Biopsy

nanuk · December 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 · December 2003

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

nanuk · December 2003

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

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 · December 2003

nanuk said:
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

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

Unknown · December 2003

Hey Bud:

I agree with Emily. Is there any way you can get to a major cancer center. I can tell you first hand that when I finally got my husband Bert covered under my insurance, and we had our first appointment with new onc, the difference was like night and day...at least for us it was. Not only did this onc spent much more time with Bert, he explained procedures, options, what ifs, etc. and he assured us that the place was fully and completely staffed with all the latest machinery, gadgets, people, labs, etc. so we wouldn't be running all over town. Not that we did with Bert's current onc, but more technology is definitely available at a cancer center.

As I understand it too, Pet Scans show "hot spots" but do not determine malignancy...biopsy is still needed for that.

Keep us posted, okay. My advice again, for what it's worth, if you can, get yourself to a major cancer center. Bert and I will have to travel about 60 miles for future appointments. While that's not an arm and a leg (I know some folks travel 100's of miles), it's much further than the 8 miles we were traveling.

Fondly,
Monika

aleftina · December 2003

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

KrisS · December 2003

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

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

nanuk · December 2003

2bhealed said:
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

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.

nanuk · December 2003

unknown said:
Hey Bud:

I agree with Emily. Is there any way you can get to a major cancer center. I can tell you first hand that when I finally got my husband Bert covered under my insurance, and we had our first appointment with new onc, the difference was like night and day...at least for us it was. Not only did this onc spent much more time with Bert, he explained procedures, options, what ifs, etc. and he assured us that the place was fully and completely staffed with all the latest machinery, gadgets, people, labs, etc. so we wouldn't be running all over town. Not that we did with Bert's current onc, but more technology is definitely available at a cancer center.

As I understand it too, Pet Scans show "hot spots" but do not determine malignancy...biopsy is still needed for that.

Keep us posted, okay. My advice again, for what it's worth, if you can, get yourself to a major cancer center. Bert and I will have to travel about 60 miles for future appointments. While that's not an arm and a leg (I know some folks travel 100's of miles), it's much further than the 8 miles we were traveling.

Fondly,
Monika

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

2bhealed · December 2003

nanuk said:
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.

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

vcavanagh · December 2003

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.

Biopsy

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