Lung Biopsy

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Kazsmiles74
Kazsmiles74 Member Posts: 25 Member
edited November 2023 in Head and Neck Cancer #1

I was wondering if anyone has had a lung biopsy? If so, can you explain your experience, and how you felt after?

My husband had his post treatment PET, his cancer in his throat is NED, but they found a nodule on his upper right lung. His oncologist feels it is most likely inflammation(hoping so), she wanted to have him wait and do a CT scan in 2 months. His ENT took it to the tumor board to see their opinion. Apparently, it was mixed opinions and was left up to my husband. He decided not to wait and move forward with the biopsy as this is a recurrence from 2018 and his anxiety is quite high. He is also under follow up care from Melanoma in 2022. We were just curious if anyone has been through this procedure and can share their experience.

Thank you!

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  • wbcgaruss
    wbcgaruss Member Posts: 2,366 Member
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    Hello Kazsmiles.

    I have not had a lung biopsy but I do have a nodule in my lung that is being watched through my yearly scans of the H&N area and the chest. I believe there is a small nodule on my liver that is being observed also and no plans to do anything unless they start to grow.

    I would say with your husband's cancer history he is wise to go ahead with the biopsy but there is also the option that my doctors are using, yearly CT Scans with contrast to watch for any growth increase of the nodules then consider treatment.

    My sister had a nodule in her lung and it was monitored for quite a few years until it started growing then they decided to treat it. They used the Cyber-Knife which applied a small number of radiation treatments and it was eradicated.


    I did find some information for you though and a video explaining about the 4 different types of lung biopsies performed. I would imagine your husband would most likely have the needle biopsy.

    Needle lung biopsy

    A needle biopsy is performed under local anesthetic, so the patient is awake but comfortable during the procedure. The procedure should take about 30 to 45 minutes and is not painful, although patients may feel some pressure when the needle is inserted.May 23, 2023


    Lung Biopsy explanations and video...

    https://www.ypo.education/general/lung-biopsy-t666/video/

    Wishing You The Best

    Take Care, God Bless

    Russ

  • Kazsmiles74
    Kazsmiles74 Member Posts: 25 Member
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    Thanks Russ for always being so willing to help out on this forum. I’m not sure what I would have done if I did not find this helpful/insightful forum. It has helped me understand what to expect and how to better help my husband through this. It certainly has been a tough 8 months.

  • wbcgaruss
    wbcgaruss Member Posts: 2,366 Member
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    Very well Kazsmiles I am so glad you are finding help here and it helps you know what to expect to happen. Many times when we take the unknown away and get the knowledge we need it is much easier to handle. I understand you when you say it has been a tough 8 months through my own experiences and others on this forum what they went through is hard to imagine. But the amazing thing is when we are faced with tough times we find strength, perseverance, stamina, and power to get through the tough times and surprise ourselves because we do things we never thought we could. It also drives us to prayer and brings us closer to God.

    I keep forgetting to search this site so I did a search on lung biopsies and there are plenty of results if you want to look through them. First is links to several posts I picked out...

    #1 https://csn.cancer.org/discussion/281236/lung-biopsy-negative

    #2 https://csn.cancer.org/discussion/225632/lung-biopsy-yesterday

    #3 https://csn.cancer.org/discussion/291616/lung-biopsy-results

    And lastly here is the link to the search itself...


    I am Wishing You The Best and praying and hoping your husbands biopsies turn out negative and you have no more concerns and can put this behind you.

    Take Care, God Bless

    Russ

  • Windmill
    Windmill Member Posts: 28 Member
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    I had a lung biopsy in November 2021. My oncologist watched the nodule for 6 months and decided it was time for a biopsy to see what we were dealing with. It turned out to be metastasis from my base of tongue hpv opc that we had treated the previous year.

    The procedure was painless and and I spent one night in hospital to make sure there were no complications. I was laid on a table in the medical imaging department, put to sleep and a specialist radiologist inserted a fine needle into my lung through my back using a cat scan for guidance. When I woke up I had to stay in the imaging department for a while so they could test my breathing function.

    In all a very painless procedure, the small hole in my back didn’t even require a stitch. My treatment for this metastatic nodule was sbrt. He’ll be fine.

