Tumor on diaphragm

I read a post somewhere about a tumor on the diaphragm and having a dry cough and coughing up bloody sputum but cannot find it. If you wrote about it, could you please answer a question on two? I have unexpectedly coughed up some sputum a couple of times in the last month, although it wasn't bloody. I have also felt a tightness in my diaphragm area when jogging, and my CA125 has gone from 13 to 56. How did the doctor find it? Was a CT scan necessary or was it palpable? Was the removal basically uneventful and easy? I'm having my blood rechecked in a couple of weeks and will definitely mention this to my doctor. Thanks for any help!

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3H,
I have never written about this before, but when my surgery was performed for Stage IV ovca, I had a tumor on the diaphragm. I did not have a problem with coughing. I had pain in my lower right rib cage that was specific to the area where the tumor was seen in a CTscan. I thought I had bruised or broken a rib. My ca125 was never very high. The CTscan was what caught the culprit. Good luck. willie

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somebody jusgt posted on firing their gyn on diagnosis, just up from here and those were her symptoms.

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somebody jusgt posted on firing their gyn on diagnosis, just up from here and those were her symptoms.

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Thanks Patricia 123. That was what I'd seen!

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3h

It was me that wrote about my wife having her first metastatic recurrence to her diaphragm in 1996. She was having dry coughing spells at first, but then she began having a mucus discharge, which eventually was bloody. A chest xray and Cat scan had shown a lesion inside her diagphragm.

That recurrent ovarian cancer was surgically excised (extrapleural lobectomy). It was a metastatic transdiaphragmatic tumor from the original ovarian cancer (1972), with attachment to the lung, liver and other midline structures of the chest.

Parts of those structures were surgically resected (the diaphragm is a common site for ovarian metastatic recurrence). Although it was not uneventful, the thoracic surgical oncologist stated that she was 100% successful and did not feel that further treatment with chemotherapy was indicated.

A number of thoracic surgeons over the years told me that this surgeon was just trying to make my wife disease free. Recurrent ovarian cancer patients can live a long time (with optimal debunking surgery). She left us with the knowledge that a second place an ovarian metastasis possibly could occur maybe the central nervous system (CNS) like the brain and/or the spine (little did she know how correct she was).

Until recently, it was very rare for ovarian cancer cells to metastasize to the CNS. In fact, up until 1994, there had been only 67 well-documented cases in medical literature. A multi-institutional study of 4027 ovarian cancer patients over 30 years identified only 32 cases while an autopsy study of ovarian cancer reported an incidence of 0.9%. Metastasis of ovarian cancer cells to the CNS was uncommon and rarely seen before the use of present day chemotherapy regimens.

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That sounds like one helluva surgery,,did the gyn surgeon do it with a chest surgeon. Amazing what an aggressive surgeon can do.

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Patricia1123

The tumor strategically settled in the diaphragm, with attachment to the lung, liver and other midline structures of the chest. It called for a thoracic surgical oncologist. Fox Chase Cancer Center (at that time) had a liver specialist at the ready. I say "at that time" because two years later (thanks to Taxol), when I called the cancer center to tell them my wife had a metastatic recurrence to her cerebellum, they told me they did not have any neurosurgeons on staff. How would you like to have that information hit you right in the face!? They began losing good surgeons. In fact, the thoracic surgical oncologist left.

I say the surgery was "not" uneventful because when my wife was first treated for her ovarian cancer back in 1972, persistent effusion showed malignant cells on thoracentesis. After total abdominal hysterectomy and pill-dose Chlorambucil (Leukeren) treatment, she had talc placed into the lung walls for them to adhere to the lining and kept them from collapsing.

Twenty-four years later, the thoracic surgical oncologist said the talc oozed down to the bottom of the cavity and was as hard as rock. She had to literally use a hammer and chisle to clean it all out. I only found out a couple of years ago in a University of Florida study that the talc probably gave her the twenty-four year ride without any recurrence. But the over twenty years of HRT most probably returned the cancer cells. Go figure!

The extrapleural lobectomy is no picnic! The thoracic surgical oncologist was known for her "shark-bite" stitches (some surgeons are known for their Mercedes Benz symbol stitches). And my wife had Gore Tex where her diaphragm used to be!

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Wow! That talc story is amazing. Maybe every gynecological oncologist should pour it in after surgery! Hopefully, when I mention my couple of cases of sputum along with the occasional tightness in my diaphram to my doctor in a couple of weeks, he'll check things out and should there be anything, we'll catch it good and early. Your wife certainly had a long time before metastisis, and you are one informed man. Thanks for all the info.

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I had my surgery Oct 2008. In addition to all reproductive organs they removed tumors from the outside of my liver; removed my spleen and appendix; tail of my pancreas; omentum; I had cancer along my diaphragm, bladder and small/large intestine which they used argon ablation for treatment. My surgeon amazingly achieved optimal debulking although unfortunately I had disease progression while still on first line chemo. I am currently stable on a phase 1 trial with 2 liver mets and a bunch of lymph nodes.

I still feel a lot of tightness along the area where my diaphragm is located. I do not know if it is adhesions/scar tissue from ablation or who-knows-what. PET and CT's still show clear. I did not have an issue with coughing prior to diagnosis.

I wish you the best

Teri

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Hi,

I had HIPEC surgery on September 14, 2009. During that surgery there were microscopic cells found in the diaphragm. Therefore those sections were removed and resectioned.

As ovca with seeding was explained to me, the spreading goes in a definate circle through out and around the abdomen starting in the pelvis area, then up to the liver, to the diaphragm and down to the sigmoid colon area and then along the entire pelvis girdle.

That was the exact course of my seedings. I had no tumors, just seedings less then 2cm.

Please do not delay diagnosis. Even with such a slight elevation of your CA125 - a cat or pet scan should have been ordered STAT.

Mine scan was delayed only one month and I had extensive spread in that month due to the fact I have a HIGH GRADE cancer.

I am not trying to scare you, but I would insist on a scan and another CA 125 ASAP. Early diagnoses and a low staging can save your life.

If in the sad event you are diagnosed with ovca, please look up the HIPEC procedure before commiting to any treatment. There are only about 40 to 50 places that do HIPEC in the USA. Unfortunately, many women are not even aware of this proceedure.

Good luck,
Jane

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Hi Jane,
I was optimally debulked with stage IIIc ovarian cancer two years ago November 17th, and the elevated CA125 was found in my 3 month checkup. I am having it checked again Nov. 30, and I have a superb gynecological oncologist whom I trust completely, so when I see him I'll mention the diaphragm issue. I'll also ask him about the HIPEC procedure you mentioned. Thanks!

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