Chronic Obstructive Pulmonary Disease (COPD) Expert Forum
83 Year Old Man
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83 Year Old Man

My father, 83 years old, quit smoking 25 years ago, has had a thyroid tumor removed 10 years ago and has had radio (iodine) therapy follow ups on an annual basis up to two years ago when he started doing the therapy twice a year.

He recently complained of back and hip pains, and was diagnosed with a spinal tumor on D12 and left lateral rib, which was partially removed and followed up with four treatments of radio therapy.  This followed further pains, the doctors carried out a C.T. Scan of the Chest and came up with these conclusions:

- Multiple bilateral pulmonary nodules are seen scatter in both upper and lower lung lobes
-  Basal pulmonary interstitial and intra-alveolar shadowing/consolidation with fibrotic strands and bronchiectatic changes.
-  Ground glass appearance is seen at the right upper lobe and to a lesser extent to the left upper lobe.
-  No obvious pleural effusion seen.
-  Basal pleural thickening is visualized.
-  Mediastinal lymph nodes are seen particularly on the left side.
-  Patent tracheobronchial tree.
-  Possible hiatus is visualized
-  Cardiac configuration is essentially within normal.

The problem is, none of the doctors are able to explain to us in simple English what this all means, if there is a proper treatment, or where to go for such treatment.  That is the problem with some private hospitals, they seem to want to keep the patient in to continue ongoing tests without providing recommendations.  Could anyone please please help me with this and tell me what it all means.

Thank you so much in advance.
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Your description of your father's doctor's response to his need for care is strange.  It should not be assumed that the pulmonary nodules are cancerous, from either your father's thyroid or spinal tumor.  The nodules and the "ground glass" appearance could represent alveolitis or bronchiolitis and may be treatable.

Your first step should be to request that a pulmonary/thoracic radiologist review the CT scan and render an opinion on the most likely diagnosis.  You should also ask his oncologist, also called cancer specialist, for an opinion on how likely is it to be that the CT findings suggest cancer.  Finally, with the preceding information, you should request consultation with a lung specialist for determination of the likely diagnosis and recommendations on further diagnostic procedures, including lung biopsy.

If his doctors are unable to recommend consultants, contact the nearest university medical center and arrange for your father to be seen there.

Good luck.
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