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Old 04-16-2005, 12:29 PM   #1
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changes in CT SCAN

Hi.......looking for any opinions on the following: I had my 6 month CT Scan done for a lung nodule that was discovered a year ago by a chest x-ray. This is the result of the recent CT Scan:

The study demonstrates apical thickening at right lung apex anteriorly: a right apical lung nodule is seen with strands of tissue extending in to the previously described apical pleural thickening in right lung apex; this nodule is noncalcified and is irregular in outline; three enlarged mediastinal lymph nodes are present.

Do I wait for another CT SCAN in 3-6 months or do I look into this right now? My doctor has suggested waiting to see if there are any other changes in 3 months. This CT Scan showed changes from the one done 6 months ago. (I didn't the enlarged lymph nodes then nor did the last report mention the tissue strands from the nodule extending.)

I'm a little nervous with these changes but wouldn't my doctor suggest doing something right now if this was lung cancer?

The lung nodule is 12.8x9.4x11.9mm with a total prostatic volume of 351.4+/-59.7mm

Thank you.....

 
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Old 04-16-2005, 01:12 PM   #2
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Re: changes in CT SCAN

My Mother has advanced lung cancer, she waited and wished she had not. She has CT scans often and there is always something different. A secound opinion might be wise, but remember my Mothers Lung Cancer is unoperable. She has gone from 175 to 97 pounds. A secound opinion is always good with cancer, but My Mothers was just to advanced for surgery. Also my Mother has fought cancer since she was 22, hysterectomy, skin cancer and now lung cancer, which came back, but this time they can not operate. My Mother is 69 years old. Take Care and hope you message again, to let us know how you are doing.

 
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Old 04-17-2005, 09:42 AM   #3
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Re: changes in CT SCAN

There is NO WAY I would wait one day to call and make an appointment to get that nodule out of my body...

Growth - enlarged lymph nodes - irregular outline - BIG red flags! Why would you want to wait? I don't know what your doctor could possibly see as a benefit of waiting... please get another opinion!!

Have you seen a pulmonary doctor yet? This would be my first step - it actually was my first step when I found out I had a nodule - had the surgery to have it removed - as a matter of fact - I think I have corresponded in this board with you regarding my surgery in Sept. A thoracic surgeon was my second call after the pulmonary doc...

Please be proactive and get moving on this - Keep us posted!!!
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Old 04-17-2005, 07:25 PM   #4
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Re: changes in CT SCAN

Hi MWessell, Thanks for responding. The doctor that suggested I wait is a pulmonary physician. We did correspond before about this last September. You have given me excellent advice and I plan on calling a surgeon tomorrow. I agree that I should never wait for answers. How long did it take you to heal after the surgery? Thank you for your concern and I'll keep you posted.

 
Old 04-17-2005, 07:56 PM   #5
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Re: changes in CT SCAN

I was in the hospital for 3 days and feeling great after about 2 weeks or so. It was worth every minute of pain and discomfort...I overdid it when got home otherwise I think I would have felt better sooner...

I am a wimp - never had surgery before...I am so glad I did it.

Keep me posted

Mary Ellen
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Old 04-19-2005, 10:06 AM   #6
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Re: changes in CT SCAN

HI

I agree, I certainly wouldn't want to wait, either. Although, I'm in the same boat. Nodule is larger, and nodes are also now enlarged. I'm in the 'hold' pattern.

Given a choice, though, I think I"d opt to have it removed, especially with the apparent growth! What could your doctor possibly be thinking?

Good luck

 
Old 04-19-2005, 02:37 PM   #7
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Re: changes in CT SCAN

I saw a thoriac surgeon today and he explained to me that the past 3 ct scans that I had done were read manually....the one I had done last week was read by a computer and manually. The computer reading says that the nodule is bigger. Manually it hasn't really grown. He first suggested waiting 6 months to have another one done and then see how the computer reading matches up. If it shows growth, then we act on this. He didn't mention anything about the enlarged lymph nodes or the shape of the nodule (changes from before)...neither did I (very stupid of me) but this dr. took me by such surprise by coming in the room and not so much as asking me anything about health...he just shook my hand and said that after reveiwing the films that he thinks everything is fine and that we can re-test in 6 months. I think he saw the shock on my face and then asked what my pulmonary dr. thought needs to be done (yet she faxed him my records and her suggestions which he apparently didn't read). Anyway, my husband asked him about a needle biopsy and he said that there are to many false negatives with that so if I wanted to we could do another pet scan (last one done last year) I said yes and it's scheduled for thursday then I see him again next week. I told the dr. that after this scare, I am considering surgery to have the nodule removed...he didn't say to much to that except that he doesn't want to put me through it if it's not needed but having it removed may or may not be a good thing to do...I can kick myself a million times for not being more assertive today but this whole appt. was weird. I have never been to a new dr. that didn't sit and discuss my health and symptoms with me first and then talk about treatment, if any is needed. I know I'm rambling on here...sorry. I wonder if I should be worried about the nodes and shape even tho we didn't touch on that today?

