Multifocal Adenocarcinoma of the lung, continual recurrences

Posted by Merry, Volunteer Mentor @merpreb, Dec 11, 2018

We have multifocal adenocarcinoma of the lung. @linda10 and @sakota.- Please join me in this discussion.

For a short explanation of this tongue twister. Briefly, Multifocal Adenocarcinoma (MAC) of the lung is a clinical entity of multiple synchronous (less than 6 months) or metachronous (more than 6 months), often ground-glass opacities (GGO) on CT scan, typically indolent-behaving cancers. There is a scarce amt of clinical data to guide treatment decisions.
This came from http://ascopubs.org/doi/abs/10.1200/JCO.2017.35.15_suppl.e20041.

This means that more than one potential cancerous lesion, mostly ground glass, shows up at a time. For instance I had 3 cancerous lesions 10 years ago in my left lung and in the same area. They were all different sizes. They grow at different rates.

Multifocal adenocarcinoma is a very complex cancer because the medical profession doesn't know if the ground glass lesions are the primary cancer or small metastases of another primary cancer. They don't even know where they start..

Multifocal Adenocarcinoma has sub types and it's management is based on whether it's indolent or very virulent.

These are very simplistic explanations. Even doctors are confused by it and it's only been within the last twenty years that they have separated it from a Bronchioloalveolar Carcinoma (BAC).

The constant recurrences are the buggers. Not only do we have to constantly face lots of CT scans but when lung cells change, which they often do, we are in terror of another virulent cancer. I presently have several ground glass lesions. And I have had many that have disappeared. It's enough to drive you nuts and PTSD is exacerbated by the frequency of these devils.

Interested in more discussions like this? Go to the Lung Cancer Support Group.

Greetings all. Had another CT-Scan today. Bilateral semisolid and groundglass pulmonary nodules (suspicious for multifocal lung adenocarcinoma) remain stable. Additional scattered tiny solid pulmonary nodules are stable.
So I just wait until the next scan in 3 months.
Anyone also have other non-nodule issues in lungs?
Found this article on multifocal:
https://www.jto.org/article/S1556-0864(18)30964-X/fulltext

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@vic83

Greetings all. Had another CT-Scan today. Bilateral semisolid and groundglass pulmonary nodules (suspicious for multifocal lung adenocarcinoma) remain stable. Additional scattered tiny solid pulmonary nodules are stable.
So I just wait until the next scan in 3 months.
Anyone also have other non-nodule issues in lungs?
Found this article on multifocal:
https://www.jto.org/article/S1556-0864(18)30964-X/fulltext

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YEAH!! I have COPD and emphysema from smoking for 35 years. Sometimes it's difficult to tell which one affects me most. When I have a COPD flare-up, it's usually for a short period of time and I can help with some tricks of the trade.

Do you have any Vic?

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@vic83

Greetings all. Had another CT-Scan today. Bilateral semisolid and groundglass pulmonary nodules (suspicious for multifocal lung adenocarcinoma) remain stable. Additional scattered tiny solid pulmonary nodules are stable.
So I just wait until the next scan in 3 months.
Anyone also have other non-nodule issues in lungs?
Found this article on multifocal:
https://www.jto.org/article/S1556-0864(18)30964-X/fulltext

Jump to this post

Hello Vic. I had a 1 cm nodule in lower left lung and a lobectomy in March. Ground glass with some thickening, if you will, on one outer edge. Adenocarcinoma (determined by needle biopsy). Also, 4mm in upper right which (may) be scar tissue and 6 mm in right center lobe, undetermined. Have follow up CT scan in September. Just waiting to see if both of these are stable.

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@merpreb

YEAH!! I have COPD and emphysema from smoking for 35 years. Sometimes it's difficult to tell which one affects me most. When I have a COPD flare-up, it's usually for a short period of time and I can help with some tricks of the trade.

Do you have any Vic?

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My CT-scans don't talk about COPD, although it got added to my list of health issues, maybe because they sent me home from the hospital with night oxygen (which I no longer need). However, the last scan mentions "Stable probable UIP pattern fibrotic interstitial lung disease, mildly increased compared to scan six months ago". Not sure what that means for me. I have been increasing my exercise load in cardiac rehab and oxygen levels holding well (88 or higher during exercise). I can easily walk my usual 35–40-minute route. Despite having VAT surgery, Covid, coronary stent, and even an isolated arthritic flareup of the hands in the last six months, I am currently walking around like nothing happened.

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@colleenyoung

@merpreb So glad you started this discussion to connect people living with multifocal adenocarcinoma of the lung. I'd like to invite you, @linda10 and @sakota to get the conversation started. When were you first diagnosed? How are you doing today?

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I'm still living with it and get my ct scans every 6 months but things have been pretty quiet in my lungs for awhile now. I go again for ct in september so will find out then if anything is new. Guess I take each day as it comes and thankful for each day I have. I am also dealing with copd now and last winter was not a good one, was in out and out of the hospital. I am now in assisted living and things seem to go ok. Keep the faith and family close .. Hugs to you all. Joan

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@jp78

I'm still living with it and get my ct scans every 6 months but things have been pretty quiet in my lungs for awhile now. I go again for ct in september so will find out then if anything is new. Guess I take each day as it comes and thankful for each day I have. I am also dealing with copd now and last winter was not a good one, was in out and out of the hospital. I am now in assisted living and things seem to go ok. Keep the faith and family close .. Hugs to you all. Joan

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I am going for my second pass of followup nodules in my lungs in a few weeks. I am hopeful since the one in my thyroid has neither grown nor changed--but they may not be connected. My Vit D levels are finally normal after six months of taking a daily dose. I had covid and was concerned, but passed the PFT, I believe.

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That is so sad, never heard of this before, do you have pet scans each time
Do they see a new one on a CT scan? They tell me you see more on a pet scan.
They can see your whole body that way.
Thank you for sharing this, I had never heard of it before.

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Had my six month follow up CT scan after lobectomy in March, 4mm and 6mm nodules seem stable so go back in six months. As they all say, this is the new normal, waiting for 6 months at a time. Best of luck to you Mary on your next scan, stay positive!

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Here is an interesting update for multifocal lung cancer. A year ago, I had a 3.1cm stage 1b cancer removed from right lung (wedge resection). I am being monitored with usual CT scans. I had a recent CT scan which was more intense compared to the usual ones I do because of some pleurisy. This scan listed 8 lung nodules in various stages of development from pure ground glass to part solid components. The report stated that some nodules mildly increased and many likely reflect adenocarcinoma spectrum lesions. I asked about all these nodules and was advised that the nodules are treatable if we need to. If they don't grow very fast, then we may not have to do anything.

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I am exactly 1 month post left upper lobectomy for NSCLC and doing well. I am stage 1-all nodes removed were negative and no treatment needed at this point. I have my first CT Scan in April and praying it is okay. I wasn’t aware that reoccurrences were so common. Praying.

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