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Exploratory CT guided bronchoscopy?

dearfoam's picture
Posts: 82
Joined: Apr 2011

Originally they said dad's tumors weren't accessible for a regular bronchoscopy, so we waited another 2 weeks for him to get approved and worked in for a needle biopsy of his lung. Needle biopsy seemed to go fine last Thursday and had no problems for 3 days. Sunday his right lung collapsed and I took him to ER for chest tube and he was admitted for observation etc.

Today (Monday) a thoratic (vascular) surgeon said since the needle biopsy didn't get a good sample, they will use a larger needle and do an exploratory brochoscopy. they will use CT to guide it. says it can reach dad's peripheral lung tumors. usually this equipment or technique is used more in heart and vascular procedures. says it uses much newer technology. i would just like to know what the *** this cancer pathology is.

Hoping it all goes well and thy will be able to remove the chest tube soon. It is really painful. He will be in hospital at least 2 or 3 days.

soccerfreaks's picture
Posts: 2801
Joined: Sep 2006

I am NOT a doctor so take what I say with a grain of salt (or perhaps a pound or two), but I HAVE had a CT-assisted needle biopsy, and must assume that a CT-assisted bronchoscopy is not so different a beast.

If I am right, it simply means that dad will be in a CT machine while the bronchoscopy is performed, so that they can 'see' exactly where the scope is and where to move it "live", not unlike what they do, again, with the CT-assisted needle biopsy.

Your apparent anger seems misplaced, incidentally, as it sounds as though your dad's physicians are doing everything within their power, within the current reaches of technology, to get to the bottom of the matter. Kudos to them!

Best wishes to your dad and his family.

Take care,


dearfoam's picture
Posts: 82
Joined: Apr 2011

I'm totally angry at the cancer - not the doctors. Didn't mean to write that between lines.

I understand the CT part of the biopsy, that is how they did the needle biopsy the week before. Just these docs are heart and Vasc surgeons and are using some other technology as well. It's all over with now. Waiting on the results while dad sits with a chest tube in him until they know they won't for sure need it anymore.

Posts: 183
Joined: Apr 2011

Hi Dearfoam, So sorry you are dealing with all this. I know it can be tough. You have been a real trooper for your dad and it is so hard with all the waiting. I can relate. I had a bronch test in January (by my pulmonary dr) and the results came back negative for cancer. I went to see a cario/thoracic surgeon to have tumors removed and he insisted upon a ct guided needle biopsy which I had 3 weeks ago. ( He didn't like the way the bronch was done previously) Tests results came back positive this time for NSCLC. During the needle bio, my lung collapsed immediately. That is a possible complication. Chest tube inserted and hospital stay for 2 days. Finally closed up. Last week the surgeon had me go thru a mediastanoscopy/bronch procedure. (we have already decided upon a lobectomy in May). During this procedure, he assessed the tumors in the lungs, and the lymph nodes on the mediastanum and collapsed the lung to look in the plural cavity where he also took samples. It is best to know exactly what condition the lungs and surrounding tissue are in and what they are dealing with. Speaking from my standpoint, I think they are doing a much better procedure for your dad. I am glad I followed up with a cardio/thoracic surgeon instead of just listening to my pulmonary doc. It could have been a matter of life or death. The waiting and not knowing are tough. Be patient and ask questions of these drs. They should be able to explain the whys to put your mind at ease. (somewhat, anyway) Sorry I rambled on, but I just wanted you to know that sometimes these tests are for a very good reason and can mean a big difference on the choice of treatments. We want the best odds we can get. I hope my experience has reassured you. Hugs and prayers to you Dearfoam for being a wonderful daughter.

dearfoam's picture
Posts: 82
Joined: Apr 2011

I really just wanted to know if anyone else had had it done or knew about them. I think the other commenter implied I was angry at doctors and that was quite an assumption.

Dad will not be out before Thurs night at earliest. Lung has sealed but have to wait to remove tube until they get a positive biopsy result. We aren't looking for a clean biopsy, we already know he has a late stage unnamed cancer. :(

Dapsterd's picture
Posts: 291
Joined: Jun 2010

I had a drain tube put in through my upper back due to an Infectious (strep/pnemonia, right lung lower lobe) Pleural Empyema, with the doctors being guided by use of Ultra-Sound, I guess a CT may be equal or better for guidance. This guidance procedure is not uncommon, but rather required for the procedure to be less evasive....but......make sure the pain meds person is close by !!!!!!!!!! they had to keep giving me more and more and then procedure was over, but terrible pain during and for days afterwards.

Intervention Radiaology Dept performed this procedure, with consultation of other groups, especially Thorassic Surgery Dept.

Josephine Ford Cancer Center-Henry Ford Hospital--West Bloomfield, MIchigan.

Best wishes

dearfoam's picture
Posts: 82
Joined: Apr 2011

Dad had no pain complaints about the collapsed lung over the weekend, which is why we didn't know at first. None. He calls the chest tube a B*tch though. Taking tylenol 3 pretty regularly now.

Posts: 199
Joined: Jan 2011

As someone else has stated sometimes several tests have to be done before they are satisfied that surgery is an option. I had two bronchoscopies, and a needle biopsy. two stress tests, perfusion scan and so on. Just keep patient if you can and believe me I know how hard that is.

Posts: 39
Joined: Mar 2011

Dearfoam... it is so important for them to fully figure out what they are dealing with... or at least the best they can. The waiting is so very hard I know. I felt so helpless during my dad's initial discovery of "the mass" until the final pathology reports were in and treatment was decided upon. During that time he underwent a needle biopsy, scans, tests.. appointments... and then surgery. The surgery determined his tumor was too "extensive" and inoperable. I wish somehow they could have figured that out before they cut him open. He then had to recovery from that surgery before he could start chemo and radiation (which he is currently enduring). Anyway... just saying I understand the frustration... I still feel like screaming most days. But.. it is what it is.
Keep taking one day at a time. And you're doing the best you can... take comfort in that.
Thoughts with you and your dad.

dearfoam's picture
Posts: 82
Joined: Apr 2011

I'm not sure that he will be a candidate for any surgery since he has so many mets. I think we will be in the symptom management category after the diagnosis and prognosis come back. It's amazing how so much is hinging on this biopsy (like home health or home hospice orders that we really need), and that we have waited over 5 weeks for an accurate pathology due to everything that can go wrong. There are the bright sides, too, like at least all this didn't happen at first biopsy and get us stuck in PA with no insurance. And we got to enjoy the weekend. And I got a couple full night's rest lately. Bittersweet though.

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