Q
: 1
07/07/2009 |
I have five 1-2mm lung nodules that were found on a CT scan I had after experiencing several symptoms consistent with lung cancer. They told me not be concerned, but my symptoms are getting worse. What should I do next?
The best thing to do is to repeat your CT scan approximately 2 months from the time of your most recent scan. If the lung nodules increase in size, then it would be reasonable to be concerned. If the lesions remain unchanged, I would then plan to get a follow-up CT scan approximately 6 months later.
|
Q
: 2
06/10/2009 |
My mom is 55 years old and was just diagnosed with stage IV adenocarcinoma. She has tumors on her lungs, a spot on one of her ribs and a spot on her vertebrae. She sought out a second opinion and both doctors agreed on her treatment; three rounds of chemotherapy. They agreed that surgery was not an option. Why isn't surgery an option? Should we consult with a surgeon? She's in great health other than this new disease.
The goal of any surgical procedure for cancer is complete removal of the cancer with no evidence of cancer left anywhere else in the body. When a patient has lung cancer like your mother has, it is very difficult to achieve this goal. Your mother's best chance for a cure is for her to respond well to the systemic chemotherapy. As surgeons, we have never been able to demonstrate that the addition of a local therapy such as surgery or even radiation therapy in a situation like your mother's has improved a patient's chance for a cure. Because of the potential risks of surgery, and because a patient cannot receive chemotherapy during their recovery phase, there is a real opportunity cost associated with adding surgery in this situation.
|
Q
: 3
05/19/2009 |
Would you be concerned with a 7mm nodule on the lower lobe found accidentally on an abdominal CT scan of a 15 year old? How would you proceed with follow-up? The pulmonologist has scheduled a high-definition CT scan and an appointment was made for 4 months from now.
That is a very reasonable approach. It will be important for the radiologists to try to use the lowest possible dose of x-ray that will allow then to visualize the nodule.
|
Q
: 4
05/10/2009 |
Can non-small (large) lung cancer metastasize to small cell brain cancer? My dad was diagnosed with non small cell last year and now he has six brain tumors. But the doctors are saying that the brain cancer is small size. Does that mean the brain cancer is primary or is it possible for the cells to change when they metastasize?
It is hard to know the correct answer to your question unless the biopsies from his lung cancer can be directly compared to biopsies from his brain. Lung cancer often metastasizes to the brain, but normally the primary lung cancer and the brain metastases look similar under the microscope.
|
Q
: 5
05/02/2009 |
In Feb 2009 I was diagnosed with malignant pleural effusion; metastasized from the breast; metaplastic cancer. I was also told there are 2 small nodules in the left lung. Had 2 liters of fluid removed in March. I've been doing lots of research & came across Radiofrequency Ablation therapy for lung cancer & according to the studies I'm a good candidate for this procedure; especially since metaplastic cancer is chemo-resistant. Does your facility do RFA?
When breast cancer cells travel and grow in the lining of the chest and cause a malignant pleural effusion, there are 2 necessary treatments: 1) prevention of the rapid return of this fluid so it does not press on the lung and cause shortness of breath; and 2) treatment of the breast cancers cells with systemic therapy. Local therapies directed at the cancer cells growing in the lining of the chest like RFA ablation have never been shown to be more effective than systemic therapies in the overall care of patients with breast cancer. If you would like to meet directly with with me concerning the optimal management of you pleural effusion, please feel free to call my office at 410.328.6366.
|
Q
: 6
04/29/2009 |
I have NSCLC that after treatment last year, the cancer is gone, at least for now. I am about to get my first 6-month interval PET/CT Scan for the first checkup. That PET/CT Scan is from the skull base to the mid-thigh. I am concerned about the cancer metastasizing to the brain and could become undetected until it starts showing symptoms and then could be too late for survival. Should I insist on a brain MRI?
If you have already had a previous brain MRI that was normal and that you have no new symptoms such as headaches or blurred vision, than a brain MRI is not absolutely necessary.
|
Q
: 7
04/01/2009 |
I had lung surgery for cancer; it was contained, no spreading anywhere else in my body. I had the surgery in late 2008. I still experience moderate pain (level 7 at times). I started this cough-- like a tickle in the back of my throat, some clear mucus at times. Is this normal?
