Those with METS to lungs

jennsam

quickie question: Did you have symptoms that warrented a CT scan of lungs or was the mets found routinely? AND what was seen?
I am 9 weeks post OP left partial for RCC clear stage 1 grade 2. I never had any surveillance done to r/o mets but this week got pretty sick and was in the hospital...turns out I have Pneumonia and pleural effusions(small) left lower lobe of lungs. THEY SEE NO masses. CAN the effusions be an early CA popping up? Did anyone with mets to LUNG have effusions?
MY symptoms were severe lightheadedness with fast heart rate and intense pain with breathing in my left flank all the way up to throat. I had IV abx and am home but they want me to see pulmonary...just wondering


JENN

KJones1969

no symptoms
My husband didn't have any symptoms to warrant a CT scan of the lungs. Once his renal cancer was found the doctors immediately did scans to his lungs.

That is great with no masses but I would follow up with my oncologist if you have any questions as all. Good luck Jenn and I'll keep you in my prayers. Let us know what the doctor's say.

alice124

Hi Jenn,
Sorry your most
Hi Jenn,

Sorry your most recent history required a stay at the hospital, and you are feeling better at this point. Since John (husband) is not around right now, I'll answer with his experience.

After weight loss occurring over several months, John developed a cough which had become pretty severe by the time he was diagnosed. When the internist ran the CT, he saw the primary tumor (kidney) and the nodules that had metastisized to his lungs. Hopefully, your effusions are related to the pneumonia and not an indication of cancer expansion.

I'm certainly not a doctor but believe seeing a pulmonologist is a smart move. Good luck to you Jenn and keep us posted.

Eliezer2

Pleural effusions
Unfortunately I know more about these than I would like to know.

First, while it is true that for the general population pleural liquids are usually NOT cancer related, for those of us in the RCC fraternity there is a high probablity that they are. Second, the liquid is NOT IN THE LUNG, but rather in the space between the lung and the rib cage. Third, the liquids can themselves be a health problem because they press on the lung from the outside and prevent its full expansion and so interfere with proper functioning of lung. They also make you cough a lot (dry cough). The liquid can be triggered by small tumors, especially in the outer rim or barrier of the lung, and these may not be visible on an Xray. I think on Xrays they would not see it unless the tumor would be about a centimeter. CT can see a lot more and smaller stuff. SO you could have growths even if Xray looks clean. The pleural liquid can of course also be caused by pneumonia but sometimes what looks like pneumonia is actually a side effect of the RCC disease. I am not exactly clear why the small lung tumors trigger the liquid effusions but it has something to do with the lung sensing diseased tissue in the outer rim of the lung. In any case, the liquids can be drained, which sounds worse than it is - it is not much worse than a blood test. The problem is that they will return quickly if there is an underlying condition that is producing them, like tumors. It is also possible to take a medication that drains liquids from the body (Fusid) and it sometimes works but will make you pee every 10 minutes. Yes, you should go to a pulmonologist.

Two pieces of good news. The Sutent and other drugs that reduce RCC lung tumors or freeze them can cause the liquid effusions to end. That can take a while though. There is also a relatively mild surgical procedure, although must be done with general anesthesia, which can stop the effusions and make breathing easier and stop the cough - it involves a sort of biological glue made of talc where the problem part of the lung is pasted on to the rib cage and the effusion usually stops after that. This is also not as bad as it sounds and you quickly get used to the slightly different feel in your chest and the different feeling when you cough.

I am 17 months after my bout with the effusions and the "pasting" procedure of the lung to rib cage and I breath fine now, lung tests show full functioning, I can do 30 pushups and I am 62 years old!

Eliezer2

Pleural effusions
..

Eliezer2

Pleural effusions
..

foxhd

Eliezer2 said:

Pleural effusions
..

lung mets
And I was jogging pretty well with no shortness of breath when I found out that I had multiple lung mets. Go figure.

garym

Eliezer2 said:

Pleural effusions
Unfortunately I know more about these than I would like to know.

First, while it is true that for the general population pleural liquids are usually NOT cancer related, for those of us in the RCC fraternity there is a high probablity that they are. Second, the liquid is NOT IN THE LUNG, but rather in the space between the lung and the rib cage. Third, the liquids can themselves be a health problem because they press on the lung from the outside and prevent its full expansion and so interfere with proper functioning of lung. They also make you cough a lot (dry cough). The liquid can be triggered by small tumors, especially in the outer rim or barrier of the lung, and these may not be visible on an Xray. I think on Xrays they would not see it unless the tumor would be about a centimeter. CT can see a lot more and smaller stuff. SO you could have growths even if Xray looks clean. The pleural liquid can of course also be caused by pneumonia but sometimes what looks like pneumonia is actually a side effect of the RCC disease. I am not exactly clear why the small lung tumors trigger the liquid effusions but it has something to do with the lung sensing diseased tissue in the outer rim of the lung. In any case, the liquids can be drained, which sounds worse than it is - it is not much worse than a blood test. The problem is that they will return quickly if there is an underlying condition that is producing them, like tumors. It is also possible to take a medication that drains liquids from the body (Fusid) and it sometimes works but will make you pee every 10 minutes. Yes, you should go to a pulmonologist.

Two pieces of good news. The Sutent and other drugs that reduce RCC lung tumors or freeze them can cause the liquid effusions to end. That can take a while though. There is also a relatively mild surgical procedure, although must be done with general anesthesia, which can stop the effusions and make breathing easier and stop the cough - it involves a sort of biological glue made of talc where the problem part of the lung is pasted on to the rib cage and the effusion usually stops after that. This is also not as bad as it sounds and you quickly get used to the slightly different feel in your chest and the different feeling when you cough.

