Pet Scan = Remove Lung?

We need some input....

My husband has a mass on his left lower lobe of his lung and in a lymph node next to his heart.

The pet scan revealed that these areas are glowing pretty good.

The Dr. has not gotten a biopsy until last Friday. We don't know what kind of cancer it is yet, but Dr. is planning on removing his whole left lung next week.

We are scrambling trying to get a second opinion. They are doing a MRI of the Brain tomorrow and a bone scan on Thurs. At our insisting.

The Dr. removed four inactive nodes from his trachea area between his lungs to see if it has spread. Next week the plan is if they are negative to go in through his side and remove the node affected next to his heart and take out his lung. if positive start Kemo & Rad.

We asked our primary Dr. for a referral for a second opinion but he said that we have the best Dr's. We don't want to delay things or make the Dr. mad what should we do?

Is this normal to remove before shrinking?

diagnosis code is 239.1 what ever that means!
198.3 unknown malignancy - eval. for metastatic disease confirmed.
eval. for intracranial mastatic disease with unknown primary tumor.

Help please!

i would get a second opinion.

i am concerned that they did not do a PET scan. i am concerned that they want to remove the lung without a complete staging workup.

for example, suppose this was colon cancer that metastasized to the lung. without a staging workup (including a PET scan and other things) they would not know where the primary cancer was. your husband would be without a lung and still have colon cancer.

maybe i am off base because i am basing what i say on what your said which may not be complete.

however, unless you are at a place like md anderson or sloan-kettering or johns hopkins, i do not see how your doctor can claim you are already getting the best care possible when you ask for a second opinion.

is this being done by your primary care doctor and a surgeon? with no oncologist involved? that is bad.

based on what i read in your note, it sounds like they are incompetent. even if they are on the right track, getting a second opinion is still the right thing to do.

pick someplace on the list below. my suggestion is to go with one of the top 3. go to their web site. click on patient appointment or something similar, call the phone number listed and just make an appointment. ask them what they know about transportation there (some airlines may offer discounts) and what hotels are near the hospital that they suggest (they may have a deal with a local hotel to give cancer patients a discount).

TOP 50 BEST *CANCER* CENTERS 2006
http://www.usnews.com/usnews/health/best-hospitals/rankings/

1. Memorial Sloan - Kettering Cancer Center, New York
2. University of Texas M. D. Anderson Cancer Center, Houston
3. Johns Hopkins Hospital, Baltimore
4. Mayo Clinic, Rochester, Minn.
5. Dana - Farber Cancer Institute, Boston
6. University of Washington Medical Center, Seattle
7. Duke University Medical Center, Durham, N.C.
8. University of Chicago Hospitals
9. UCLA Medical Center, Los Angeles
10. University of California, San Francisco Medical Center

i re-read your note with my glasses on this time and i see they did a pet scan. that is a good sign.

if there was cancer elsewhere it would have shown up on the pet scan. so this is likely a primary lung cancer that has only spread to one lymph node.

removing the lung and local nodes has a good chance of curing the cancer. people can live perfectly fine lives with one healthy lung.

if this were my lung, i would still have this done at a facility that has a lot of experience just doing just this. a top cancer facility is where i would go.

239.1 is the code for: "Neoplasm Of Unspecified Nature Of Respiratory System"

You asked about shrinking. in this case, shrinking it with chemo or radiation may sound better than major surgery, but in reality it wastes valuable time during which the cancer may spread. So far, according to the pet scan, it has not spread. So it needs to be removed before it does.

My wife had 2 lobes of her lungs removed 4 years ago. I am absolutely amazed at the bodies ability to recoup from major surgery like this. After the operation she did all of her breathing exercises as instructed. She went from 60% lung capacity immediately after the operation to 97% lung capacity in three years. The doctors explained to us that the body does not like to have vacant areas where organs used to be. It will allow other organs to grow to fill in the empty space. if you do your exercises after the lobectomy you can allow your lungs to be the organ that does the majority of growing into the empty space and therefore will allow a complete recovery.
If my wife had it to do all over again she would still have chosen the lobectomy as the preferred treatment.
A word of caution though. Keep all over the cancer testing for at least 5 years after the surgery. In my wife's case she had a metastisis to her brain that was not discovered until last year. We found out at that time that the brain is one of the main sites that lung cancer will metastisize to. Here we were getting lung X-rays for 3 years and thinking that she beat cancer altogether and in the meantime a tumor was growing in her brain. Had we known to watch for it we would have caught it earlier and possibly even beat it.
I wish you the best of luck and sincerely hope that your operation will be the end of your ordeal with cancer.

My wife had 2 lobes of her lungs removed 4 years ago. I am absolutely amazed at the bodies ability to recoup from major surgery like this. After the operation she did all of her breathing exercises as instructed. She went from 60% lung capacity immediately after the operation to 97% lung capacity in three years. The doctors explained to us that the body does not like to have vacant areas where organs used to be. It will allow other organs to grow to fill in the empty space. if you do your exercises after the lobectomy you can allow your lungs to be the organ that does the majority of growing into the empty space and therefore will allow a complete recovery.
If my wife had it to do all over again she would still have chosen the lobectomy as the preferred treatment.
A word of caution though. Keep all over the cancer testing for at least 5 years after the surgery. In my wife's case she had a metastisis to her brain that was not discovered until last year. We found out at that time that the brain is one of the main sites that lung cancer will metastisize to. Here we were getting lung X-rays for 3 years and thinking that she beat cancer altogether and in the meantime a tumor was growing in her brain. Had we known to watch for it we would have caught it earlier and possibly even beat it.
I wish you the best of luck and sincerely hope that your operation will be the end of your ordeal with cancer.

A second opinion is a good idea. If you have trouble finding a place try this list.Go to the web site below and it will give you a list of places that give second opinions and how to contact them. I went to Sloan Kettering in New York. They are not on the list but they are very good.

http://www.blochcancer.org/articles/xtrnew.asp

Stay positive,

Ernie

I was diagnosed with non-small cell carcinoma in August 2002. They estimated I'd had it for at least five years, undetected. I only had lots of crazy allergy symptoms, and no one thought to take a chest X-Ray (even though I smoked), because my lungs "sounded" so good. By the time I was diagnosed it was so large they wanted to shrink it before surgery. Unfortunately it was very resistant to chemo. I had five separate rounds of chemo combinations, including 37 radiation treatments with one of them, before it shrank. By that time my body was not in any condition to survive the surgery. Without surgery, there is no cure, so I am still fighting it, and lucky to be alive at all. If I was in your shoes I'd go for a second opinion and then surgery, just as fast as I could.

California Girl

I would have a bronoscopy done first and biopsy more lymph nodes. This I know from experience, a pet scan will show lot of concentration on infection, also, I had lung ca. and the pet scan and ct scans all showed the mass to relatively large. When the surgeon did the bronchoscopy and did the biopsey on lymph nodes, there were all negative, even down in the affected lung. They removed the lower half of my lung, and the pathologist determined the mass could not be measured accurate, due to inflamation and scarring around the mass. It was non small cell squamous, but the pet scan and ct scan will show scars and inflamation like a mass. I did the chemo, and it has been 2 years and has not returned. My surgery was done at Duke university by Dr. Berfiend, and my onocologist is Dr. Crawford, and they are absolutely excellent. I would advise anyone to consult them.

Did your wife have chemo after her surgery.?