New here - looking for advise for my 84 year old grandma

[Beth_90]

Hi all! Firstly I apologise for the long winded post and if I’m in the wrong place but I came across this forum when searching for answers and advice for my grandma who isn’t upto date with today’s technology and asked me to post for her! So our ( I say our as my grandma lives with me and my little girl so I'm here on this journey with her ) all started a few weeks ago when I contacted her GP to request some build up drinks as her appetite isn’t the greatest and I was worried she would be lacking in nutrients etc, she had recently just had her yearly general health check with her bloods being taken and all was fine. Dr said that due to her BMI being fine they wouldn’t prescribe the drinks.
Long story short to this part he said due to her being a smoker he would send her off for a chest X-ray. Little did we expect she got a call back within hours of her X-ray to say it had shown 2 shadows on her left lung  and for the X-ray to be repeated in a months time. 
Again, she got the call the shadows still there and was being fast tracked on the 2 week cancer pathway due to her history of smoking. Last week she had her first CT scan, then today, we have been to her lung health appointment and feel slightly deflated and not really knowing what to expect, consultant has said on her Ct scan there is a suspicious area and he can’t say for certain it is cancer but if it is to be then it’s likely to be adenocarcinoma? The report from the Ct scan still wasn’t back so he was unable to really give much else but is expecting the report to be fairly much the same as what he has told us today. He’s requesting she goes for a PET scan and lung test, which possibly a biopsy. Our questions I guess are, how are they able to say it’s likely to be adenocarcinoma but can’t be certain it’s cancer and if it is to be then there is things they can do, grandma is 84 and won’t stop smoking ( fully her decision as she doesn’t really do much else ) has anybody dealt with this before and does the fact she has to go for a PET scan indicate they are fairly confident on a cancer diagnosis? 
 

thanks so much for anybody who has taken the time to read this 😊

[LouT]

Hi Beth,

Sorry you need to be here, but glad you found us.  Sometimes the diagnostic process for this disease alone can make one crazy.  It needs to be exacting, definitive, and accurate.  I can tell you know that while CT and PET Scans have a place in diagnosis the definitive diagnosis is made via a biopsy.  So shadows, nodules, and other abnormalities could be indicative of cancer the biopsy is the only definitive tool to determine malignancy, and other factors (i.e., genetic markers).  Please take a look at "Navigating Your Diagnosis" and you'll see the difference between screening, markers, and definitive diagnosis.  You need to get to the biopsy stage for a true diagnosis.  Along with that you also want to know what genetic markers may be impacting the findings.  Once you have that data settled you will begin to look at what treatments are available to help your Grandmother.  So while it may be possible or even probable that it is cancer we don't pull the trigger on anything until it's been diagnosed.

I'm not fully familiar with the UK health system but others here are and I'm sure that you'll hear from them soon.  In the meantime please keep us updated and ask any other questions you may have.

Lou

[BridgetO]

Hi Beth and welcome. Lou's information and advice is excellent. I just want to add something in answer to your question about the PET scan. Ordering a PET scan means that the doctor is suspicious that what the CT shows could be cancer. A PET scan shows areas in the body where there is high metabolic activity. Since cancer cells usually grow faster than normal cells, cancer will normally "light up" on a PET scan. If the suspicious areas in the lungs 'light up" it definitely increases the likelihood of cancer, though, as Lou says, only a biopsy is definitive. If the cancer has spread to other parts of the body, those would likely register, too. The higher the numbers on the PET, the higher the likelihood of cancer.

Some things to know, though:  sometimes other things like infections can also register on the PET, and sometimes cancers don't. My adenocarcinoma didn't show up there because it was small and slow growing , so not enough metabolic activity to register.  Even though the PET isn't definitive, it does give the doctors information about whether to proceed with biopsy or to look for other causes for the abnormalities on the CT and Xray.

If you let us know when your grandma has more test results, and what questions you have, we can probably give you more information. Let us know how we can support you.That's what we're here for!

Bridget O

[Karen_L]

Hi Beth,

The reason he says "if it's cancer, it's probably adenocarcinoma" is because that's the most common type of LC. The diagnostic process is a long one and involves multiple tests and processes, the PET being one of them. 

I don't know much about your health care system, but you will need some info about how to be an effective advocate. I have a good resource posted in my footer. 

I also don't know how they will respond to her case if she is not planning to give up smoking. 

Best of luck as you and she move ahead in this process. You might find the caregiver strand here helpful as well. 

Karen