I am 17 months after my bout with the effusions and the "pasting" procedure of the lung to rib cage and I breath fine now, lung tests show full functioning, I can do 30 pushups and I am 62 years old!

Pleural effusion...
Eliezer,

Following the motorcycle accident (and 6 broken ribs) that led to my dx I had a fairly significant pleural effusion, enough so that it nearly derailed my nephrectomy, my lung capacity was about 50% compromised on the left side. Long story short, 5 days after my kidney was removed I was back in the OR for a thoracotomy where they opened up my left side, used a rib spreader on my already broken ribs, and the surgeon literally reached inside my chest and scooped out 3 liters of fluid/goop. Before closing me up he used talc, as you said, to paste my lung and rib cage together. They sent the fluid/goop to pathology because of the possibility that it was related to the RCC, fortunately that was not the case. I too have had no ill effects and actually began weight training again 3 weeks after the procedure.

Gary

lbinmsp

Pleural effusion
my remarks were not necessary here. My apologies.

jennsam

foxhd said:

lung mets
And I was jogging pretty well with no shortness of breath when I found out that I had multiple lung mets. Go figure.

update:
so I was sent home friday and back in Sun with high fever. OF COURSE the HURRICAINE hit as I was in the scanner to have a real CT of the LUNGS not CTA. SO no go.I live on LONG ISLAND and the town the hospital is in is half underwater. I am still in the hospital on IV antibiotics for pneumonia. MY HEME/ONC saw me and said it is NOT LIKELY that this is an early cancer( the effusions) but I pulled a CT scan from about 2 mo ago that shows there was a small 2mm nodule where the effusuion is now, so he said it wouldnt be a bad idea to scan.
Waiting for electricity to come back on CT to be up and running...I do feel better now on day 4 of IV antibiotics so hope its just the pneumonia.
JENN

alice124

jennsam said:

update:
so I was sent home friday and back in Sun with high fever. OF COURSE the HURRICAINE hit as I was in the scanner to have a real CT of the LUNGS not CTA. SO no go.I live on LONG ISLAND and the town the hospital is in is half underwater. I am still in the hospital on IV antibiotics for pneumonia. MY HEME/ONC saw me and said it is NOT LIKELY that this is an early cancer( the effusions) but I pulled a CT scan from about 2 mo ago that shows there was a small 2mm nodule where the effusuion is now, so he said it wouldnt be a bad idea to scan.
Waiting for electricity to come back on CT to be up and running...I do feel better now on day 4 of IV antibiotics so hope its just the pneumonia.
JENN

Pneumonia
Jenn,

Wishing for "just peneumonia." If my mom were still alive, she'd have that wagging finger saying "young lady--if you can't wish good things for someone, don't wish them at all." But I'm guessing this qualifies as a good thing???

Good luck Jenn; keep us posted.

jennsam

alice124 said:

Pneumonia
Jenn,

Wishing for "just peneumonia." If my mom were still alive, she'd have that wagging finger saying "young lady--if you can't wish good things for someone, don't wish them at all." But I'm guessing this qualifies as a good thing???

Good luck Jenn; keep us posted.

update
I was released on Thurs. on oral antibiotics. I am feeling better but continue to have an odd cough. I did not have the CT scan it was still down and i really needed to get home because the hurricaine devastated my home and surrounded areas on LONG ISLAND. I have a house full of people. I am glad I can help. NOW we are getting hit with the Nor'easter incredible stuff I tell ya. SO no CT yet I will get one in a few weeks even a 2mm nodule with effusion shouldnt change too much in 2 weeks. I need to focus in my people right now and family !!!

alice124

jennsam said:

update
I was released on Thurs. on oral antibiotics. I am feeling better but continue to have an odd cough. I did not have the CT scan it was still down and i really needed to get home because the hurricaine devastated my home and surrounded areas on LONG ISLAND. I have a house full of people. I am glad I can help. NOW we are getting hit with the Nor'easter incredible stuff I tell ya. SO no CT yet I will get one in a few weeks even a 2mm nodule with effusion shouldnt change too much in 2 weeks. I need to focus in my people right now and family !!!

update
Jenn,
With so much going on, you won't have time to become preoccupied with only one issue. Guess that's a good thing. Hope you get through this latest storm without serious problems. Know we're pulling for you in regard to both the Nor'easter and the CT scan.

xinhope

jennsam said:

update:
so I was sent home friday and back in Sun with high fever. OF COURSE the HURRICAINE hit as I was in the scanner to have a real CT of the LUNGS not CTA. SO no go.I live on LONG ISLAND and the town the hospital is in is half underwater. I am still in the hospital on IV antibiotics for pneumonia. MY HEME/ONC saw me and said it is NOT LIKELY that this is an early cancer( the effusions) but I pulled a CT scan from about 2 mo ago that shows there was a small 2mm nodule where the effusuion is now, so he said it wouldnt be a bad idea to scan.
Waiting for electricity to come back on CT to be up and running...I do feel better now on day 4 of IV antibiotics so hope its just the pneumonia.
JENN

nodule
2mm nodule is very small. I don't think that they can tell its nature when it is that small.

I am surprised that the doctor did not tell you about this nodule when you had the scan 2 months ago. Usually, when they have an indeterminate nodule like this, they monitor it with CT in 3,6,12,24 month to see if it is growing.

You might want to wait until the pneumonia settles down so that the doctor can clearly compare the nodule with previous CT.