  • Kazsmiles74
    Kazsmiles74 Member Posts: 25 Member
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  • Windmill
    Windmill Member Posts: 28 Member
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    I forgot to add my oncologist wanted to wait at least 6 months to make sure the lesion was oligometastasic and not the tip of the iceberg.

  • LuvnTN
    LuvnTN Member Posts: 75 Member
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    This is the type of situation where I feel the NavDX blood test might shine. I had been declared NED post one-year post-treatment through both physical examination and scans; however, that pesky NavDx number kept creeping up. Turns out I too had a met in a rib bone that wasn't waving a red flag on scans. My met was also treated with 5 sessions of sbrt (every other day for week and a half - piece of cake compared to previous treatment).

    So, if there is a spot and it doctors are not able to determine for sure... I'd request a NavDX and see what those results are.

  • wbcgaruss
    wbcgaruss Member Posts: 2,366 Member
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    OK, LuvnTN, I have a question then.

    You were declared NED.

    Physical examinations and scans.

    However, the NavDX number kept rising.

    So my question is if you had a metastasis in a rib bone that wasn't waving a red flag on scans how did they find it eventually? Did it finally get big enough to show on a scan?

    Interested People Want To Know

    Take Care, God Bless

    Russ

  • LuvnTN
    LuvnTN Member Posts: 75 Member
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    The sequence went like this: on 6-month post-treatment follow-up and NavDX, my ENT and Onc (with a CT w/ contrast) declared me NED. The 6-month post treatment NavDX was also "negative". At this point, everything was looking really good. 9 month check up.. nothing new, NED (no scans done). 12-month post treatment.. ENT declares "unofficially" one-year NED (based on scope and physical exam) pending results of NavDX. ENT tells me he now can stretch me out to 4-month check-ups vs every 3 months. So far, so good. Two weeks later, the NavDX score comes back "positive" with a score of "8" on Jan 4 this year. This triggered more scans. CT w/ contrast of head/neck/soft tissue and upper chest. Results of those scans are "negative". Ordered another NavDX on Jan 24th for back-up.. that score came back "positive" at "74". The number is climbing. That triggered a PET scan. the results of the PET scan were a hot spot on the rib bone. When the ONC pointed to the spot, I mentioned that I had a pain there for a long time (as in... prior to any diagnosis and initial surgery/treatment). The Onc went back and reviewed the original pre-surgery PET and noticed a small "hot spot" there as well. Meaning, that rib met was there the whole time... everyone had just missed it (the original PET scan was poor quality resolution). The explanation for the first "negative" NavDX score was that the chemo must have knocked it down enough to almost get rid of it... but not 100%. After that time, it started growing again.

    Lessons learned: getting an "all clear" on scans and physical exam is not 100%. Getting a "negative" on a NavDX is not 100%. But, using all the tools at their disposal can help to catch something that might have been missed. Had I not had a NavDX done in Jan, I would be on a 4-month re-visit schedule. At that time, would anyone be looking for a hot spot on my rib bone? Who knows. All those doctors knew is that there was something there... they just had to find it.

  • Windmill
    Windmill Member Posts: 28 Member
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    Unfortunately where I live we have no access to this test. I agree that this test would be extremely beneficial to someone as the op’s husband whose anxiety levels are high “He decided not to wait and move forward with the biopsy as this is a recurrence from 2018 and his anxiety is quite high.”

    Having this test would go a long way in easing someone’s mind. As most of us know scans are unable to pick up cancer when it is very small, (micro metastasis) so if the test identifies something is there ( like a rising psa test ) thenthe clinician will introduce regular testing until the spot gets big enough ( I think it’s around 7 mil for a PET/CT scan) to identify and treat.

    I waited 6 months on my oncologists advice to biopsy the spot in my lung. The reason was explained as it’s like pulling out a dandelion. You pull out one and 5 more grow back. Is it truly oligometastaic or polymetastasis this has huge implications on treatment, curative or palliative.

    Knowing what is was dealing with would have helped me greatly in the waiting months.

  • wbcgaruss
    wbcgaruss Member Posts: 2,366 Member
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    LuvnTN, thanks for the detailed explanation.

    It shows how sometimes and many times something can be missed.

    No one or system is perfect.

