.5 (image 87). There is hypermetabolic right hilar lymphadenopathy with an SUV max of 2.6 (image 92).

There is hypermetabolic activity corresponding to the reference 15 mm pulmonary nodule with an SUV max of 3.1 (image 79).

There are scattered pulmonary micronodules which do not demonstrate hypermetabolic activity below the resolution of PET/CT and appear unchanged when compared to the prior study.

ABDOMEN PELVIS:
No hypermetabolic lymphadenopathy in the abdomen or pelvis. There is physiologic uptake in the abdomen and pelvis.

Note is made of diverticulosis without evidence of diverticulitis. There is a moderate-sized periumbilical hernia. There are vascular calcifications of aorta and its branches. The patient is status post cholecystectomy.

MUSCULOSKELETAL:
No hypermetabolic lytic or sclerotic lesion is identified.

IMPRESSION:
1. Hypermetabolic activity corresponding to the reference 15 mm pulmonary nodule in the right upper lobe suspicious for primary pulmonary malignancy.
2. Hypermetabolic activity corresponding to mediastinal and right hilar lymphadenopathy suspicious for metastatic disease.
3. No hypermetabolic activity corresponding to the reference indeterminate pulmonary micronodules which are below the resolution of PET/CT examination. Continued follow-up examination is recommended.
4. Other findings as described above.

 

Thank you, I am doing my best to keep my chin up.

[LouT]

Okay, time to take a closer look at some aspects of Lung Cancer, even though the PET Scan indicates malignancy, a biopsy would be in order to confirm that diagnosis.  And when they do that you need to request biomarker testing, if only for future potential treatment options.  In the meantime I'd like you to take a look at a blog called "10 Steps to Surviving Lung Cancer; from a Survivor" and it can be found here.

Lou

[lukejames]

Lou there has always been angels in my darkest moments in my life and this is  sure one of them thanks for being there I have a biopsy tomorrow and all kinds of other things he is going to look at while they’re in there it’s gonna go down my throat with the tube it’s about four hours so I guess I’ll see what happens and I’ll ask for Biomarker testing. Thanks again Lou. 

[Justin1970]

Hi luke 

Goodluck with the biopsy it's not as bad as you think I had a good anaesthetic that knocked me out, I didn't remember anything it is dreadful waiting for results but stay strong and positive and you will get through this 

All the best Justin 

[lukejames]

Thank you Justin. One day at a time

[LouT]

LukeJames,

You're not alone in this now.  We'll be here with you.  There is a lot of information and experiences to share.  Ask any questions you have and know that you are in our thoughts and prayers today.

Lou

[lukejames]

Thank you LouT!

[lukejames]

4.8.22

Hey everyone, I had my BRONCHOSCOPY procedure yesterday.  They will be sending the samples of the lungs, etc. out to see what it is.  They even used the ad of a robot scanner or something.  It all took about 6 hours from start to finish.  They took an X-Ray before I woke up of my lungs.  I know the Xray does not show what the biopsy with show/tell, but maybe the x-ray is a ray of hope.  I have an appointment on the 13th of this month with my Lung Doctor who did the biopsy and then he will tell me what is going on.  When I woke up my lung doctor who did this procedure looked at me and said, "I think it is an infection".  I was just waking up, so I hope I heard him right.  Can't get my hopes up are down, just have to wait until the 13th.  I did copy/paste that x-ray below to see what you guys think, I know it is an experienced opinion and I really need that right now.  Thanks, and love.

Study Result

Narrative

Chest portable, 4/7/2022 4:48 PM

Indication: Shortness of breath

Comparison: 3/5/2022

Findings:

The heart size is within normal limits. The mediastinum is unremarkable. The pulmonary vasculature is not increased.

There are increasing infiltrates around the nodule in the right upper lobe. Remainder of both lungs are grossly clear. There is no significant pleural effusion or pneumothorax.

There are degenerative changes of the thoracic spine.

Impression: Increasing infiltrates around the nodule in the right upper lobe.

[Tom Galli]

Luke,

You may (hopefully) have an infection. Your PET scan SUV magnitudes were border line. Here is more insight into understanding PET SUV.

Let's hope your association with this site is short indeed because the biopsy does not yield a lung cancer finding.

Stay the course.

Tom

[Justin1970]

Hi luke

I'm really praying for great results for you try and stay positive all the best 

Justin 

[lukejames]

I will Justin1970, thank you.  I will find out the 13th what the biopsy samples hold when I see my lung Doctor.

[lukejames]

7 hours ago, Tom Galli said:

Luke,

You may (hopefully) have an infection. Your PET scan SUV magnitudes were border line. Here is more insight into understanding PET SUV.

Let's hope your association with this site is short indeed because the biopsy does not yield a lung cancer finding.

Stay the course.

Tom

Tom Galli, that would be great.  but those readings that I gave where from the portable Xray that they took right after the lung biopsy right before I woke up.  I will get the biopsy results when I see my lung Doctor on 4.13.  Thank you.

