Question for Dr.Heinrik

[canary1955]

For Dr.Heinrik... and thank you Football_fan
I deeply appreciate any help regarding my question. I am certain that I have pancoast tumors. My breathing has become difficult in the years and I have had cardiac work which always turns out fine except the MD's would always add "we're a little concerned about your breathing". I've been physically exhausted for a while. In the past four months my left shoulder-clavicle,ribs have ached. Initially it seemed to effect me when I ate or drank fluids. Slowly the aching effected me all the time but worsened after meals or fluids. I also can not eat much because it feels like there is no room. About a  month and a half ago the aching started to actually at times become painful.  My left side of my neck is now starting to  feel effected besides ribs/back- clavicle when I lay on my left side in bed. I've also lost about six-8 pounds,probably due to eating less. It is unsual for me to lose weight. I do not feel anxiety,instead frustartion but I do know anxiety can trigger weight loss,experienced thta as a youg mom 30yrs ago. In Mar/Aug 08 had CT's and nothing shows. On 10/30/08 had MRI and no show! I am an unemployed social worker for a year and will potentially lose my car have no Dec rent or money for bills.  I've paid everything out of pocket w/help from my friends. The reason I am stating all this is not to whine, but that I am 53 on Nov,20th and I have fought hard for every and anything all my life and even though I am tired,I will not give up because that inner voice we all have guides me re;Pancoast tumors besides physical symptoms. I have no medical insurance and now that my $283.00 unemployment per week(70.00 too much to get any free med assistance) is diminished, I can now  possibly get some medical assistance.  
I have been proactive and want to share> refer to www.e-radiography.net>"A major issue with Pancoast tumors is the delay in diagnosis.  The apical lung cancer may not be visualized on an chest radiograph and by the time the patient  presents with symptoms, the tumor has almost always invaded nearby structures. In addition the symptoms produced by the disorder can be mimicked by numerous neurological and musculoskeletal disorders, thus delaying diagnosis."
Also> refer to  e medicine health.com > "Blood exam for persons with Pancoast tumors is not specific, and the results are not diagnostic."  Also read w/Pancoast tumors it is common that Pancoast tumors are difficult to diagnose till later stages.
So doctor is it possible that it is too early, inspite of my symptoms, for tests to reveal a Pancoast tumor diagnosis?  
Thanks for any help/Peace,

[bizbuzz]

My dad has been in the hospital now for almost 4 weeks with no diagnosis. Original thought was pnemonia when he was having difficulty breathing. After antibiotics and many cat scans of no change, the thought then moved to possible cancer because of the mass in the lung. Adrenal gland, lymph node and cells of the lungs were all negative for cancer. The next step they are discussing is a biopsy of the mass itself. The mass, however, is wrapped around a main artery. The doctors had said originally that this would be a very dangerous procedure, now they are saying it is not because my father has a tube draining the lungs, and that would prevent the lungs from collapsing. My whole family is completely frustrated and losing hope. I continue to research additional ideas of what this mass could possibly be. Any help you can give would be greatly appreciated.

[HeinrikMD]

Hi,

The best thing to do is to discuss your symptoms at length with a doctor and then to map out the affected areas during the examination.

There are some points you need to consider.

Yes, early disease may not be detectable with physical examination maybe not even with scans.
Pain is not a sign of early disease. Hence, if there is something there, the MRI (currently the best imaging tool for this area) would be able to see something.
IF we would imagine it to be too small for the MRI, then odds are the pain is not diffuse. You report pain involving the shoulder and the clavicle and the neck. What are the odds that all of these areas would be individually affected? (hence, the importance of mapping out exactly where you feel the symptoms).

There is no blood test to diagnose Pancoast tumor.

Stay positive.

[football_fan]

Hey again...I completely understand your thinking and where you're coming from. Again I will preference this by saying I am not a doctor. However I think you are doing the same thing I did/am doing and letting anxiety get the best of you.
After reading this last post I can tell you are doing the same thing in using the internet to self dx. Thats my first mistake. It's pretty much ruining my life and I don't want to see anyone else go down this road. Stress and anxiety is nothing to take lightly.
Having said all that, I wanted to address the bottom of your post.
you mention "chest radiograph" - This is a chest xray not a ct scan. A chest x ray can miss a lesion because sometimes they could be hidden behind boney structures or shadows. A CT Scan is much more accurate than a chest radiograph and can take slices from different angles. So if you had a clean CT last month, its unlikely that you have anything. But I'll defer to Dr. Heinrik to confirm that.
As for blood exams, they are not really reliable for any type of LC. Especially in early detection. They are good for more advanced stages that secrete stuff into the blood stream or if it metasises(forgive the spelling) to other organs and causes over or under production of bodily chemicals.
Good Luck, Stay Positive and Peace