Dad's biopsy negative but recommended surgery

• By hermanade
• Posted August 29, 2008 at 2:18 am

You can miss cancerous cells with FNA--no biopsy can be 100% conclusive for zero malignancy.

Furthermore, you say that there has been growth and, now, uptake on PET.

I think you are wise to consult with Jahan at UCSF.

And, yes, there was a poster on this very website who had a biopsy that indicated a benign lesion, and it and another lesion turned out to be malignant after much debate over which malignant pathology he had.

Consult with the thoracic oncologist at UC.

Best of luck!

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• By worriedgrl
• Posted August 29, 2008 at 2:30 am

Thank you Hermanade for your reply at this late hour. your response makes me feel stronger abt getting 2nd opinion -

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• By Chum
• Posted August 29, 2008 at 9:41 am

Look into a VATS procedure. I had a lobectomy through VATS and it seems to me that even a person of more advanced age could take it. They could do a more complete biopsy and, if called for, could then take out the mass. It is growing.

Courage

Chum

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• By Toddy
• Posted August 29, 2008 at 10:19 am

Neither of my biopsies showed my 6 1/2 cm x 7 1/2 cm mass to be malignant, they both came back inconclusive. However post-surgery pathology as expected showed it to be malignant.

Surgery is the gold standard, VATS being the least invasive and easier recovery. Given your dads age and not knowing other medical conditions he has surgery may or may not be the best option for him. You are wise to get all the opinions you can, including your dads.

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• By Ray
• Posted August 29, 2008 at 1:44 pm

Worried girl

What are you waiting for? His choices are (1) surgery, (2) Cyberknife, or (3) 6 months and it gets bigger becomes inoperable.

Tumors that size are almost always malignant. The purpose of that biopsy was to determine if cancer has spread. The negative means it (likely) has not spread. Without cancer at 86, he probably has about 8-10 years left. So I would seriously consider a non surgical apprpoach.

VATS might not be accepted because of the size of the tumor. So they might want full thoracotomy. But the same thing could be said of Cyber knife.

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• By worriedgrl
• Posted August 30, 2008 at 1:53 am

Thank you everyone for your suggestion and comments. in the next appmt I will ask about VAT as you all mentioned and very disappointed at the Oncologist since he did not mention it as one of Surgery options. Yeah, we're all so concern about his age and if he can go thru and recover from a traditional surgery. Someone also mentioned the RF? meaning burn the tumor via a needle with high frequency radiation. Did any of you hear about this? wonder if it's effective?
take care,

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• By rdeegee
• Posted August 30, 2008 at 10:03 am

Even vats is no easy trip. I had a vats type surgery mid August and I'm still suffering with the after effects. The usual little tiny hole or puncture in my case was pretty good sized but still better than having my ribs fractured.

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• By stage4survivor
• Posted August 30, 2008 at 10:16 am

WG,

FNA's are quite unreliable. This surgery is largely dependent on general health in terms of tolerating the procedure. Your onc wasn't remiss in discussing the method, VATS, thoracotomy, etc. The thoracic surgeon determines which method is best, if any.
One very positive sign regardless of being malignant/benign? Very slow growing, 1 to 3cm in 3 years!

Sincerely,

G

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• By worriedgrl
• Posted August 30, 2008 at 10:46 am

hi Rdeegee,
what are the after effects you get now? my dad is a very determined person, his first reaction was he wanted surgery to get it out, but we still want to get 2nd opinion. He was not told yet what involved along with effects of each treatment. the lung dr. also said next step is Mediastinos, did you have this? appreciate much for your info - thx

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• By Bette_Tx
• Posted August 30, 2008 at 10:59 am

I would get a second opinion. While biopsies can be right most of the time, there are cases when the actual mass and/or lobe was removed and part of the tissue was found to be cancerous.

I would be suspicious of the PET lighting up and would want to know for sure.

Since your father is 86, surgery would depend on his general health condition. Some 86 year old people are able to withstand surgery - for others, it is too much of a risk. My mother had a small mass show up on a CTscan at age 87. But she had serious emphysema and was on oxygen 24/7. The doctors said even the biopsy would be risky for her and if it turned to be malignant, she would not be able to go through the surgery. With her lungs, if she survived, she would be intubated for the rest of her life. So we did nothing and she lived on to be 90 yrs old.

In your dad's case, if he has no history of lung problems - copd, emphysema, not a diabetic, good blood pressure or normal with meds, etc .. he might be considered a candidate for surgery.

That's why you need a second opinion with a doctor who will weigh the benefits of further surgery. And, last but not least, you will feel better whatever the outcome is.

Best wishes and keep us posted.

Bette

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• By rdeegee
• Posted August 30, 2008 at 11:05 am

Typical surgery stuff, very sore and stiff. I think the older you get the harder it is to bounce back. I was so worried that I wouldn't be able to do a vats type surgery because I wasn't sure I could survive regular surgery. I do have two very large incisions...not just the punctures they talk about with vats.

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• By worriedgrl
• Posted August 31, 2008 at 12:27 am

Thank you Bette and rdeegee!
Bette: thanks for telling me about your mother's case who's about my father's age. definitely, these are very helpful information for us to talk to his Onco. In gerenal, he's in good health, he's taking medication for hi blood pressure and hi cholesterol. we'll keep you posted.
Praying for miracles .

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• By rdeegee
• Posted August 31, 2008 at 8:50 am

Yes I did have the mediastony and every thing looked clean and no involvement. It was only after the final pathology was in that they found involvement in the 20 or so lymph nodes in the area. I had a large cut under my right breast and another one my back plus the puncture wounds and I still feel them...I keep hoping every day that the little bit of improvement continues but I can't even imagine what the big surgery must be like.

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• By worriedgrl
• Posted August 31, 2008 at 9:19 pm

Thank you rdeegee! I'm praying for your speedy recover.

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• By worriedgrl
• Posted September 3, 2008 at 12:49 am

thank you Stage4survivor ! i will keep everyone updated.

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