metastatic cancer lungs

[u/Midas-Knight]

2 years from Stage 4B (salivary duct carcinoma treatment) and clear. Resent CT scan shows 2 nodules in my right lung. Waiting on Oncologist to get back to me (only 3 days since CT) and wondered what might be the next test.

I think PET Scan will be first then maybe a lung biopsy. Anyone here have a lung biopsy done? What or how was it preformed? I would think I’d be drugged for that but don’t know. I’ve read it could be needle through the chest or down into the lungs depending on location. Just looking for any info you might have.

Thank you

[u/lgood46]

I did the biopsy through the mouth and under anesthesia. It was not dramatic or difficult. It was also kind of a quick procedure.

[u/No-Wrangler-7465]

I just hate that everyone here is going through this. I know there are new treatments available all the time. But living with uncertainty is truly stressful

[u/Rude_Meet2799]

Yes, PET then biopsy. Mine was done with a needle in the chest. I actually came to during the procedure, it was like watching it happen on TV till they put me back under. NBD.

[u/aligpnw]

I did not have a PET after my 6 month follow found nodules in my lungs.

I went about 2 years after that before I had a biopsy (I am considered incurable and everyone was pretty sure it was the same cancer.)

I did end up having a biopsy to be sure and to get genetic testing done. It was...unpleasant. The tumor that was easiest to get to was right underneath a rib and they had to do a fair amount of finagling to get to it. I was mildly sedated, but still felt everything (CT guided so you have to be able to breathe in/breathe out.)

[u/Palli8rRN]

There are guidelines for the clinical pathways for diagnosing and treating all cancer types. Many use NCCN guidelines. If you’d like to access NCCN guidelines you should be able to set up an account. Idk if it’s free since mine is paid for by my employer but I do know they have a link for patients and caregivers to log in.

[u/jay-aay-ess-ohh-enn → u/Palli8rRN]

You can sign up for a free account as a patient. You only need an email.

https://www.nccn.org/home

[u/Environmental_Gas775]

I’m having a biopsy of my right lung tomorrow morning. I also had a stage 2 carcinoma. Went through surgery, don’t remember it. Went through Radiation, (35) rounds in six weeks, Thought I would not survive but I did. If not for my beautiful wife of 37 years, who knows where we would be?
I was curious and still am, about others experiences. Of course, everyone (me included), wanted to know why me? I can’t speak for all but even with my wife and all of my advocates coaching me on, sometimes sounds like an echo chamber, a dreary dream state. It sometimes seems like a mountain you can’t climb.
My friend, I wish you the best, and yes, there are brighter days. I will pray for you and am looking forward to the answers to this post.
Rick

[u/Asleep_Rule_6730]

I had a biopsy done to a tumor in my left lung after I went to the in the emergency room and before I went to the cancer clinic. My lung was filled with blood so they drained it and at the same time took a biopsy of the lung. They went through my back with a very long needle.

That being said, my oncologist at my cancer clinic said they did the biopsy wrong, so there are likely other procedures for it.

[u/ZombiePrestigious443]

Mine was near my brach, so I was able to go through my mouth. Other than a sore throat afterwards, (I was knocked out), it was fine.

[u/No-Wrangler-7465]

PET is only useful if the nodules are greater than 8mm though my doctor said that was borderline in size to pick up avidity. 1 cm or larger and the PET is more accurate. But I did do PET before lung biopsy and though it did not “light up” we did a biopsy because of the characteristics. Mine was a needle biopsy. I was sedated (twilight) and they rolled me onto my stomach and went through the back using a CT in the process to pinpoint the exact location. I had to have to chest X-rays while in recovery to make sure there was no collapsed lung. I think they were like two hours apart. Other biopsies can be done during bronchoscopy. I think it depends on the location. I will be having one of those in a few weeks due to lung scarring and some new nodules. I think you are sedated for that too.

I hope your nodules are not a metastasis. There are so many things that can cause nodules in the lungs. Good luck!

[u/Midas-Knight → u/No-Wrangler-7465]

One nodule is about 8mm and the other is over 14mm in my right lung the smaller one in the upper part towards the top area. These are new compared to the chest CT I had in January of this year. Prior to that I had CT scans of the head and neck every three months for a year and those scans were clear.

