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Biopsy

nanuk's picture
nanuk
Posts: 1363
Joined: Dec 2003

I had surgery for colorectal cancer and colostomy in 2000, and no recurrence until recent CT;preliminary radiologist's report notes "numerous 1-3 mm nodules in chest and enlarged R Refro-crural LN..suspect mets.." Oncologist says latter may not be accessible for biopsy, but suggest a non-evasive procedure involving 3 1" incisions in chest which allows surgeon to "look".
Is this an adequate way to determine malignancy?
Onc says local surgeon who usually does this procedure hasn't done them in a while, and recommends a new surgeon which Onc likes.
I'm wondering if I should opt for traveling outside my area to find a radiologist-surgeon, or
if this is a procedure that can be handled by any
competent surgeon. Does someone have experience in this? Bud

pattieb
Posts: 176
Joined: Mar 2003

Have they done a pet scan? I have never heard of that procedure, maybe you should get a second opinion.
Pattie

nanuk's picture
nanuk
Posts: 1363
Joined: Dec 2003

Pattie: No, the only thing that has been done is a CT, which found spots that were not on previous CT.
Does PET scan identify malignancies? Would it take the place of biopsies? I guess I would prefer a PET to more invasive-(surgery) methods, esp. if it is able to identify mets in all areas..? There always seem to be more questions than answers; having a real give & take conversation with the oncologist is difficult because she is so busy, and I am in a remote area & must depend upon playing telephone tag. I guess I would rather go through a minimum of procedures to determine my protocol, etc. This site is a blessing tho.. Bud

2bhealed's picture
2bhealed
Posts: 2084
Joined: Dec 2001

Hello Bud,

Nanuk? Alaska perhaps? I am a musher so am curious. :-)

Is it possible to just connect with a major cancer center and get the tests done where they focus on the latest cancer diagnostics?

I go the the Mayo Clinic in Minnesota and they will run all the tests pronto CT, PET, etc and have on staff some of the best so if one does not know the answer s/he will consult with the expert of that area.

Is it true that exposure to air can spread cancer? Someone? Is that false info?

PET will show "hot spots" but not if it is malignant or not. Biopsy is still needed to determine disease...at least in my case when I had a 'hot spot' turn up on my last PET but an ultra sound determined that it was just an ovarian cyst that happened to be smack dab on the original site. SCARY!!

This site is a blessing...yes.

peace, emily

nanuk's picture
nanuk
Posts: 1363
Joined: Dec 2003

hi Emily..yes, Alaska-close to Palmer. Have you been following Rachael Scdoris' attempts to run the Iditarod? She is a blind musher from Oregon. Unfortunately Mayo doesn't accept Medicare assignment, and my share would be more than I can
afford. I have been talking to a lot of people, and can't really decide on a course of action until they do a thoroscopy to get a tissue sample. It's a tricky procedure, esp. because nodules are
small. So far they think only lungs are involved, and nodes (20+) are too small for PET to see.

2bhealed's picture
2bhealed
Posts: 2084
Joined: Dec 2001

Hi Bud,

I hear bits and pieces about her. I'm not sure how I feel about it if she gets a guide. I am inspired by her tenacity and courage to be part of such a grueling sport, but I am not sure about special privileges. I want to root for her in one hand to go for it but then again......

What's your scoop on it? What's the skinny in Alaska regarding her requests?

peace, emily

nanuk's picture
nanuk
Posts: 1363
Joined: Dec 2003

Monika: I'm going to Seattle for the biopsy, then I'll weigh the options. It has to be a center that accepts Medicare assignment, and I haven't found one yet, but if I do, I'll relocate if necessary to get comprehensive treatment. to answer aleftina's question, CEA is 3.0, up from 2.5

aleftina
Posts: 102
Joined: Nov 2003

Nanuk, what is your CEA? I know it is not a reliable marker, but I was curious.

KrisS
Posts: 232
Joined: Apr 2003

Nanuk- It sounds like what they want to do is a laproscopic biopsy. This can be safer that trying to have a radiologist do it with CT guidance if they would have to pass through a lot of normal lung tissue to get a needle into the things they are suspicious of. This is the same sort of thing that they are using to take gall bladders out and even apendixes in some people with apendicitis. Although it is becoming more common to do these procedures, it does take some skill and training, so I would not want someone who doesn't do these routinely doing it. Working in the chest isn't quite the same as working in the abdomen, so I would want someone who is used to doing thoracoscopies.

Guess that the decision about whether to travel further would depend on how experienced the surgeon is who is recommended.

Best wishes,

Kris

vcavanagh
Posts: 86
Joined: Dec 2002

hello Nanuk,
It seems that a biopsy is necessary. Go to the surgeon who has most experience in doing this, even if he is outside your locality. The more experience, the more skill and the better the outlook.
Blessings,
Vincent.

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