    I think it is great that you got the NavDX test and I believe your story proves it's worth in cancer detection and I believe saved you from a more extensive cancer in the future.

    Wishing you NED and all clear scans ahead.

    Take Care, God Bless

    Russ

  • Kazsmiles74
    Kazsmiles74 Member Posts: 25 Member
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    Just wanted to let you know that we are awaiting the result from my husbands post treatment NavDX test. I have requested his results from pretreatment NavDx and post treatment. We never received the first. We are hoping to receive those results before his biopsy on Thursday. To be clear, it was presented that half of the tumor board felt a biopsy would be best to do now. The other half said it would be okay to wait and rescan in 2 months. Thus, my husband’s decision. Being that his anxiety is high and he is still under care for melanoma, he decided to have the biopsy sooner than later.

    I appreciate everyone that has responded. It really helps me with my anxiety to hear all of your thoughts and what you have been through.

  • steven59
    steven59 Member Posts: 100 Member
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    I had a lung biopsy when the ct scan on my throat showed up something. They put me to sleep and did a needle biopsy. I don't remember any side effects other than being groggy. Test showed negative for cancer, bou nodules were likely asbestos. no treatment for lungs recommended

  • LuvnTN
    LuvnTN Member Posts: 75 Member
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    Case in point.. yesterday, 11/01, I had my 4-month check up with the ENT.… and I got the “everything looks great”. I am set to see him in another 4 months. I am also scheduled for CT w/ contrast on Nov 11 and a scans-follow-up with the Onc after that. Today, I got a message that the result from my latest NavDX just got in… and, it is “positive”. So, now they are getting me in to a PET scan ASAP. The roller coaster continues. Will keep the updates posted as they roll in.

  • wbcgaruss
    wbcgaruss Member Posts: 2,366 Member
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    LuvnTN, it just goes to show it's always something.

    If it ain't this it's that and if it ain't that it's this.

    Wishing You The Best

    Take Care, God Bless

    Russ

  • Kazsmiles74
    Kazsmiles74 Member Posts: 25 Member
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    Update: My husband had his biopsy. He had a partial pneumothorax(lung collapse) and was in the hospital with a chest tube for 24 hours. He is doing fine now. We got news that his NavDx was negative and 3 out of 4 slides from the biopsy came back as inflammation. The fourth slide showed positive for P40(SCC). The pathologist says because of this he can’t rule out cancer. So biopsy was basically inconclusive. Oncologist said he can get another biopsy or wait a month for CT scan to see if the nodule has grown in size. Being that he already had complications with the initial biopsy he is leaning toward waiting for the scan. However, he is not sure this is the best decision. Anyone have any thoughts?

  • wbcgaruss
    wbcgaruss Member Posts: 2,366 Member
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    Kaz, so sorry your husband had a lung collapse but glad he was in the hospital and they got everything resolved with it. It seems a scary thing to have a collapsed lung.

    Kaz I remember when your post was started you said "His oncologist feels it is most likely inflammation(hoping so), she wanted to have him wait and do a CT scan in 2 months."

    You know sometimes it is just better to wait no matter how quickly or badly we want to resolve something right now. And the waiting is the hardest part. Which reminds me of a song and we will have to get in the Wayback Machine for this one all the way back to 1981 is when it came out...

    Tom Petty And The Heartbreakers - The Waiting (Live Aid 1985)


    It appears his oncologist was right and his NavDX test is negative and 3 out of 4 slides from the biopsy came back as inflammation. And one slide showed positive for P40(SCC).

    So you have the oncologist's original recommendation of waiting 2 months to get a CT Scan and it turned out with the biopsy that he was mostly correct except for the fourth questionable slide, and his NavDX test is negative, you can't get much better than that and if that's negative it leads me to believe the questionable slide is probably not cancer or it would have showed in the NavDX test but they will be keeping a watch and scans on it. I would count my Blessings that his NavDX test is negative, his biopsy slides came back virtually negative, mostly indicating inflammation, he got a chest tube but has recovered from that, and I would count your Blessings that you have a very good oncologist that knows what he is doing and is worth listening to. I think the risks of another collapsed lung or some other effect here outweigh the benefits of another biopsy right away. Looks to me like the docs got you covered and are keeping a close watch on your husband.

