Metastasis Adenocarcinoma Detected In The Fluid Drained From Right Lung Using Pleural Tab

Hi,
   I came to know about about devastating news about my mom on last friday that metastasis AdenoCarnoma Cells were detected in the fluid that was drained from the lungs (between lungs and chest wall). Here is the brief history of the events over last couple of weeks. Please bear with me if I don't spell/use  technical terms correctly.

My mom is 60. She was having shortness of breath for few days. The doctor advised a chest x-ray. She did complain about constipation in the past months too

- In the X-ray, he spotted some fluid/liquid accumulating between the chest wall and right lung.

- The doctor carried out a procedure to remove the liquid/fluid from the lungs using pleural tab. The fluid was sent to a dignostic lab for investigation.

- In the mean while, WBC and other blood tests were conducted and they didn't show any abonormalities. All values were normal.

- Then we received a horrifying news that diagnostic centre found metastasis AdenoCarcinoma cells in the fluid. The malignancy was also mentioned in the report.

- My dad discussed the report with the Ecologist.  He advised that it's a stage IV (4) and more investigations are needed to find out the primary site of the tumor cells.  He mentioned that patient normally has 1-2 years left in this condition. It was a devastating news for the family. My mom still doesn't know about it because she is not very strong about the diseases like 'cancer'. She is already bit down to hear about all these tests. The doctor advised to have CT scan, tumor markers (for Ovary & Intestine) and bone scan.

- Following the meeting with the doc, the mom had the CT scan for chest, abdomin and pelvis. The ultra-sound was also done for stomach or chest. Nothing was detected in either of tests except the fluid in the lungs. The radiologist wrote the report that there is no tumor in any of the scans. However, he did mention that there is a small repture in the lung and may be it's because of the presence of the fluid or it happened because of the  procedure to remove the fluid

- The tumor markers (for Ovary) are already with the lab. We should find out tomorrow. We are also going to have the Tumor Markers done for Intestine.

- After the CT scans, we discussed the results with the Ecologist again. He advised not to go ahead with Bone scan test on Tuesday and asked us to wait for the Tumor Markers results.

-He further advised that he will remove the fluid again to have it tested from three different diagnostic labs to ascertain that the previous cytology results were correct. At least, the removal of fluid will also relieve the shortness of breath. My mom still complains about shortness of breath but it's not that severe.

- The doctor also did the physical examination of my mom and ruled out the presence of breast cancer. The memo-gram is not done though. The doctor also mentioned that my mom does not have any symptoms of infected cells in the brain either. I am also told that none of the lung or it's lymphs are affected at this point.

Couple of bits I missed before cytology was done:

- My mom takes the medicine for blood pressure. She is not diabetic. The doctor did the EKG in the begining and ruled out the heart problem as a cause of the fluid. Similarly she was put on TB(Tuberclosis) medication for a week but no TB cells were found in the fluid. Therefore, the TB medication was stopped after cytology results. 

As you can imagine, we really pray that results stay negative and repeated cytology exam will not indicate any malignancy or bad cells.

I will be very grateful if any of the forum members can go through this post and reply with some valuable comments/insight.  Kindly let me know if I can follow some other pointers at this stage. Do you see a chance of error in the original cytology?

Regards.

HI. 

I wish I could give you some more insight on what you have experienced, but unfortunately I cannot.  A very dear friend of mine was having a lot of trouble with shortness of breath, generalized weakness and a respiratory infection that was not responding to antibiotic therapy. 

It was thought at first that maybe he was having some cardiac issues again as he had to have bypass surgery about 7 years ago.  In August 2007 he had to have a stint placement as he was found to have a blockage, but his cardiologist wasn't convinced that this was what was causing the weakness or the shortness of breath. 

The problems didn't correct themselves after this procedure was completed, so he went back to his famiy doctor and was referred to a pulmonologist.  He was found to have a significant amount of fluid built up in his right lung and of course due to his lack of response to previous antibiotic treatments decided that the fluid needed to be drained and tested.  Cytology reports came back much as what you stated that your mom's did.  He was diagnosed as having Stage IV metastatic adenocarcinoma of the lungs.  No tumors have been identified, nor has there been any evidence of any further spread.  Although biopsies were completed on areas of concern in the lung, they all came back negative.  The only area that appears to have cancer cells present is in the fluid surrounding the lung. 

He did go for a second and a third opinion and further testing with the same results from each one.  Him and his wife are devastated.  Due to his history of cardiac problems and a history of Hodgkin's lymphoma that has been in remission for about 10 years, his treatment plan has been monitored very closely.

