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PostPosted: Wed Oct 10, 2007 10:11 am 
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Joined: Wed Oct 10, 2007 9:48 am
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Location: Arlington, Texas
I am a 4 year breast cancer survivor new to this site. You all are such a wonderful encouragement to me. Please give me your advise on performing biopsies on both lungs for 8mm nodules. Oncologists has done scan every 3 months with slight internal nodule mass changes showing on last scan. He suggested waiting and doing another scan in November. regular oncologist out of the office and due to cough and pain around rib section sent me to a pulmonary specialist who wants to biopsy both lungs. He cannot confirm he will be able to biopsy the exact nods are they are so small, but will try. He also states due to the small size he may not be able to get an accurate reading. I canceled the biopsy and have decided to wait under the next scan when my doctor gets back in town. What do you all think? :roll:

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PostPosted: Wed Oct 10, 2007 3:40 pm 
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Faith,

I don't know if ANY of us can tell you what is what OR what you should do. It SEEMS that mm nodules are USUALLY too small to do anything about. My own DH has watched nodules for a couple of years now. BUT I would NEVER advise you what to do. Seems like you could get another opinion from another reputable facilty.

I sure hope it is nothing to worry about. Keep us posted as to what you decide and any outcomes of procedures done. In the meantime, let me just offer you a heartfelt WELCOME to LCSC.

Kasey

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Kasey ~ 8 year survivor ~ Stage IIIb 'inoperable' (yea, right!) lung cancer
9/20/04 Dx lc
9/24/04 Bronchoscopy
10/08/04 CT guided needle biopsy
10/14/04 Dx Pancoast tumor - NSCLC 111a(?) - inoperable - incurable
11/02/04 2nd opinion - Sloan-Kettering - concurs with local dx and tx
11/03/04-12/02/04 Radiation x22 chemo x5 taxol/carboplatin
11/04 - 3rd opinion - FoxChase -turned away
11/04 FOUND LCSC & HOPE
11/04 4th opinion NIH - surgery possible
1/04/05 Successful surgery - RU lobectomy - all margins, nodes, and path reports are NEGATIVE
2/05 chemo x2 taxol/carboplatin
3/05 Esophagus stretched twice
4/06/05 bloodwork, chest x-ray, CT scan, PET scan, NED
5/05 2 more esophagus stretches
7/13/05 bloodwork, chest x-ray, CT scan, PET scan, brain MRI, NED
10/05/05 bloodwork, chest x-ray, PET/CT scan, NED
1/11/06 bloodwork, chest x-ray, PET/CT scan, brain MRI, NED
4/05/06 bloodwork, chest x-ray, PET/CT scan, NED
6/10/06 emergency appendectomy
7/12/06 bloodwork, chest x-ray, PET/CT scan, brain MRI, NED
9/26/06 bloodwork, chest x-ray, PET/CT scan, NED
1/10/07 bloodwork, urinalysis, chest x-ray, CT, PET/CT scan, arm CT, brain MRI, NED
7/11/07 bloodwork, urinalysis, chest x-ray, PET/CT scan, brain MRI, NED
1/9/08 bloodwork, urinalysis, chest x-ray, PET/CT scan, brain MRI, CT w/contrast.....mm 'spot' lower right lobe - watch and wait 3 months
4/8/08 bloodwork, urinalysis, chest x-ray, PET/CT scan, NED
10/14/08 bloodwork, urinaysis, chest x-ray, PET/CT scan, brain MRI, NED
4/15/09 bloodwork, urinalysis, chest x-ray, PET/CT scan, brain MRI, NED
10/13/09 bloodwork, urinalysis, chest x-ray, PET/CT scan, brain MRI, CT/contrast, NED
4/13-4/15/10 bloodwork, urinalysis, chest x-ray, PET/CT scan, brain MRI, CT/contrast, PFT, echocardiogram, EKG, stress test, NED
4/11-4/13/2011 bloodwork, urinalysis, chest x-ray, PET scan, CT scan w/contrast, brain MRI, NED
4/16-4/18/2012 bloodwork, urinalysis, chest x-ray, PET scan, CT scan w/contrast, brain MRI, NED


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PostPosted: Wed Oct 10, 2007 6:36 pm 
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What kind of scans were done? A CT scan will show mass. A PET scan should show an uptake if it is cancer. This is not positive, but I would want it done before a biopsy.

