Needle Biospy not performed in 2005 (lump in 2006 was cancer)

Sorry
I don't really have an answer for the protocol or procedure. I know when I first was diagnosed with possible throat (tonsil) cancer, I also had a tumor pop up. When I first visited the MD he had mentioned that he was removing the tonsils, and doing a needle biopsy on the tumor.

A few days later the tonsils were removed and he did a quick biopsy at the same time (tonsil tissue), confiming that it was SCC. He sent the tissue off to determine if it was HPV+, it was.

Anyways, I had asked him later about the needle biopsy, he said he didn't do it. I asked why, but his explanation, which satisfied me, was there was no need. He already confirmed that I had SCC in the tonsils. Anything else would show up during the PET.

I know that is a different scenario than your brothers in the fact that they didn't diagnose, operate or perform any further treatment at the time for your brother, and that is unfortunate.

All I can really offer at this time is that it has been determined to be cancer now, and that they are planning a treatment stradegy. Be positive and there for your brother.

Unfortunately there's nothing that can now change what has or has not been done. Hoping for the very best for you and your brother in the upcoming weeks and months.

Best,
John

Seething
Hello Patty, I can see why the doctor's seemingly off-the-cuff remark bothered you. It would me too, but I would've done the same, given the doc was scheduled to perform the surgery. Can't really speculate on his/her awkward attempt to diffuse a situation that might become an issue at a later date . . .

John is on the mark though. Your admirable restraint shows that you're already aware that the primary concern now is your brother's treatment and recovery.

best to both of you, Hal

Patty, that is aweful and
Patty, that is aweful and totally unacceptable. It absolutely blows my mind to see how doctors truly DON'T CARE!!! I'll bet they'd be upset had that been thir loved one. I am very sorry and definitley understand why you need to vent. I would do the same if it was my brother. I keep telling my bros and sisters they must take control of their health, ask questions and get mad if that is what's it takes. We can insist they do this test or that test. Patty, I will put your family in my prayers. My heart and best wishes go out to you now. Take care and try to calm down. Your brother is really gonna need you now.
God bless you,
debbie

stevenl said:

Procedure
I went to my primary when I first noticed a small lump in Dec. 09. He gave me antibiotics and said give it 10 days. I think he knew there was a problem because when I told him there was no pain and it was not bothering me at all, he said not good. Told me if it was an infection it would probably be bothering me in some way. But he followed protocol and gave me the antibiotics. But he did want me to return in 10 days. When I returned he sent me for an MRI and CT scan. He got the results in about 3 or 4 days. From that time until April everything was kind of a blur. That is how it happened for me but I've got a real good primary care doc who sent to some of the best doctors anyone could ever hope for.

Best,
Steve

Hi Patty in NC
Steve reports the best case scenerio. My partner, Mark, pictured to the left, had a lump in his neck for several years. He also has two other lumps on his body which are fatty deposits. When he first had the docs check his neck, he was told it was the same thing he had on his arm and torso. In January of 2010 he began having ear and throat pain, went to the doc, he was put on anti-biotics. Pain did not go away. He returned...he was put on stronger anti-biotics, pain did not go away. He returned again and he was put on strong anti-biotics for a longer period of time and was told if this did not take care of the problem he was to get a CT scan. Needless to say, I would not be writing this if that 3rd round of anti-biotics did the trick.
He was diagnosed on April 13th 2010 with SCC left tonsil, stage IV. Yikes!!
Many were appalled at the primary physician's continuation of anti-biotics and late CT scan. I had a hard talk with the ENT who did his surgery...he felt 3 months is the acceptable time frame for a primary physician to pick up on cancer with presenting symptoms like Mark's. He felt a law suit for Mark would be a lot of work and no guarenteed outcome. He thought it could be 50/50. Mark was interested in another kind of fight...a fight for his life. We are not pursuing anything.
Steve's doctor seemed to, not only be right on target, but ahead in the game. (Steve, your primary is a keeper).
Patty, your anger is justified. Mark's advanced stage of disease would not have been so andvanced had this been picked up on sooner...he probably would not have had to have the radical neck dissection which has altered his appearance. May be less noticable when he gains some weight back.
What you want to do with your anger is entirely up to you. You may have a malpractice law suit worth pursuing. The doctor will never admit that he said what he said to you, but the record shows your brother presented with symptoms a year ago. But after the anti-biotics your brother did not return, so the doctor could have the position that the anti-biotics worked. In PA, a malpractice attorney will review a case for free to see if it has merit. Again, it is how you decide to direct your energy at this time. I know I had no energy for a law suit, I let other family members carry that anger, and it subsided for everyone as Mark got into surgery and treatment.
Patty, cancer just sucks, and we want something to do with our anger and our helplessness. Talk things out here on these boards. It helps tremendously.
My Best to your brother, you and all the wonderful people you will encounter here,
Kim

