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Update to Nodule in Left Lung

Posts: 9
Joined: Feb 2007

I just received results of Needle Biopsy of Nodule in Left Lung it was inconclusive but Doctor is recommending immediate PET Scan. Does anyone know what a PET Scan will tell them that a Biopsy did not? Will a PET Scan be definitive? Doctor suggested next step after that might be Open Chest Biopsy? Anyone have any experience of when you can request 2nd opinion? Does it have to wait for diagnosis? Does all this sound right or does it sound like my doctors don't know what they are doing? Just don't know where to go or what to do>
Thanks for those who responded to my earlier post. Your thoughts and prayers are appreciated!

Posts: 1048
Joined: Aug 2006

It sounds like you have a pretty good doctor. You want to check things out until you KNOW it is not cancer. Try for a PET/CAT scan if you can. It takes about 2 hours and gives the doctor lots of valuable information. Cancer absorbs glucose (sugar) faster and more than normal tissue. You fast overnight and come in (preferably early) for the test. They do a lot of hurry up and wait on this test. You drink some chalky flavored smoothie (mine was a mild berry flavor and not too bad really). They hook you up to an IV and you have to nap for set periods. I remember the radioactive glucose was in a lead container and they gave it to me back in the "napping"room. Finally they do the scan. I got heated blankets on that part--very comfy and it helps the test turn out better. Apparently cancer cells absorb more of the radioactive glucose and "light up" on the film the radiologist reads. The advantage of a PET/CAT scan is that it shows where the organs are, what shape the nodule is, as well as what nodules are lighting up. My PET/CAT scan was a bit iffy, so it was followed up by a regular CAT scan about 3 months later. My sister, the doctor, said that was customary. The radiologist thought that the spot had grown then and recommended a biopsy. I was with Johns Hopkins that offered the VATS procedure for biopsy. You get 3 tiny cuts (like 1 inch each) and they do everything by camera. The advantage is the faster recovery time. Traditional chest surgery requires a much bigger incision. I was jogging and walking around a track 8 days after the VATS procedure. They removed a wedge of lung containing the nodule. After preliminary examination in the operating room they knew I had cancer. With lung cancer it is the gold standard to remove the lobe the nodule is in for stage 1 cancer and the patient can tolerate it. They did a breathing test on me to determine how much lung I could lose without getting handicapped. I had a history of breast cancer and they thought it was that during surgery. A week later they found out through genetic testing that I had lung cancer. That meant another operation and a bigger incision. Trust me, go for the VATS procedure if you can qualify for it and get it anywhere close. I did okay with the 4 incher (a modified VATS), but recovery has been much slower! I feel for those with traditional chest surgery. Incisions there run 10 inches. . .
However, before you get scared of all those gory details, realize you only have to take things one day at a time. Don't forget to breathe! Use the internet to find out the lung cancer centers near you. Call the American Lung Association or the ACS for recommendations. Get your 2nd opinion whenever you need it. Even though I trusted my surgeon (hey, he was at Hopkins!), I checked out the "Ask an expert" at University of Maryland website. The doctor there confirmed that removal of the lobe was the "gold standard" at that time. I was glad I asked. It made going back for more surgery a little less stressful. At least I knew I was doing the right thing, even if it ouched. Good luck!

Posts: 13
Joined: Mar 2007

I had a nodule in my left lung for three years that my doctors were keeping an eye on. Finally, by the third year it had started to grow, so my pulmonary doctor ordered a PET scan. This returned positive for cancer. The PET scan I received was a lot quicker than the 2 hour one Cabbott talked about. They gave me an IV injection of a glucose-type substance and had me rest in a room for about 30 minutes and then took me to the PET scan area where the scan itself took about 45 minutes. The nodule lit up on the scan, proving to be cancer and the surgeon started out with the VATS procedure, but after he opened me up and saw that the cancer was a little larger than originally expected, went ahead and removed my left upper lobe. They declared me cancer-free with all lymph node biopsies coming back negative and told me to return in 6 months for another CT scan. I would definitely recommend getting the PET scan. It is a pretty conclusive test. Good luck to you. My surgery was rough, but it was worth it for them to get all the cancer.

Posts: 30
Joined: Jan 2006

I hope this does not confuse you but my approch was a little different. After monitoring a nodule in my right upper lobe for 3 years my pulmonologist felt and I could also see a definite change in the nodule. He ordered a PET scan which was inconclusive. He then recomended VATS for a biopsy. After getiing two additional opinions from surgeons at the University of AL and MD Anderson in TX (both of whom felt the advantages of vats were outweighted by the dangers of missing something). MD Anderson recomended a needle biopsy although I was told it was not always a definitive test. As a result I elected to have surgery (at MD Anderson) to do a bioposy which determined a stage 1a cancer. The right upper lobe was removed as is appropriate. I also elected to have chemo after the surgery although some Docs do not feel it useful for stage 1a. Good luck

sexysam's picture
Posts: 2
Joined: Jun 2007

i just went thru all of this u snould have a pet scan they should have done that first they inject u with radioactive substance almost like sugar and they do this becasue cancer cells feed off of sugar and so when they scan u they will find out if it is cancer thats how it was explained to me they scan your upper body and down to your knees and if any chance of cancer the substance will light up so good luck and any more info i can give u dont hesitat to ask

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