Stay positive, :)
Ernie

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[size=75]Photo: Wife Carol. Myself and my Mooney Ovation

Turned 70 March 2007

7/6/05 Annual physical, was told I was in great shape. Requested an X-Ray.
7/7/05 X-Ray showed fluid in right lung area.
7/8/05 CT scan showed tumor 2.4 cm
7/15/05 Fluid about a cup of fluid drained for biopsy. It was malignant.
7/18/05 PET scan positive showed main tumor plus many nodules. Said it looked like someone took a paint brush and flicked it inside my lung. Was told that it was inoperable. Stage IIIb or IV nsclc with a pleural effusion of the right lung.
8/1/05 Second opinion at Sloan Kettering. Agreed with planned treatment of Carboplatin and Taxol. Only thing they would do different would be to drain the fluid from the chest area. I asked if the fluid would go away by itself and was told “Not a Chanceâ€


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PostPosted: Fri Oct 12, 2007 9:29 am 
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You could ask the Dr why he wants the biospy?
On the CT scan he can see characteristics that will more likely be seen on a malignant nodule.

Are the edges regular or smooth? Is it spiculated, etc. I don't know all the things a radiologist would look at but I think they can give a percentage chance of cancer based on different measurements and the look of it

8mm is pretty close to 1cm so it is not too tiny.

I am not sure if a PET would show anything that is smaller than a cm but it might be worth asking.

Can he give you a percentage of getting a conclusive biopsy?

Good luck

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Mother Stage I clinically, Stage IIIa pathologically. Large cell neuroendocrine carcinoma. Deceased March 2003
Please seek 2nd opinions and verify everything


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PostPosted: Sat Oct 13, 2007 10:19 am 
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I feel first you should have a pet scan to see what the uptake is.

That seems rather small to biospy, usually they wait until it is a centimeter.

That is the opinion on what my husbands doctors feel.

Keep us posted.

Maryanne

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"Life is not measured by the number of breaths we take...but by the moments that takes our breath away"
[size=75]
Husband Joel, 58 dx 10/18/04 Smoker since age 15 stopped when diagnosed
Adenocarcinoma- stage 1B
Lobectomy Left upper lobe on 12/15/04
biopsy on lymph nodes - negative NED
1/13/04 Oncologist appt.to see about preventive Chemo.
Cancelled due to chronic fatigue
1/12 fentynal patch for pain
1/14 discontinued Fentynal patch bad reaction
1/15 Blood test showed high T levels
2/1 Endoconrinologist visit diagnosed over-active thyroid
2/8/05 took Radioactive Iodine to kill thyroid
2/16/05 appetite back, fatigue leaving
2/24/05 visit with Pulmonary Doc. Breathing at 96% capacity,
Next visit 3 mos.
3/9/05 Endocrinologist visit -T levels went from 25 down to 5.
3/30 started Synthoid(thyroid med)
3/31 Oncologist. appt. CT results NED...
4/14 starting adjunctive Chemo (carbo/taxol) 4 treatments
3 weeks apart.
6/15/05 Joel finished chemo, chest X-ray clear, Next CT in August
9/01/05 1st CT since Chemo.. NED
11/17/05 CT - small nodule found 4 or 5 mil. in his good lung
1/10/06 CT - nodule Stable
7/2006 CT/ Nodule stable
10/2006 CT Nodule seem to have grown from 4 to 7 mil.
10/2006 Pet- showed some uptake
10/2006- operation- wedge section right upper lobe turned out to be cancerous 2 nodules next to each other. 2 different types of cancer. 1 squamous cell carcinoma (new primary)2- adenocarcinoma-(not sure if new primary or metastasis)
May be restaged to IIIB
11/07/2006 will start 4 rounds of taxotere. 3 weeks apart. Will take Decadron before, day of and day after. Will get a shot of Leunesta the day after. Here we go again.. Joel's attitude.... great as usual
Horrible reaction to the neulasta shots. One night(New Years eve) went to ER. Spent 3 days in hosptal.
Feb 2007 finished chemo.
March 2007 had his CT .. as expected right now all is clear.
June 2007 NED!!!
Sept 07- CT- small nodule 3.5 mm
Going to do another CT in 6 weeks.
October 07- CT done, results STABLE...YEA
Jan. 2008... STABLE!!!
April 2008 little growth but still called stable
July 17 208 nodule doubled in size to 9mm. Needs Pet Scan, tests, hopefully cyberknife...
July 29 met with his surgeon... said Cyberknife is the way to go.
August 1- Cyberknife visit... Joel is a canidate, its a go...Happy B-day Joel...
Sept 22, 2008 finshed up the last of 3 cyberknife procedures
Nov. had CT scan
Nov. 9th results of CT from Cyberknife..... Tumor completely gone... right now NED!!!
Feb. 09- Pet/CT results. . . NEd!!!
May 09 Pet/CT results. . . NED!!!
Sept. 09 Pet/CT results.....NED!!
Jan. 2010--- NED!! Pet now will be every 6 months.
June 8,2010 Pet scan on our Anniversary... hope thats a good sign..
June 17, NED!!!
Dec. 30,2010... NED!!!
June 20,2011... NED!!!
March 2012....NED!!!