He is currently undergoing chemotherapy using a combination of Avastin, Taxol and Carboplatin and has had few side effects at this point in time.  The most recent CT scan completed is showing some progress in slowing down the cancer and some of the areas of concern noted on previous CT's have been noted to have shrunk.  He is aware that the type of cancer being contended with is not a curable cancer, but the improving test results have restored some faith back into his life.  Especially considering that in November 2007 he was told that when they diagnosed him that he probably had 6-18 months and he needed to get his affairs in order.

He isn't with the first oncologist that he started with, that offered them no hope at all.  His current oncologist is understanding of their needs and most of all the need for hope.  Miracles do happen on occasion.  I am a nurse, but not an oncology nurse and am learning right along with them.  I would be very interested in knowing what kind of a treatment plan that they have your mother on and compare notes with the progress that your mother is making.  Support is something that we all need when answers seem to be few and uncertain.

My prayers will be with you and yours.  Have faith and keep up the hope.

Hi,

    Thanks for replying to my message. I  wish your nothing but fast recovery and some quality time with his family and loved ones.

  My mom started with chemotherapy in August. She had two sessions of carboplatin and Texol every four weeks. The doctor reviewed the x-rays (ultra-sound) before and after each session. As my mom had pleural effusion (fluid accumulation) in the right lung, the oncologist saw almost no difference(reduction) in the fluid level. We even had the fluid removed 3 times until December 2007. Since the original CT scans did not show an indication of tumor- There wasn't really any other parameter to measure the progress.

   In October 2007, the oncologist advised the change in the chemo drug. She was put on cisplatin and Gemzar (Gemzar and Cisplatin on day 1, Gemzar on Day 8). This was based on 3 week cycle. She has had 2.5 cycles of the new drug regime. As you can imagine, my mom was getting very tired with the treament. On the basis of Xrays/ultra-sound we saw very little improvement. After she had the third cycle, she had very bad side effects including allergy,cough,nausea. Everybody was really worried with the situation. My mom refused to continue with the treatment especially if the symptoms (pleuracy) were still there. The mom had gone really weak. The oncologist decided to stop the chemo and put her on a break. He mentioned that he will advise some oral medicine(atoposide)after 2-4 weeks. I suspect that the doctor was expecting her condition to get worst. The cough was really bad - She had very strong anti-biotics etc but there was no relief for cough. Then she tried regular usage of honey with pinch of black-pepper. I can just say that the God is the greatest.

Anyways, she has not been on chemo since 20th December 2007. Lately she has been feeling good. After 6,7 months, she mentioned that she had started feeling bit hungry. She even sounded better. Yesterday, she went to see the doctor and the doctor wants to start again with the chemotherapy -  Gemzar and Cisplatin. I am feeling disturbed to know that - I am not even sure if that's the right thing to do and as to why the doctor has decided to start again. I would like to mention that the pleuracy is still there but it hasn't increased a lot.

I have to admit that I had gone hopeless at one point - Then it was a big relief to see  the progress during January. All I can say, we can do our efforts, but the relieft is bestowed by God. He is someone, who can bring some peace to our lives. Like I said before, I really suspectec in Dec that the doctor had stopped chemo because He was't sure about her survival.

I am in a distant place so it makes me more worried. I am intending to consult an oncologist in England  in order to see if they can advise something at this point. It might be difficult to see a doctor without the patient, but I have got the copies of the diagnostic reports to date. Please let me know if anybody can recomment an Oncologist I can see in/around London. I don't mean disrepect to anybody, but I am looking to find someone who can listen to me with some patience and offer some advice.

Please let me know if you have any input on the details above. My appologies if you see a big blurp in the message.

You have my best wishes and prayers.

 hi ,

The same exact case with my mother,iam gouri from india even my mom is diagonised with 4th stage lung cancer doctor has given a span of 1 to 1.5 year,we have been cemo& rediation only pain is reduced but not much of improvement in  decreasing the size of tumor. after going through lots of search in internet i had made a routine diet of her which can improve her immune system & stop the growth of cancer cells i.e.a malt made from all the cereals like ragi,wheat ,soy beans, mung dal,& few more cereals which are rich in protien which should be given in the morning later at 10 am a big cup of apple juice with one banana & dry fruits soaked in water for 7 hours like badam, dry grapes,2 apricots,dates,figs.& breakfast including all dark veggies, two more bananas,one big bowl of papaya in the afternoon.evening at 5 a juice made from 1carrot,1/4 beetroot,1 tomoto ,at 6 1 big cup of green tea , at night 8 pomogranate juice with black grapes .try to include spourted grains in lunch & dinner. never include milk ,sugar & dairyproducts,& sweets for her diet .you can contact me mt email is

. faith in god even that works.i ahve imformatiom i will mail u