Multifocal Adenocarcinoma of the lung, continual recurrences

Posted by Merry, Alumni 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.

@catlover1943

Merry I have been reading the words proton and photon and will ask what I had in 2016. They just said SBRT would be 5 times every other day about the size of a quarter for my 1.6 cm nodule and then the next year I had 14 more nodules. Maybe I don’t have multifocal as I’ve had 3 biopsies and they are adenocarcinoma similar to the old term BAC which has gone to 4 classifications of AIS, MIA, lipidic and ? Mine are semi solid and lipidic(gel like) nodules that normally don’t metastasize outside the lung. The only treatments I have had are upper left lobectomy and the SBRT. Merry, I do a lot of research but no one has committed to say exactly what I have is called so I read about multifocal and BAC and am only guessing at this point. I hope answers will be coming from U of M. Thank you, I will look up hoot info on SBRT. Sallie

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@catlover1943– Good morning Sallie. It will be interesting to see if you have multifocal adenocarcinomas. They are adenocarcinomas similar to the old BAC, but also they are different in that they do not metastasize. Each nodule is considered primary cancers, no matter the size. My very first cancer, 10 years prior to a diagnosis of Multifocal adenocarcinoma was a BAC and very fast-growing. Multifocal and indolent-very lazy, slow, maybe not growing. This is good!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209391/
After I get home from an appointment from my CT scan and results I start writing questions down for my next appointment. I don't care how elemental they sound.

How are you feeling?

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@catlover1943

Yes, CTs are always done in home town but if U of M wants me to do different I will find a way. No children, small family just 1 older sister in another city. Good to hear they send instructions and are helpful at setting up virtual. I only use iPad but talked to a friend if they feel it Would be better on a bigger screen. I’ve done FaceTime on iPad which was simple but the terms virtual, video, zoom, teletalk etc all might be the same thing. In this day and age am wishing I had kids and grandkids as I’ve fallen behind in this tech age. Thank you and enjoy the fall colors.

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@catlover1943– Sallie please keep me updated. I'm thinking of you. Stay safe.

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@merpreb

@catlover1943– Sallie please keep me updated. I'm thinking of you. Stay safe.

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Good morning @catlover1943. How are you doing? Happy New Year.

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@meka; @bluelagoon; @linda10; @sakota– Happy New Year. How are you all doing? Meka, you have an appointment coming up soon, right? I'm waiting for the radiologist to put his report on my portal, but I feel good!

I have been over careful if that's a word with COVID-19. I hope that you have all escaped it. It's very bad in my state.

Are you all well?

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@merpreb

@meka; @bluelagoon; @linda10; @sakota– Happy New Year. How are you all doing? Meka, you have an appointment coming up soon, right? I'm waiting for the radiologist to put his report on my portal, but I feel good!

I have been over careful if that's a word with COVID-19. I hope that you have all escaped it. It's very bad in my state.

Are you all well?

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Hi everyone, yes I am over here for another CT, also fibromyalgia check and throat check.
Been a crazy year, seems last March was years ago.
Have had two emergency visits since radiation, first in June, breathing/fatigue/blood clot??? Treated for possible pneumonia. Continued problems with pain breathing, feeling like baseball in chest. Ct at home detected possible 4x2x1.4 neoplasm wanted to do biopsy, Mayo recommended against. All problems thy insist is a little scarring and increased copd changes.
October after starting stilarto(sp), developed more .back pain into severe spasms and another ER visit.
Again, looked for blood clot, not, unknown reason again. Drugs, pinpoint ladicain injections got the spasms stopped. Pain continued, went to physical therapy, no relief. Finally got seen by pain specialist at home and received a costacondral trigger point injection. Acute pain has lessoned, discomfort and baseball still there. I just don't know.

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@meka– It sounds as if you have had a pretty rough ride. Not very enjoyable. Did you fall up against something that might have injured your breast bone (sternum?)
https://www.medicinenet.com/costochondritis_and_tietze_syndrome/article.htm
https://www.mayoclinic.org/diseases-conditions/costochondritis/symptoms-causes/syc-20371175
How long ago did you have the shots?

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Good morning everyone. I found out something really important. Multifocal Adenocarcinoma is not staged like regular cancer because our lesions do not metastasize. Each lesion is considered a primary tumor that begins as ground glass, as we all know.

I found this out when I recently had 2 teleconferences, one with my oncologist and the other with my surgeon. My last, and recent CT scan shows no new lesions and both doctors think that I can move the currency of CT scan to longer than 6 months.

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@merpreb

Good morning everyone. I found out something really important. Multifocal Adenocarcinoma is not staged like regular cancer because our lesions do not metastasize. Each lesion is considered a primary tumor that begins as ground glass, as we all know.

I found this out when I recently had 2 teleconferences, one with my oncologist and the other with my surgeon. My last, and recent CT scan shows no new lesions and both doctors think that I can move the currency of CT scan to longer than 6 months.

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@merpreb Congrats on "graduating" to the next level!

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@meka

Hi everyone, yes I am over here for another CT, also fibromyalgia check and throat check.
Been a crazy year, seems last March was years ago.
Have had two emergency visits since radiation, first in June, breathing/fatigue/blood clot??? Treated for possible pneumonia. Continued problems with pain breathing, feeling like baseball in chest. Ct at home detected possible 4x2x1.4 neoplasm wanted to do biopsy, Mayo recommended against. All problems thy insist is a little scarring and increased copd changes.
October after starting stilarto(sp), developed more .back pain into severe spasms and another ER visit.
Again, looked for blood clot, not, unknown reason again. Drugs, pinpoint ladicain injections got the spasms stopped. Pain continued, went to physical therapy, no relief. Finally got seen by pain specialist at home and received a costacondral trigger point injection. Acute pain has lessoned, discomfort and baseball still there. I just don't know.

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@merry Hello all! Happy New Year everyone! I’m doing well. Was up at the Mayo on January 7th for my follow up CT. The radiated area is stable. No shrinkage, but no growth either. 1 new 4mm GGO. Back in three months. I was hoping to graduate to 6 but not at this time. So happy to hear you’re past 6 months now Merry. Maybe someday I’ll make it back to 6 My 10 year Cancerversary is next month. Stay well everyone ♥️

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@linda10

@merry Hello all! Happy New Year everyone! I’m doing well. Was up at the Mayo on January 7th for my follow up CT. The radiated area is stable. No shrinkage, but no growth either. 1 new 4mm GGO. Back in three months. I was hoping to graduate to 6 but not at this time. So happy to hear you’re past 6 months now Merry. Maybe someday I’ll make it back to 6 My 10 year Cancerversary is next month. Stay well everyone ♥️

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@linda10– Hey Linda. Stable is good! Our lungs just love making these things! My CT is 9 months. They gave me an option for a year but emotionally, and yes after all this time, I feel better seeing them and being tested sooner. I hope that you have avoided COVID-19 and that you will be vaccinated soon if you haven't been already. We miss you!

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