Mary Ellen: Did you have lung cancer? If you didn't, did you know that before you had the nodule removed? Do you remember the size of it? Did you decide to have it removed by yourself or did your dr. suggest it? Had you smoked before this? If I'm asking to many questions..let me know.

Thanks, again, for being here to help...

















































Mary Ellen:

 
Old 04-20-2005, 07:48 AM   #8
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Re: changes in CT SCAN

Hi again -

I did not have lung cancer - it was benign. (I thank God every day) I did not know this before the surgery...that is why I had the surgery. It was 1cm and had a small "tail" on it (indicitive of a malignancy). Taking it out is the only way the doctors can say "no - it is not cancer". I could have waited but chose not to - why would I want to worry every day? Best decision I ever made.

The needle biopsy is not a very good tool - your doctor is right - too many false negatives. But t does sound like this new doctor did not even review your case. He needs a good kick in the *** to remind hm that you are a person!

I was given a choice by the doctors to wait or have it removed. They were not pushing me either way. BUT they did tell me that they would not give me a clean bill of health - it is considered cancer until proven otherwise.

I started smokng when I was about 15 and I am 43 now. I can't believe I smoked for nearly 30 years. I had my last cigarette the night before surgery. It has been 7 months.

So, having the surgery was the best thing to do. I don't see it as unneccessary...if it was malignant I would have been able to be cured - and since it was benign - I can sleep at night and live a peaceful life - my kids were not benefiting from me being in a state of fear all the time.

It was 3 months between finding the nodule and having it removed. I was a mess - I have a 1 year old and a 13 year old that sensed my fear and it took a toll on them as well. My husband suffered as well wondering if he was going to raise them alone.

Ask as many questions as you want - that is why I hang around the board - I am SO lucky not to have cancer - if I can help someone through the fear of waiting for the diagnosis - my job is done!
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Old 04-23-2005, 05:36 AM   #9
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Re: changes in CT SCAN

Hi Delady...I feel like I shouldn't butt in here but I wonder why you want to undergo surgery when you have both a pulmonologist and a surgeon saying you should wait longer.

...Mary, I'm glad your surgery went so well and you recovered so quickly, and that your nodule was benign....but that's my point here...you went thru surgery for a benign nodule; I've read that half of all small noudles removed, that LOOK like cancer on a CT Scan, turn out to NOT be cancer, and, depending on the surgery, there can be some big risks involved. For you to recover so quickly I'm assuming you were able to do the easier VATS (video assisted) surgery? On SMALL nodules, the easier VATS surgery often has to be changed to a full thoracotomy during the operation cuz the camera can't always find a small nodule...a thoracotomy is a major surgery that most people would want to avoid if they're not positive the nodule is malignant. What is it that your nodule turned out to be??

Delady, a PET scan can show an active fungal or bacterial infection to LOOK like cancer so you might get a false-positive answer from the PET. Is there any other way, other than surgery, that you can get a biopsy done? From what I read the needle biopsies are often inaccurate...bronchoscopy is more accurate but some nodules can't be reached that way. Sometimes a sputum culture will show cancer cells but there are false-negatives in all tests...still, you might try something easier than surgery first I'd think.

Anyway, I'm sure not advising you to NOT have surgery and have the nodule removed, but maybe you could wait only 3 months for another Scan instead of waiting 6 months, have another look at what the nodule is doing before you make a decision, since your doctors seem to think that's best?? Or at least get a second opinion from another radiologist and/or pulmonologist?? You said the computor showed the nodule to be larger than it looked in the manual readings, but it sounds as if it's not growing much if at all? How large IS your nodule? Do you live in an area where fungal infections are common??

