Mom Has Mass In Lung, Very Worried

[n8dog]

Hi I am writing to ask about my Mom.  I will start by giving some info on my Mom.  She is 50 years old and in great health.  No history of cancer in family.  She gets up at 6 am and excercises every day and then hikes a few miles ever day after work.  She is in better shape than most 20 year olds I know.  She was a smoker for many years and quit almost a year ago.  

My Mom was driving home from work recently and was side swiped by a car that ran her off the road.  As mad as I was that the driver didn't stop, I believe now this was a major blessing in disguise.  She went to the doctor to get routine scans to make sure everything was ok.  The doctor initially said she had something wrong with her heart and sent her to get a CT Scan.  It ended up there was nothing wrong with her heart.  Even know the doctor was wrong this was another blessing because the ct scan showed a mass in her upper right lung.  I met with the thorasic surgeon today to discuss the results.  She has a irregular shaped mass that measures 1.5cm X 1cm.  The mass is located on her upper right lobe periphere.  The next step they are going to take is to do a PET Scan and PFT tests.  The doctor said the next step would be to remove the mass with surgery and send it to the lab for biopsy.  If the mass is non cancerous then treatment would be finished with a check up.  If they do find cancer they would then remove the upper lobe of her lung as well as the lymph nodes.  They would then determine if the cancer has spread to the lymph nodes.  Please let me know if I am undestanding the procedures correctly.  The doctor said based on the size of the mass it would be stage 1A cancer.  Please give me any other insight or information on what is going on.  I am confused why they would not do a needle biopsy test before surgery.  If they could determine it was noncancerous with a needle bopsy, is surgery necessary??  I would appreciate any feedback. I am very worried and am trying to learn as much as I can.

Thanks In Advance!
Nathan

[HeinrikMD]

Hi,

I think what you need to discuss is the current probability that it is cancer. This would be based on the size, the shape, her smoking history, results of the PET. Since surgery has been advised – I would assume that in the presence of normal findings of PET, the image of the lesion looks suspicious.

You are correct that the biopsy is the logical next step. However, if the chances of hitting the small lesion is pretty low, then it may not be worth doing this. You would then consider a more invasive means (like an open biopsy) of getting the biopsy. Since there is an option here for cure, the invasive option is warranted.

Of course, you may insist on getting the needle biopsy first since the risk of complications from this is lower than the risks with more invasive biopsies. But if the biopsy returns as “normal lung tissue” this likely means the needle hit normal lung not the suspicious lesion. So you’ll have to decide, how many needle biopsies you would allow before more invasive means. The greater risk is not really the complications from the needle but the delays in doing definitive measures.

It is possible that the doctor was talking about a scope-guided removal of the lesion. IF this was the case, this entails less hazard than an open biopsy. It would still be more hazard than the needle, but the risk may be low enough for you to go for the scope to avoid the delay (of repeated needle biopsies).

Discuss specifics with the doctor.