Lung nodule being treated as Lung cancer due to medical history

Posted by tova @tova, Aug 4, 2022

They found a nodule in my left upper lobe in my lung and before a PET scan the oncologist is treating it is if it is cancer already due to my history of smoking, family cancer and previous stroke I had in my forties. I’m 58 years old now. Why did he scare me like that without knowing for sure? And then he says no biopsy just surgery and it’s near my heart the nodule.

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@tova

I don’t know yet what type of cancer it is. But I am a heavy smoker, I have the braca gene, my grandmother, mother, sister all had breast cancer and my 90 year old dad died last year from esophageal cancer. So it’s not work related. The dr is treating it as if it is cancer til the PET scan proves differently. But he highly suspects it’s cancer. He said no biopsies just complete removal if malignant. But it’s near my heart and I’m scared !

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Good morning Tova- Before I completely misread this what does "he’s y smoker" mean? (heavy smoker?)

I am certainly not a geneticist so I can not decipher this for you. I don't know if the gene made it easier for you to get cancer or if smoking did a long time ago and changed things. I'm sure that it is even more complicated than my simple questions.

Of course, you are scared! I don't think that anyone who has been diagnosed with cancer is blase about it. It's perfectly normal. Lately, I've been talking my fears down by thinking, "my doctor doesn't want me to be maimed, or die. It's his job to see that I come out of this as safely and healthy as can be. And without any cancer! Why would he waste all of his time, resources and education, and knowledge on me if he wasn't going to do his best? He wouldn't.

On the 30th of this month, I will be having a PET scan and lung function test at my hospital, Mass General in Boston. I have a very small lesion that has grown and my radiologist wants to make sure that everything is perfect before he zaps it with elements from the heavens!

This will make my third SBRT. (a very directed radiology technique). I've also had 2 lobectomies and Chemo, years ago. Am I afraid? YoubetchaIam! For me, my fear is that my Lung Function test will show that my lungs, from the loss of so much tissue, won't be strong enough for me to be treated by SBRT and that it will lead to a much more serious and less effective treatment for me.

But for now, I have to trust him, with all of my heart, soul, and head, and I know that he will do everything that he can for me to continue my best life.

Your doctor has decided to do a lobectomy as the safest way to treat you. He's being cautious! You can't ask for much more! There are a lot of organs that are close to your heart. There's just no way to get away from how our bodies are designed. Being near your heart doesn't mean touching or intertwined. And people have open heart surgery, have things inserted into it, etc. all of the time with wonderful outcomes.

I'm not going to tell you not to be afraid. There are multiple reasons for you to be afraid, especially with something new.
https://njnbi.com/scared-of-surgery-anxiety/
Try and use what has worked for you in the past to reduce your fear, try slow breathing techniques. To reduce your fear doesn't mean that it will all go away. It will make you more comfortable. Read, research, and learn everything that you can. Education is power. Ask your surgeon if you can see one of the operating rooms, talk to an operating nurse and ask her everything that you can think of! I'm here for you! Here's a hug and I can hold hands via the internet. Or I'll be on your shoulder if you want. YOu aren't alone and there are so many people in this group who know exactly how you feel.

Does this sound at all reasonable or helpful?

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@vic83

I had VAT surgery wedge resection upper right lobe in December. I also was a stage 1B. I recall the B was for 3 cm or greater size

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Think you are correct vic83.
Also, from the TNM method of staging, T is for Tumor and b sub-designates its size.

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@deljr

"tova's" experience is very familiar. They found a nodule in my right lung by accident - doing a PET scan for a new hem/onc doctor (blood cancer for 10yrs).
I found out via the hospital's myChart portal - nothing from doctor for 2 wks. Just the PET radiology report.
I educated myself pretty fast.
Soon, I wound up getting a 2nd opinion, had the recommended Robotic VATS surgery, and it turned out to be cancer.
Very traumatic.

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Bless the federal regulation requiring reports to be posted today. I always read them immediately.

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@lls8000

Processing the finding of a lung nodule is never easy. It’s not easy news to hear. You need to get your questions answered. Take some time to note them down, and if possible, take someone with you to appointments and let them know that they are there to help ask the questions that you’re not thinking of asking. You didn’t mention what type of doctor this is or what country you are in, but if you’re not comfortable in the approach of this doctor, find another doctor for a second opinion, preferably a thoracic oncologist.
Depending on the location of the nodule, getting a biopsy can be difficult. If any lymph nodes seem enlarged, biopsy of that fluid may be easier.
My experience says a PET is a good idea. Personally, I would not have surgery without one. IF it is cancer, I would want to know if the cancer has spread to any other area. The PET would confirm that, and allow for the doctor to assign a stage to the cancer, which can help to drive treatment options and decisions.
Best of luck to you, hoping that you get the answers that you need, keep us posted, Lisa

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I live in Ontario Canada and my doctor is a thoracic oncologist actually he is head of the department for the region so I’m happy about that. I didn’t realize that biopsies cause infection and removal is better. Will they know the stage of the cancer from the PET scan ? I can’t have it removed immediately as I’m travelling to Europe for a month and have planned this trip for 3 years. Will the nodule grow much between now and sometime in October/November for removal /surgery? Also does the PET scan show if cancer is in other places in your body ? As if it has spread to other areas ? Will it show that ?

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@tova

I live in Ontario Canada and my doctor is a thoracic oncologist actually he is head of the department for the region so I’m happy about that. I didn’t realize that biopsies cause infection and removal is better. Will they know the stage of the cancer from the PET scan ? I can’t have it removed immediately as I’m travelling to Europe for a month and have planned this trip for 3 years. Will the nodule grow much between now and sometime in October/November for removal /surgery? Also does the PET scan show if cancer is in other places in your body ? As if it has spread to other areas ? Will it show that ?

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It sounds like you have an expert on your side in your doctor, that’s reassuring.
There are different types of tumors and cancers, and they can grow at different rates. No one can really tell you how much it will grow, if at all.
The PET will show if there are other areas in the body (neck down) with suspicious areas that could potentially be cancer. In my case, a PET showed an area on the liver which was later biopsied, and determined to be from the lung cancer. That determined my stage IV diagnosis, and radically changed my treatment plan.
It sounds like you are feeling good enough to take the trip, which is great! You need to go and enjoy yourself, have fun!
Lisa

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@deljr

Think you are correct vic83.
Also, from the TNM method of staging, T is for Tumor and b sub-designates its size.

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@deljr- Good morning. I'm in the process of starting a new discussion addressing this topic. It can get very complicated so I will be as simple as possible to understand. Please give me a day or two. You are on the right track!

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