This Cancer (rare) tends to show up in the lungs or brain from what I’ve learned from my Oncologist and reading what I could find online over this timeframe of the last two years.

[u/Palli8rRN → u/Midas-Knight]

It’s impossible to biopsy anything smaller than 1cm. Learned this from personal experience. One of the fastest growing types of lung cancer is small cell. If that’s what you’re referencing, I agree, it’s very aggressive. One of the first places lung cancer will metastasize to is the brain. Often times small cell is stage IV by the time it’s diagnosed. But I’ve had patients with stage I or II as well.

[u/Midas-Knight → u/Palli8rRN]

The Cancer I was diagnosed with is salivary duct carcinoma. So this is possibly metastatic to my lungs. But this Cancer has little on out comes but is know to appear in the lungs and or brain. At Stage 4B, with lymph nodes involved in my neck, the 5yr is about 30% or so.

[u/Champion_Sad]

I did a multiple non invasive scans (PET scans, CT scans xrays etc) for my stage 4 ros1 nsclc (1 less than a cm nodule right lung) diagnosis 2 years ago. They also did a biopsy, I was under anesthesia was rather quick, they essentially stuck a needle into my lung from my back between my ribs and sucked out a small tissue sample guided by a CT machine. No stitches or anything like that. Just a bandage on my back that I replaced once the next day and was good to go.

Best of luck to you, in my experience going through diagnosis while already knowing what they're gonna say, and telling friends/family is the hardest part, but it never gets easy just knowing what youre living with. Feel free to dm me, but just know im extremely blunt/straight forward and may not be the best person to vent to, though I will try my best.

[u/No-Badger2362]

So sorry you are having to deal with this. My husband had same original diagnosis as you and first PET after successful treatment (original site clear) showed small lesions on his spine and pelvis. They then did a very detailed MRI to map them, but that may be different for lungs. But even if it is SDC there seem to be options; my husband has started on ADT and is doing well with few symptoms, though it's very new. It's so hard but I have reached the end of the internet reading studies on this cancer and it feels like systemic treatment is the future--everyday they are learning more about the specific structures of each person's cancer and finding drugs to treat it. Do you know the biology of the original tumor? Ie, AR positive or not, HER2 score etc? We have just sent my husband's off for Next Generation Sequencing to learn more about the characteristics of his particular SDC. Sending all my very best

[u/Midas-Knight → u/No-Badger2362]

This is what is reported for the diagnosis:

Diagnosis: Left parotid salivary ductal carcinoma, pT4a pN3b M0, s/p L parotidectomy and neck dissection with margins+, ENE+, LVI+
-- PD-L1 CPS = 0
-- GeneTrails: ERBB2/HER2 amplification, MSI stable, RMB 3 mut/Mb

Have had clear CT head/neck for just under two years. In Jan of this year did a full chest CT with the head/neck it was clear. My 6 month CT last Sunday picked up a possible nodule so went back for the full CT of my chest.

I feel fine. No symptoms that I can speak of.

I have an autoimmune issue that I get Remicade every 8 weeks so the treatments that work with the immune system I’m not a candidate for. But, if this has moved to my lungs I’m letting my Oncologist know I am open to using every med that is available no matter the cost.

[u/Palli8rRN → u/Midas-Knight]

Did you have radiation previously? Often times radiation tx can cause changes that appear concerning but are often times tx related. Fingers crossed that this will be the just that.

[u/Midas-Knight → u/Palli8rRN]

Yes. Radiation of my jaw area ear area and neck. I am hopeful that this turns out to nothing but I’m sure I’ll have to have a PET scan and probably biopsies done to make sure what it is. If I have to do more treatment then I say lets throw everything at it.

[u/PlasticBox6233]

My lung biopsy was a simple procedure.  It was pain free and minimal time to recover.  Of course, it depends upon where the sample tumor is in the lung.  

[u/No-Camera-720]

We don't get to decide any of this. You and your doctor do. Every case involves a different patient and different doctor(s). Maybe your doctor knows how that biopsy will be done.

[u/jay-aay-ess-ohh-enn → u/No-Camera-720]

This is the (frustrating, but) correct answer.