Pam M said:

Here, Too
Patty,
It was a young dr. who prescribed antibiotics for me and said to see my primary if it didn't get better (the huge lymph node sticking out of my neck) in a month. But I was told to have it re-checked if it didn't go down. My primary (probably mid forties) said we had to have it checked right away, and that "until you know it's not cancer, act like it could be".

Same
I discovered a lump on the side of my neck & thought it was an infection from a molar that was giving me trouble. I made an appointment & went to see my dental surgeon. He proceeded to tell me that it was a bacterial infection & as soon as we pulled the molar out my troubles would be over. So I trusted him & waited & finally found a Dr. who referred me to an ENT who ran tests & discovered that it was stage 4 cancer of the toncil. Yes I was angry, but thought about my girlfriend who just lost her 29 year old son to cancer of the tongue.She tried to hire a lawyer in our city but no one would touch her case. She finally found one from out of town & the max payout is $90,000 & after paying out lawyer's fees & their cost's there would be nothing left. Therefor I decided that I had enough of a battle to fight & to focus on my health & my family.But I do make sure to mention to anyone requiring a dentist never to go to him. That is my revenge.

micktissue said:

Patty
Exactly what happened to me. The Dr was not concerned with the lump in spite of a family history that included lymphoma. He sent me away with antibiotics which had no effect on the lump. It was 6 months of me worrying about it before he finally agreed to a biopsy which, after 2 failed tries, came back as SCC about 9 months after I found the lump.

I did some research on this and found a research paper that said this is a fairly common approach (antibiotics and no biopsy) but the procedure of giving antibiotics was unfounded. I am looking for that paper and will put it somewhere for you (and anyone else) to download. I sent my Dr (now former Dr) a nasty gram and gave him the paper as well. He has not responded. Jerk.

this is why I am so for advocating. It is always wise to bring someone with you who can talk when you cannot, listen when you're overwhelmed, and drive when you cannot see through your tears. Drs don't get it so they need to be told.

Best,

Mick

Agreed.
Patty, so sorry to read about your experience, very tough to read.

Like many here, I had a lymphnode that was "giving me trouble". In Nov. of 2009 I noticed a swollen LN on the right side of my neck. My sister in law (reseach RN) was visiting from California and I showed it to her. We both mumbled that I should get it checked out.

I went to an ENT (December)with a sinus infection and my swollen LN. Antibiotics prescibed. No change in node, infection gone. He was concerned, one more round of AB's and then "we need to watch that LN". After second round of AB's, no change in node. He wanted to CT scan right away. I spoke with a Orthopedic Surgeon friend of the family, and was refered to an ENT he knows / trusts etc. I told him the story so far and he wanted a scan to rule out C. I started to get concerned. Forward to January 2010. Had a CT scan. Inconclusive. Next ultrasound needle biopsy. Rulled out Lymphoma, but no conclusive I.D. of C. So my new ENT says..."that thing needs to come out". So it did. Local path couldn't positively I.D. which cancer it was, but it was cancer. Slides sent to Mayo Clinic, I.D. squamous cell carcinoma. My ENT referred me to MDA. After CT scan at MD Anderson...unknown primary, no tumor found.

So...2/19/10 surgery / biopsies...no primary found
3/15/10 started treatment
4/30/10 finished treatment

Again, sorry and best wishes to your brother.
Chuck.

Inexact science
PattyNC,

I sympathize with your anger and distress. I was treated at two promptcares for a lingering sinus infection/bronchitis and put on antibiotics both times. After three or four months of a persistent inflamed lymph node, I took myself to an ENT specialist. He sent me directly to a pathologist for a fine needle aspirate biopsy. The pathologist got inconclusive results and told me to get treated with a stronger antibiotic. My ENT was sufficiently concerned about the four month duration of the node and the fact that it was 3 cm in size. He admitted that protocol would be to put me on antibiotics again, but told me that he wanted to surgically remove it instead. Glad he did. That was how we found the SCC. Doctors, ENT's and pathologists seem to be all over the map on this one.

Deb