Anyway, I wish you luck and good health...........sincerely.............. .Tiz.
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Old 04-23-2005, 09:27 AM   #10
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Re: changes in CT SCAN

Hi again,

The problem I have with any waiting is that one of my best friends is dead because she waited. It will be a year on May 8. I watched her suffer and die because she waited and put off a surgery for skin cancer.

Once something as bad as cancer has spread - you could be screwed. Period. No going back. End of story and end of life. Not in every case...but in my friend's...and that was enough for me to see.

I watch her 2 girls suffer everyday growing up without their Mom. I try to fill in as best I can for the girly stuff...but I can't hold a candle to her. I just try to be their friend. Her husband is depressed...the home has a dark cloud hanging over it. I miss her every day. All this because she waited. If she had been aggressive, she would be here. I was friends with her since we were 15...28 years ago.

My surgery was a VATS (yes - I was lucky) and they have a pretty good idea when they look at the scans if you will have a VATS or not. My surgery WAS NECESSARY in my eyes- I could not live wondering if MY girls and husband were gonna suffer because I waited. I lost 20 pounds and slept about 2 hours a night after I found out about the nodule. I cried ALL THE TIME. I would do it again in a heartbeat. The doctors were not really sure what the nodule was once they took it out - I had a lot of bronchial infections and it was probably due to that.

And IF half of all nodules are benign - then HALF OF THEM ARE MALIGNANT. This is not a chance I would want to take!!!!!

I find it interesting,Tiz, how things can be looked at differently. I see your point - and it is a good one - I just do not agree. If I did not have the surgery, I would be a bundle of nerves and very unhappy. I also quit smoking after over 25 years. So I guess it is different for every patient - and everyone knows deep in their heart what is best for them.
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Old 04-24-2005, 11:39 AM   #11
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Re: changes in CT SCAN

Hi M...I'm really sorry about your friend and the pain of her family, and you, with her loss. Your decision about your nodule was the right one for you and if I sounded like I thought it wasn't, I'm sorry. I just don't want anyone to go into major surgery only because they're scared...like what's been happening to me.

I have a lung nodule, discovered about 8 months ago, and my doctors scared me into agreeing to a full thoracotomy and upper lobectomy...nearly the whole lung on that side. I talked to the surgeon on the phone and in emails several times and made plans for this surgery, but I was just horrified about it; I'm not at all well and I always felt I'd come out of that surgery worse off physically than I already am. But the surgeon said I'd be fine...then, two weeks ago I saw him in person and when he realized what poor physical condition I'm in he said he won't do the surgery. They can't do any non-surgical biopsy on me so they are not POSITIVE this nodule IS cancer, but I was ready to do a major, life-threatening surgery because they scared me so badly.

I do have major risk factors for cancer...I've smoked for 42 years, I'm age 54 and I have severe COPD...and this nodule LOOKS like cancer on the CT Scans. But I have many many reasons to believe the nodule is a fungal infection and even a HEALED fungus infection CAN look like cancer on a CT. I have some "pluses" that MIGHT mean the nodule ISN'T cancer...it's not cavitated, it DOES show some calcium in it, it's VERY small (a bit over 1 cm) and it's growing VERY slowly. There is no history of lung cancer anywhere in my family even tho most of my family are heavy smokers and many were alcoholics (I don't drink at all, which is a plus). My doctor says it's EARLY cancer, yet early cancer rarely has any symptoms; the most common early symptom is a chronic cough..I don't have one.

But I'm very sick and I have MOST of the symptoms of a fungus infection, and I have a basement full of black mold that we just discovered not too long ago. I feed birds and have many times swept the patio to clean up the seed shells and droppings...and breathed the dust as I swept (bird droppings are full of fungus, as are the fall leaves I love to rake and the soil I love to garden in). I live in Iowa and fungal infections are so common here that most people have had a lung infection from it during their life-time, they just don't know it because healthy lungs fight the infections off, often leaving small nodules behind.

But, because I smoke, my doctor will NOT do tests to see if this is a fungus infection, he tells me, adamantly, "it's cancer" and says I have to have a surgery... he's looking for a different surgeon now who will do the surgery on me but he'll have a heck of a time getting me to agree to it again I'm afraid. Since he hasn't yet found a surgeon he's set up for me to have a 4th CT Scan on May 15th....we'll see what the nodule's doing then.

