Lung cancer?

My dad was experiencing exreme fatigue, vomiting, persistent coughing  with tan mucus and loss of appetite. He is a chronic kidney failure patient, has CHF as well. We took him to the ER and he had a CT scan of the lungs and they found a mass as well as pleural effusion. They are suspecting cancer. They are draining the fluid out using a chest tube and have taken a sample of the mass for a biopsy. The doctor today said that when he called the lab, they told him the results aren't ready yet but they see abnormal cells. Isn't it possible that the pleural effusion is caused by sepsis, calcium deposits or pneumonia. Does a mass on the lungs always mean cancer? Isn't the doctor supposed to order a blood culture and send in a cardiologist to check his heart? He's currently on zocor,coreg,Norvasc,Hyralazine. I did a med check online and saw some interaction between Zocor and Coreg. He doesn't have high cholesterol, but the doctor wanted him to be safe from developing Carotid artery disease.  I know it's alot of info, but I need help. Thanks.

[Dr Sharma]

Hi there. Your father has constitutional symptoms likeweight loss,extreme fatigue etc., but these could be due to CHF,  renal compromise and also cancer. The biopsy from the lung mass showed abnormal cells it has to be taken with a lot of caution. Pleural effusion could be secondary to pneumonia, renal failure and sepsis. Any cancerous growth in lungs may interfere with breathing and cause cough, shortness of breath, wheeze, chest pain, hemoptysis or blood in cough. Shoulder pain, vocal cords paralysis if the nerves, cords are involved.  The nodule could be both benign and malignant and based on studies a solitary pulmonary nodule measuring 11 to 20mm in diameter, prevalence of malignancy could be up to 60percent.  The common causes and differentials for benign solitary pulmonary nodules are healed granulomas, active granulomatous infections like TB, hamartomas, lung fibrosis, lung abscesses,bronchogenic cysts, hemangiomas. Predictors of malignancy are old age, current or past history of smoking, history of extrathoracic cancer, or spiculation in the nodule and upper lung lobe location.
CT chest with thin sections through the nodule is recommended, with contrast enhancement if the renal function is intact, transthoracic needle biopsy or bronchoscopyto confirm the diagnosis unless contraindicated. If this is cancerous, you will need to be examined for any distant metastasis to organs like brain ,bone. Surgery is advised if resectable to external beam radiation /radiofrequency ablation would be undertaken as deemed by the pulmonologist. you need to be first assessed further with the background of your clinical symptoms. Consult a cardiologist for assessment of cardiac function and the medicines. Wishing you best of luck. Take care.