    Count your Blessings


    I would personally wait and do the scans. I have a nodule on my lung, have had it for a while and they are keeping watch on it with yearly scans. I also have a small nodule on my liver also. I think these are fairly common especially as we age. My sister also had one on her lung and they watched it for a number of years with scans every 6 months until finally, it started to grow so then they acted on it and it was easily treated with radiation using the CyberKnife. I think it was 5 treatments or a little more and it was gone.

    The choice and decision in this situation is totally and wholly up to your husband and you but that is my 2 cents...

    If I am incorrect on the facts you have presented let me know but I think I got your story down alright.

    Wishing You The Best

    Take Care, God Bless

    Russ

  • Kazsmiles74
    Kazsmiles74 Member Posts: 25 Member
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    I appreciate your reply. He is definitely waiting for his scan. As I’m sure you’re aware the amount of anxiety this causes. Especially because he had melanoma of the abdomen in 2022. And that was quite the surgery. This is just a perfect example of how cancer just rocks your world. Trying to live with cancer instead of stuck in cancer can be an extremely difficult thing at times. It has been a long 5 years. But, yes the positive is that he has been able to be here with us for 5 years. Often times others are not so lucky.

  • wbcgaruss
    wbcgaruss Member Posts: 2,366 Member
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    I am confident you are making the right decision and it is only 2 months till his next scan so it's not a big time gap.

    The anxiety of scans, yes it is not fun and on here we call it "Scanxiety."

    I looked up melanoma of the abdomen and from what I find your husband definitely went through quite a time and his situation was very serious. The fact that you say 5 long years tells me you bo0th have had suffering with the situation of this evil disease but have kept on fighting and have come out stronger.

    Yes, I agree cancer is difficult and it looks like you have learned to live with all the troubles and trials that come with it and you folks are able to see the positive in it. It is good he is still with us after going through great difficulties and I like your outlook that he is Blessed because there are others who were not so Blessed and you are thankful for it.

    It can be and is a wake-up call for many people.



    I have a few quotes to share from Ken Curtis one of America’s most talented Christian moviemakers.

    Ken Curtis

    Many people who get diagnosed with advanced cancer surprisingly, actually come to say, cancer is the best thing that ever happened to me. They call it their wake up call and they say that the blessings far outweigh the pain. I can personally say that the three and a half years since I got my diagnosis have been good years. And I have to say even in some ways my best years, because I savor each day so much more. I treasure family and friends I used to take for granted. And it’s good not to have to prove anything to anyone. Right now all I need to do is discern, what does God want me to do and then do it joyfully.

    I know a young man who cancer has severely limited his life, but he refuses to despair. He puts it this way. My glass is not half empty, it’s half full, and it’s not only half full it tastes great.

    Ken Curtis

    After fighting cancer for over eight years, Ken says, “I have been privileged to live an unusually full life. I have had extraordinary blessings, travels, opportunities, ministries, freedom, and honors, so in all honesty I do not feel like I can in good conscience ask for more. I am content to leave it in God’s hands. I am a servant of a faithful master whom I trust more than I trust myself. Surely goodness and mercy have followed me and I will dwell in the house of the Lord forever.”


    Ken Curtis Quotes


    One day I woke up dreaming about going back to the time before I had cancer.

    And then I realized I did not have to give cancer more than it’s due.

    Because cancer’s like a wicked thief that broke into my house to find money,

    jewelry, and other valuables.

    But that thief misses so much.

    My books, my pictures, my written journals in which I preserve cherished reflections,

    these the thief leaves untouched.

    They’re some of the most precious valuables.

    And I came to realize that there are things in life that cancer simply cannot reach.

    Maybe it can ravage the body, but it has no claim on the soul.


    Wishing You the Best

    Take care, God Bless

    Russ

  • Kazsmiles74
    Kazsmiles74 Member Posts: 25 Member
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    Hi Russ,

    I was wondering what size your lung nodule was and what size it is now? In one month my husband’s has gone from 1.4 x 1.2 cm to 3.0 x .7cm with a new smaller 9mm nodule present. Honestly, we were really hoping to catch a sigh of relief with this scan. We were hoping to hear it resolved and he appeared to be in NED again. Oh well onto our next plan of action. Whatever that might be.