Meanwhile I've organized a major effort to clean my basement of mold...to walk thru the basement you can't SEE the mold, you have to LOOK for it, but we found some very frightening areas down there (once the spring rains started here you could SMELL the mold). Many cardboard boxes covered with mold, some old pillows, an old foam-filled footstool...and panelling with bad areas of mold inside the closets. I have nearly every symptom of toxic mold exposure they list, including asthma-like gasping for breath attacks with even the slightest of activity. I've been really sick for the last 9 months and I believe it's from the mold, and I believe there's a very likely chance this nodule is a fungal infection.

I hope I'm NOT wrong because, without a surgeon, I don't have any options other than to "wait and see". I'm trying to see an Infectious Disease specialist and so far can't find one who'll see me without my doctor referring me, and he WON'T, he just keeps shaking his head and saying "it's not fungus".
But anyway, my last post was just trying to say, like you said, we each must make the decions that are right for us and we all hope we make the right ones cuz the wrong decision can kill us. But no one should be SCARED into surgery, certainly not a full lobectomy, for a very small, very slow growing nodule just because they smoke or used to smoke. ALL possibilities should be looked into and I'm trying to find a doctor now who'll at least explore other possible reasons for this nodule in my lung.

Sincerely...................Tiz.
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Old 04-25-2005, 06:06 PM   #12
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Re: changes in CT SCAN

Tiz...

It's sounds like you have alreay been diagnosed...why would they do a lobectomy unless it was malignant?

"My doctor says it's EARLY cancer"
"he tells me, adamantly, "it's cancer" and says I have to have a surgery" It sounds like the doctor made himself perfectly clear...I hope you are ok...

I think you may need to get an official diagnosis...they would never take the top lobe of your lung out just to do a biopsy...

I hope you are not in denial...

Keep us posted...
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Old 04-28-2005, 11:17 AM   #13
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Re: changes in CT SCAN

I am trying to get ahold of shadowrose. I need to ask her a question about Chaz, if she knows where his cancer started?

 
Old 04-29-2005, 08:56 PM   #14
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Re: changes in CT SCAN

Hi Everyone,

Sorry I haven't been here lately but I've been in a crazy mood. Not really able to do much.
I saw my thoracic doctor again this week, after a pet scan, and he told me that he feels that things are ok so wait for 3 months, have another ct scan or I can have him remove the nodule. I swear I can't believe this man is a doctor!! I have never met a dr. that thinks he's God! It wasn't the waiting that floored me...it was how he talked to me. After this man told me my pet scan was negative, he preceeded to say that it was only 2 weeks ago that another one of his patients had her scan come back negative too but he felt that she should have surgery anyway...she did and it WAS cancer. He said he had a feeling about her even tho she had no symptoms or anything except a lung nodule. NO cough, no smoking...NOTHING! Surely he knew that would scare me! Then....LoL...I hope I'm making sense here...I asked him about the other changes in this ct scan that wasn't there 6 months ago (3 enlarged lymph nodes) and the fact that my voice has gotten raspy and he bluntly asked me "Where the hell did you get your medical license?" I was shocked and said the internet. To this he said "You read to damn much!" My husband asked him what the chances are that this could be cancer and he said small but would you want to be in the group that has a lung nodule and it be cancer and do nothing. All the while (10 mins. at most) he was talking to me, he was edging toward the door. He left the room telling me to decide what I want to do...leave it or remove it and call his office to let them know. My husband tried to ask him one last question: What would you do if this was you? His response: I can't tell you what to do...it's not like it used to be when drs. could make a suggestion like that...maybe someday it will go back to that. Off he went to the next room. I was so upset and still am. This man is treating ppl at a cancer center and I just can't imagine having him as my dr. if I did have lung cancer! Is it to much to ask for a little understanding at a time like this in my life. Someone on here said that it's important to go by your gut feelings and I don't think I have cancer but after what he said to me, I'm scared. If the pet scan came back negative for that other lady...could it for me? He made that remark to my husband (would you want to be one of the ones that has it) and that makes me wonder if he thinks I should have surgery. Oh yeah...how could I forget...he also said enlarged lymph nodes and a raspy voice have nothing to do with lung cancer!!!! Is it me? Or him??????

 
Old 05-06-2005, 01:19 PM   #15
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Re: changes in CT SCAN

I know this is probably after the fact but you need to get it checked immediately.......I'm currently dealing with my mom's lung cancer and if only i had known a year ago what i know now.......anyone who smokes should get a ct scan yearly.....Most people fail to realize the cruelty lung cancer can bring at an advanced stage......my thoughts and prayers are with you also

 
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