[LouT]

All fingers and toes crossed for you.  In the meantime, take to time find things that make you smile and let you appreciate your day.  Worrying about a result does nothing to make it either a good or bad result.  Tom Galli actually came up with a term for it, he called it "Scanziety" and we all now use that term pretty much whenever we are awaiting the result of almost any test.  Hang in there.

Lou

[lukejames]

4.12.22

 

Hey Everyone, I just got this test result a second ago.  I am not sure if it is the entire BRONCHOSCOPY with Monarch robot, are just a part of it.  I know they sent off the biopsy sample(s) last week.  I hope what I do have below is good news, sure need your all's experienced opinion right now.  Thanks.

CULTURE: AEROBIC AND ANAEROBIC WITH GRAM STAIN, TISSUE/BIOPSY - Details

Component Results:

Aer/Ana Tissue Culture:       Light Growth Mixed gram positive organisms, no Staph aureus or beta strep isolated

Resembles Normal Respiratory Flora

Aer/Ana Tissue Culture:         No Anaerobes Isolated

Gram Stain Result:                 No organisms seen

Gram Stain Result:                  No Neutrophils seen

General Information

Collected on 04/07/2022 4:37 PM from Chest (Lymph Node)

Resulted on 04/11/2022 10:47 AM

Result Status: Final result

 

[Tom Galli]

Luke,

I don't see anything on the biopsy report that suggests lung cancer (or any cancer) in the tested lymph node. The primary diagnostic method for lung cancer is called a histology--a viewing of a thin section of tissue under a microscope by the pathologist. The cellular structure of lung cancer is easily determined by this method, and I don't see any indication the pathologist saw evidence of lung cancer.

On April 5th, you posted results of your PET scan. This showed low SUV for right paratracheal lymphadenopathy (SUV=3.5), right hilar lymphadenopathy (SUV=2.6) and a 15 mm pulmonary nodule (SUV=3.1). The biopsy report is not specific about which lymph node was sampled but no reference to adenocarcinoma, squamous cell, large cell or small cell is indicated. Perhaps this biopsy ratifies the low (marginally high) uptake values of the PET.

Hopefully, you dodged a bullet.

Stay the course.

Tom

[lukejames]

Thank you, Tom, for the words of encouragement and hope.  I'm not sure which lung, but maybe they did both, not sure.  Tomorow I will ask that if my pulmonary doctor does not tell me first.  I pray it is an infection that can be cured by antibiotics.  I wonder if I should have waited to get my 2nd booster shot Moderna a few days ago?  Still so many questions but I see hope.  Thanks again.

[lukejames]

I just saw my Pulmonary Doctor for the results of my BRONCHOSCOPY with Monarch robot, and he looked me in the eyes and said, "NO CANCER"!  I wanted to cry.  He did say that he is 85% sure it is an infection are a virus, not sure.  He already ordered more blood, urine, and a percutaneous biopsy of nodule very soon.  Sorry that this is so long, I am just copying and pasting and not sure how to edit to make it smaller.  I just wanted yo all to know.  Thank you all for being there and will keep you posted.   As always, I appreciated your experienced opinion.  God Bless!

 

Pathology:

4/7/22

A. Lung, right upper lobe, fine needle aspiration and cell block:
            -Satisfactory for evaluation.
            -Negative for malignancy.

            -Few groups of benign respiratory epithelial cells.
            

B. Lymph node, 4R paratracheal, fine needle aspiration and cell block:
            -Satisfactory for evaluation.
            -Negative for malignancy.

            -Lymphocytes present.

 

Right lung, upper lobe, nodule, transbronchial biopsies:

-Fragments of benign lobulated lung parenchyma.

-No granulomas or evidence of malignancy are identified.

PFT DATA:

PFT Results

4/6/2022

FVC

3.74

FVC % Pred

79

FEV1

3.00

FEV1 % Pred

84

FEV1/FVC

80.21

FEF 25-75%

3.21

TLC % Pred

107

FRC

4.22

FRC % Pred

129

RV

3.14

RV % Pred

131

DLCO

24.8

DLCO % Pred

88

 

 

Last 3 CO2:

CO2

Date

Value

Ref Range

Status

10/14/2020

26

23 - 31 mEq/L

Final

 

Carbon Dioxide

Date

Value

Ref Range

Status

12/06/2021

28

21 - 31 mmol/L

Final

05/18/2021

27

21 - 31 mmol/L

Final

 

 

Last ABG result:

No results found for: DEVICE, SAMPTYP, PHARTBLD, POTARTBLD, BAEXARTBL, HCOTARTBLD, HEMGLBNARBL, HCTARTERIAL

Plan:

Preponderance of the evidence would suggest a non-malignant etiology and we are still awaiting a few serological tests to further risk stratify. Suspect infectious (poss fungal) but no growth on cultures as yet and we will await. Will also check a few additional fungal and inflammatory markers. Have offered a program of close radiographic follow-up to monitor nodule and await additional serological tests versus additional biopsy for more tissue. He is anxious to arrive at a conclusion as soon as possible and so would like to proceed with percutaneous biopsy of nodule. Will refer to IR, get additional test.

[LouT]

LukeJames,

I can't tell you how happy we are that you have no cancer.  Now, get out of here and go live your life!

Lou