It is relatively common for people to have a dry cough after lung cancer surgery that often lasts for 3-6 months. However, it is always possible for lung cancer to recur despite having as favorable a cancer stage as you describe. I normally obtain a new CT scan approximately 3 months after surgery, which functions as the new baseline scan in monitoring for recurrent lung cancer. If this scan only shows the expected changes from surgery with no suggestion of recurrent disease, then it is likely that your cough will slowly improve with time.
|
Q
: 8
11/19/2008 |
My mother-in-law underwent a pnuemonectomy 12 years ago. Since then she developed empyema, which I understand is quite usual. She has had the drain site below her left shoulder blade for several years now. Is she stuck with this drain for the rest of her life, or is there something else that can be done for her?
An alternative treatment for this condition would be wide drainage of the empyema cavity and daily packing with sterile saline-soaked gauze. This is usually very effective in draining the infection, but does require an operation and an in-patient hospitalization.
|
Q
: 9
11/17/2008 |
I have a family history of lung cancer. I lost two uncles to this deadly disease, one at age 45 and one at 55. Both were heavy smokers. I am 40 years of age, do not smoke, and exercise everyday. I am concerned about getting lung cancer. Do I have a higher risk of getting this disease?
The fact that you do not smoke is the single most important thing you can do to decrease your risk of developing lung cancer. Because you have a family history of cancer, your risk of developing cancer of any type, including lung cancer, is increased compared to patients with no family history of cancer. For this reason it will be important for you to continue to abstain from smoking. In addition, it will be important for you to work closely with your primary care physician for all of your routine and preventive health care needs.
|
Q
: 10
09/22/2008 |
I am looking for a specialist who deals with malignant pleura effusion post-breast cancer.
The treatment of malignant pleural effusions in patients with a history of breast cancer is something that I take care of on a regular basis. If you would like us to see you, or one of your family members, please call 410.328.6366 and we will set up an appointment.
|
Q
: 11
09/16/2008 |
My 80 year old dad has asbestosis. Is there any new help for this? I read an article: "Thoracic Surgeons Help Healthy Lung Tissue Expand in Emphysema Patients, April, 2006." Could this work for asbestosis patients?
Unfortunately, emphysema surgery does not help patients with asbestosis.
|
Q
: 12
09/09/2008 |
I just had my lower left lobe of my lung removed because of stage I cancer. The key hole surgery went well. It's been two weeks now and I developed a constant urge to cough and convulsing both when at rest but significantly worst when trying to speak. I can hardly speak now. I was told it is the body's reaction to the materials used to sew me up internally and the body will react to it for some time. I can't find information on this. I have rather bad case of GERD and am concerned that the spasms are due to my GERD. May I know your opinion please?
The symptoms you describe are somewhat unusual for a routine lobectomy. My recommendation would be to see an otolaryngologist so that he/she can carefully inspect your vocal cords for normal movement or for any evidence of reflux esophagitis/larygitis.
|
Q
: 13
09/08/2008 |
My chest CT scan shows an 8mm non-calcified nodule in my left lower lobe and ground glass in left upper lobe. I understand it is too early for a PET scan to be accurate. When should a biopsy be done? I was a smoker for 45 yrs. Until I see the pulmonary specialist, I am in limbo.
I would normally repeat a CT scan in approximately 2 months from the current CT scan to monitor for growth of the nodule. If the nodule grew, I would proceed with the assumption that this nodule is a cancer until proven otherwise. That would include a PET scan to exclude distant disease, followed by excisional biopsy.
|
Q
: 14
08/31/2008 |
My husband was told a week ago that there is a mass in his upper left broncial tube. They did a bronscoscopy which showed a mass, but they were not able to take a biopsy. His doctors say they need to remove part of his lung. Is this likely to be cancer and is thoracic surgery to remove part of the lung the standard treatment?
Based on what you described, your husband likely has a carcinoid tumor of the lung. If that is the case, the optimal treatment for him would be removal of that section of the lung (a lobectomy) via thoracic surgery.
|
Q
: 15
08/26/2008 |
My chest CT scan showed a 5x7.5mm solitary nodule in the right upper lobe. They say it may be too small for PET scan. I am 46 and have smoked 1/2 pack a day for 20 years. Should I have a CT done sooner, have a biospy or wait the 3 months?
I believe that the best thing to do would be to wait the 3 months. If the lesion is a small cancer it will grow over time. A CT at 4-6 weeks would likely be too early.
|
