Second Opinion for lung nodule biopsy

Posted by d41king @d41king, Feb 12, 2020

during a routine CT scan, a 15 MM nodule was found near the base of my right lung - close to my spine and diaphragm. My oncologist wanted us to get a biopsy even though she said there was only a 25% chance it was cancerous (my PET scan showed very little activity at the site), but the lab said that the nodule was too close to the spine and diaphragm and too small, so they could not do the biopsy. My doctor then said we would simply wait 3 months for another scan to see if anything changes. My wife is upset because we wanted the biopsy to rule out cancer. I am seeking a second opinion, but not really sure where to start - except that I am going to let my oncologist know I want to get the second opinion, especially for the peace of mind for my family. I would appreciate any thoughts on this.

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@d41king- Welcome to Mayo Connect. I certainly understand the angst of having to wait for test results. Biopsies in the lungs are often difficult because so many parts of the lungs are so close to other organs. A small lesion oftentimes does not show a lot of activity because they are so small. Over a 12 yr period of Multifocal adenocarcinomas, I have not yet had a biopsy because of the size. I have just had to bite to the bullet. My suggestion is to follow your doctor's suggestion and wait to see if there is any growth or changes in your lungs. Also, a second opinion at this time might mean another PET scan and I'm not sure that you want all that radiation in your body so soon after your first if another doctor would do one.
What is the reason for your annual chest CT scans? Are you at high risk for lung cancer?

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I had a calcium CT scan to look at plaque build-up in my coronary arteries. I did this to show my doctor that I did not need a statin that he was pushing. I am a very healthy 64 year old and still run 20 miles a week, eat healthy and get good sleep and keep my stress down. the Scan showed me int he bottom 10% for risk, but also showed a cyst in one of my kidneys and a nodule on my lung. I am not at high risk for lung cancer with only 13 pack years of cigarettes. However, I was a uranium worker back in the late 70's. There have not been any cases of lung cancer reported by my coworkers, but it is another point for concern.

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From Nancy )shortshot8i0) In 2015 October and November I thought I had a really bad cold so went to EMT he took xray and thought pneumonia. My primarily doc said CT scan which showed fluid in my left lung both months. So I was sent in to have the fluid drained and both months showed over 2 cylinders full. I was told to get a Lung doc who sent me to a Surgeon who operated on me and put two holes in my side Put a plastic hose in my lung to drain for four days. After that and I kinda woke up, Doc told me that I had mesothelioma in my left lung and small cell cancer in my right lung. I have had chemo which gave me allergic reaction and then Immune therapy which made my body hurt, then predinosone for the pain for several months. Nothing then until I started to cough up blood. Then Radiation March 12 of 2019 and in Jan 22 more radiation. Don't know what will be next but if I was in your position would not
do anything now! I would wait till they find if it is growing. Then I would do something but if is really close to my spine I would think twice before a surgery at this time. Now saying that.... If they could put a needle in and get a needle full of something that would be ok. OPTions are out there just be careful of your choice. Nancy

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Thank you Nancy I appreciate your inputs. God bless you in your journey. My oncologist agreed to help me get a second opinion and my recent bloodwork is clean

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@d41king

I had a calcium CT scan to look at plaque build-up in my coronary arteries. I did this to show my doctor that I did not need a statin that he was pushing. I am a very healthy 64 year old and still run 20 miles a week, eat healthy and get good sleep and keep my stress down. the Scan showed me int he bottom 10% for risk, but also showed a cyst in one of my kidneys and a nodule on my lung. I am not at high risk for lung cancer with only 13 pack years of cigarettes. However, I was a uranium worker back in the late 70's. There have not been any cases of lung cancer reported by my coworkers, but it is another point for concern.

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@d41king - Good morning. I've been thinking about your dilemma and I'm not sure that I would wait for 3 months either. Having worked with uranium for years increased the risk of lung cancer, having been exposed to radon gas, a radioactive material plus mining dust. I'm sure that you have had concerns for quite a while about the potential side effects of your exposure. Since you have already decided that you definitely want a second opinion now I'm glad that your dr. will work with you on that. I'm sure that you have felt like a powder keg all of these years. Do you have any large teaching hospitals near you where a second opinion will be easy to secure? Are you coughing a lot?

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@merpreb

@d41king - Good morning. I've been thinking about your dilemma and I'm not sure that I would wait for 3 months either. Having worked with uranium for years increased the risk of lung cancer, having been exposed to radon gas, a radioactive material plus mining dust. I'm sure that you have had concerns for quite a while about the potential side effects of your exposure. Since you have already decided that you definitely want a second opinion now I'm glad that your dr. will work with you on that. I'm sure that you have felt like a powder keg all of these years. Do you have any large teaching hospitals near you where a second opinion will be easy to secure? Are you coughing a lot?

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As mentioned, none of my coworkers have lung issues and I only worked with metals not mining. I’ve never had much concern since I am also very fit and have run 25 marathons. Univ of Colorado Anchutz cancer center is close by but my PCP and the oncologist will choose a good thoracic surgeon for me I’m sure

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@d41king

As mentioned, none of my coworkers have lung issues and I only worked with metals not mining. I’ve never had much concern since I am also very fit and have run 25 marathons. Univ of Colorado Anchutz cancer center is close by but my PCP and the oncologist will choose a good thoracic surgeon for me I’m sure

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@d41king- I'm relieved to hear that you weren't exposed to mining dust. Please keep us updated on what the determination is for your lesion! Working actively toward a diagosis and treatment plan, if needed, will help you and your wife feel more in control.

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@merpreb

@d41king- I'm relieved to hear that you weren't exposed to mining dust. Please keep us updated on what the determination is for your lesion! Working actively toward a diagosis and treatment plan, if needed, will help you and your wife feel more in control.

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Thanks so much !

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@d41king

Thank you Nancy I appreciate your inputs. God bless you in your journey. My oncologist agreed to help me get a second opinion and my recent bloodwork is clean

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@d41king that is great that your oncologist will help you get a second opinion. This article may interest you:
- Mayo Clinic researchers demonstrate value of second opinions https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-researchers-demonstrate-value-of-second-opinions/

As you likely know, lung nodules can be a sign of many different things. In this discussion in the Lung Health group members offer thoughts that you may appreciate:
- Small lung nodules: How often should they be scanned / monitored? https://connect.mayoclinic.org/discussion/lungs/

If at your second opinion consult, it is determined that a biopsy is not possible, I might suggest you have your questions ready?
- How do I know the cause of the nodule without a biopsy?
- How should I be monitored and how often?
- What are the risks?

Your physical fitness will serve you well. Have you noticed any changes in your running ability or breathing?

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Thank you for your note Coleen. I appreciate the article on second opinions and am amazed by the statistics associated with second opinions. Thankfully, the only thing really impacting my running or speed is my age. My lungs are still very strong. Thank you again

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