pic of Joel and our daughter Nicole at walk NOV. 07

[img]http://www.freewebs.com/beansprouts2005/nik_and_dad_1LC_walk.jpg[/img]

http://www.babababies.com


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 Post subject: Follow up
PostPosted: Tue Dec 04, 2007 7:16 am 
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Joined: Wed Oct 10, 2007 9:48 am
Posts: 3
Location: Arlington, Texas
Thank you for thinking of me ! You are so kind. I had my 3 month follow up yesterday and the nodules are still there no major changes in either lung.
Main concern right now is depression is comsuming me. I am seeing a doctor today. Will keep you posted!

Bless you.

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 Post subject: Follow up
PostPosted: Tue Dec 04, 2007 7:16 am 
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Joined: Wed Oct 10, 2007 9:48 am
Posts: 3
Location: Arlington, Texas
Thank you for thinking of me ! You are so kind. I had my 3 month follow up yesterday and the nodules are still there no major changes in either lung.
Main concern right now is depression is comsuming me. I am seeing a doctor today. Will keep you posted!

Bless you.

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PostPosted: Tue Dec 04, 2007 7:50 am 
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I am SO GLAD to hear there was no major changes!! :D Stable is good! Is the depression related to the nodule ordeal, or were you dealing with it prior? I ask because I think that has been one of the major hurdles I have had to deal with in my own "watch". The anxiety/fear, etc. can be overwhelming at times. I'm glad you are seeing your doc...hopefully you will soon be feeling much better and able to enjoy your holidays!

((BIG HUGS)) Hang in there!!

Yours in HOPE!
Stacey

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In Loving Memory of my Dad, "Eddie" Jan. 26, 1940 - June 8, 1996. Gone fishin' and holding my pole 'til I get there...
Adenocarcinoma of the lung.

Father in Law dx'd Sept. 04 Stage IIIb Squamous Cell LC...May 31, 2006 - On to Heaven, and the BEST cup of coffee...Love you, Pappy!

I'm a 41 year old married mom of five beautiful kids. Lost my Dad, Grandma, Great-Uncle, FIL, and many others to LC. Quit smoking in 2002 when a 5mm nodule in R lung was seen on Xray.
1/2005: Follow-up xray shows NO nodules, but...
2/2005: CT scan shows new/changed lobulated, non-calcified nodule in L lung (only 7mm x 10mm), three tiny (3-5mm), non-calcified nodules in R lung and nodular pleural thickening in both lungs...still too small for biopsy. We wait & watch w/ CT scans every 3 mos...next one in Aug.
May 05 - Dx'd w/moderate to severe asthma.
CT Scan Aug. 05 - "Essentially stable". L lung nodule grew to 11mm. R lung nodules are unchanged. No new nodules. Scan again in Feb.
8/05: Consult with Mayo Clinic Scottsdale. Mayo wants to rescan in Nov. 05.
11/05: CT shows "some" new noncalcified nodules in the R lower lobe, (now they are in all three lobes of the R lung...what a bummer) all tiny (<5mm) and some mild pericardial thickening (??). Otherwise, all other nodules are unchanged. No new ones in the L lung. Hmmm...now what...?? Still too small for biopsy - Next scans in Feb. 06.
Feb. 06 - CT shows a new subpleural nodule in L upper lobe, <5mm. Dominant nodule is relatively unchanged. The count appears to be 4 in the R, 2 in the L - now "it" is in all lobes.
May 06 - On to Mayo Clinic. New scans, labs, PFT's scheduled for June 2nd. The current nodule count is 7.
June 06 - Insurance denies Mayo claim, "not one of their providers" and "their" pulmonologist refuses to see me anymore because I went to Mayo!!! Sends me a certified letter to that effect.
Aug. 06 - 43 years old!! New doc orders CT. Nodules stable (yeah!!!)
Sept. 06: Pulmonologist wants another PET scan since I've had slight progression over the past year.
October 06 - PET/CT scheduled ~ results show new teeny spiculated nodule in RLL, as well as enlarged axillary nodes, but NO significant uptake except in the throat area (I talk too much...heehee) Scan again 1st week of January '07.
Jan. 07 - Nodules, mediastinal & axillary nodes stable!! Rescan in March.
Mar. 07 - EEEK!! Another new nodule!!! 4mm in LUL... 3 months fever of unknown orgin, and very high CRP levels...all else is stable.
4/07 - US and CT show enlarged liver & biliary duct dilatation. 2 lymph nodes in neck - one in armpit.
6/07 - Oncologist ordering a bone marrow biopsy, another PET/CT, and more liver/abdominal imaging. Maybe lymphoma...???
8/07 - 44 years old!! WOOHOO!!! Bone marrow biopsy shows no metastatic lymphoma, but shows iron depletion, and abnormal red calls... PET/CT shows another new nodule in LUL. Neck/axillary nodes increase. Neck dissection scheduled. Still thinking lymphoma...
10/07 - 3 enlarged nodes removed from neck. Prelim. shows no lymphoma present. Re-scan lungs this month to check on new nodule.
CT shows numerous blebs in left apex, but NO NEW nodules!!
12/07: Breast MRI for armpit/axillary node - negative
2/08: 3 years since this began. Mayo for follow-up CT. Doc is only concerned with 4 of the nodules and has finally graduated me to CT annually with xray at 6 months, barring any new symptoms/complications!!! YAY!! Started on pulmo. rehab. for COPD

A CANDLE FOR A CURE!!! 25% of proceeds will be donated to LUNGevity!!! Visit: http://www.candle4acure.com/


Pictured: Cassidy & Mommy ~ My youngest of five! May, 2008


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PostPosted: Tue Dec 04, 2007 9:51 am 
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a PET would not give you much i think. the standard tends to be anything above 1CM will light up the PET if it is malignant. so something at 8 mm may be too small to accurately say anything based on the results from a PET. just an FYI.

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My sister Kelly was diagnosed with 3b NSCLC in May of 2007. A nodule on her adrenal gland has at times been thought to also be involved, but I, her surgeon, her radiation oncologist, and many oncologists I work with don't think it is. So we're going with that. She completed 5 rounds of carbo/taxol on a weekly schedule with concurrent radiation for 37 days. CT and PET showed nodes were clean but still residual activity in the tumor, which was reduced in size from 8x5 cm to 3x2cm. She attempted a lobectomy on 22 January 08 but the tumor resides a bit in the lower lobe in addition to the upper lobe, and the surgeon would not remove the entire left lung. She started Tarceva on 27 February 08. Her first scan showed decreased activity in the tumor and yet again, nothing new outside of that tumor. Her Dr. and I were actually kind of shocked! June '08 she had a total of 48 Gy of radiation via cyberknife. Her PET from 10 Sept '08 showed nothing new, the tumor size not really changed, but the SUV went down again, from 3.9 in May to 3.1, down from about 19 when this all started. She took a bit of a Tarceva holiday as we had some electrolyte issues due to not eating anything. She is currently back on it and taking 50 mg with tolerable toxicity. December '08 scan showed stable disease and yet again, less activity than before. April '09 scan actually said "area of hypermetabolic activity previously noted is not visualized today"! I could hardly believe my eyes and read it over and over. August and December '09 scans nearly identical! Now the June 2010 scan is just like the last ones - no uptake in the tumor, no new sites! Scan in January 2011 showed something on a rib on the contralateral side. Everyone in agreement that she broke a rib when she took a really bad fall a couple months ago. No one seems to think it is cancer, since the PET showed nothing in the lung or lymph nodes! Not moving to yearly scans yet though, so back in July! Our family really needed that good news as a month before we buried our 26 yr old nephew and are all still reeling from the shock and pain. July 2011 scan showed nothing new and she and the dr agreed to give her a drug break, so she went off Tarceva and so he wants to scan again in 3 months. There was a 3 mm nodule in the other lung and he didn't want to wait too long to scan given that and the no drug status. Scan in October of 2011 again showed nothing new, no growth, all is stable. The nodule in the other lung still listed as 2-3 mm. February 2012 scan was same as it ever was. :) Next scan is in August and she'll have gone one year without any treatment at that point. On May 19th it was 5 yrs from the day we heard she had lung cancer and we marked the occasion with a big party full of family and friends! She had a scan on Aug 24th and the results were more of the same, and marching orders from her oncologist that he doesn't need to see her for another year!


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PostPosted: Tue Dec 04, 2007 10:47 am 
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It looks as though waiting for the Nov. scan was a good choice. Glad there was no change. I'm not sure the anxiety ever goes away.
Muriel

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Dx NSCLC 5/03. Surgery UR lobe. Staged as 1B. Chemo (taxol & Carbo)9/15/03 - 11/13/03. Wonderful CTs until Nov 04. Surgery 11/27/04, again staged as 1B. Chemo (Cisplatin and Gemzar) 2/05 to 6/05. Good CTs and PET since chemo.


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