British Lung Foundation
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Desperately looking for answers, extremely anxious. Please help. Chest infection or lung cancer?

I am a 32yr male, with no medical conditions, and have been an on/off social smoker for approx. 12yrs. Usually I would have 1 or 2 cigs a day after work, and then maybe a 6-8 during a night out when drinking (which I would say on average would be once every 2 weeks). Therefore, I would estimate at the very most on average would be 40-50 cigs a month (some months zero)

Sorry this a little, long - this is my story so far:

Mid Oct 2017 – minor cold, which cleared up after 3-4days and started to feel better. Cough lingered for 3weeks.

Mid Nov 2017 - and started coughing up blood. Had a chest XR which showed some consolidation in the lower right lobe. All blood tests, including TB, WBC, CRP, HIV, all normal. Took amoxicillin for 1 week. GP referred to chest clinic as lung cancer (they advised that it is more likely chest infection, but the only way to get seen within 2 weeks is to)

Early Dec2017 – Coughing up blood became less frequent. Another XR showed the same consolidation, and I therefore insisted to the chest clinic that I was very anxious and wanted a CT scan.

Mid Dec 2017 – CT scan showed persistent consolidation with possible abscess formation. “An ill-defined area of consolidation within the RLL with a 4.3cm thin walled rounded low attenuation component, adjacent to which is a 1.6cm area of low attenuation”. I was advised by the consultant that based on this scan lung cancer has been ruled out, as no mass or other node abnormality was seen in the CT and that most likely the appearance is infection with abscess formation.

Mid Dec 2017 - had a bronchoscopy where no abnormality has been seen. BAL (sputum) collected for analysis – it’s been 6 weeks or so and no growth seen. (Apparently can take on average 6-8weeks)

Feb 2018 – still waiting on Sputum AFB (checking for mycrobacteria and TB etc.), and potentially another CT Scan will be done later this month.

I appreciate this is a complicated diagnosis, but I feel completely helpless and really can’t move forward in life. The consultants believe the CT findings and hemoptysis are due to TB or a TB like bug (NTM, MAC or fungal) but are struggling to prove this just yet.

My main symptoms are fatigue (comes and goes, some days I feel ok), occasional chest pains, wheeze and some breathlessness – which is made worse when doing light exercise, coughing up blood (which has become a lot less frequent, but still happens and the blood is definitely coming the lungs), cough- comes and goes which is worse at night and in the cold. No fever, no night sweats, no chills.

Has anyone been through the similar tests / diagnosis process? I hope someone can relate to what I am going through and help? I am scared of lung cancer, but every time I mention this the consultant tells me that the CT scan has ruled this out and given my age and lightish smoking history that the chances of lung cancer are extremely small and I need to forget about this as everything is pointing to chronic infection of some kind. Is this my anxiety getting the better of me or am I right to be so worried? Would anyone suggest any other tests to be done? Or likely cause?

Thanks for reading my post, god bless.

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Ron, I am not a Dr, but will say based on the ct scan and bronchoscopy results that I agree with your Dr’s that it does not appear to be cancer . Beyond that, all I can say is trust your Dr’s diagnosis and plan of action. Best Wishes, judg69

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If was cancer would see protein in bloods ... I think drinking might be issue really.

Lot of drinkers do get congested have bad chest.

Clearly am speculating and is just a thought 💭

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Despite the publicity lung cancer is actually relatively rare and 19 of out 20 cases are caused by smoking over many years. It would be very unusual at your age and with your smoking history. It would also show on your CT scan so believe your consultant. x

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not sure what to say I had all kinds of tests done MRI CT scan PET scan nuclear scan because I had a nodule on my lung I wasn't on oxygen or anything and just had a cough and shortness of breath they had a meeting and 9 doctors decided that I'm more than likely had cancer with that many doctors was frightened so against my gut feeling had the surgery. I didn't have cancer they caused my lung to collapse and all tubes had to be reinserted. They were over medicating me and did not feel safe there

I had myself removed from that hospital into another hospital and they determined I had a horrible staph infection so then had to go to a nursing home for a few weeks for medication and therapy. I am doing better now but will never get back what I had. I actually wanted to die at one point so just be careful and if unsure get second and even third opion.y son asked what would have happened if I didn't have the surgery they said they would have just monitored it. I wish I would have gone that route.

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That is not good and I know our doctors are not God but we pretty well rely on them to take care of us.

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I am so sorry that you are worried about the risk of cancer and that you still haven't got any clear answer.

Firstly, if you are still waiting for the results of the sputum test, please try and chase them up today.....it's been a long wait so far, so try and see what's happened.

Secondly, you say you have had one week of amocycillin only......does this mean you have had no other treatment for your possible chest infection since then, or have you had more antibiotics?

Thirdly I contracted double pneumonia twenty four years ago now, and I coughed up blood for some time, and suffered chest pain. It's happened on and off since then but not for a long time now. If that's any reassurance to you I don't know. There were no CTs scans available then , only X-rays which showed patches of infection . i used to cough up pus as well as discoloured sputum....is your cough productive with green, brown or yellow sputum.

Please ring and see if your results are back, or find out how much longer they will be, so that your treatment can proceed.

Thinking of you and sending best wishes.....sorry for the long reply!

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Hopefully the results of you sputum test will put your mind at rest but worrying isn't going to help. If cancer's been ruled out - that's good news, and you should be feeling more positive instead of dwelling on that now. Until you know what the problem is you don't actually know what you're worrying about and thats making you over anxious. Obviously you want to know what's wrong with you but worrying won't get the tests done any quicker, it's just going to turn you into a nervous wreck without having any effect on the outcome of your tests. Be patient, don't worry, concentrate on the positive outcome of the CT scan and be thankful for that. Wishing you well.

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I have a bacteria in my lungs as well that they think is TB related but cant be identified the scrapped some out and srnt it to the infectious disease specialist and it wouldn't grow so still no answeres

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Could the blood be coming from somewhere else besides your lungs have the ruled that out?

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Hi all, thanks for your thoughts, care, advice and support.

The sputum tests still have not shown anything concrete - I have been advised that the Sputum tests have an unpredictable sensitivity - somewhere estimated between 40-50% and on top of that slow growing bacteria can take up to 8 weeks (and sometimes even longer) - and then to add to this, the issue I have is right at the bottom of the lung which makes it difficult to know if the sputum samples do actually come from the bottom of the lung - this makes the diagnosis even more complex.

Based on the findings so far, my consultant has proposed to put me on the NTM MAC treatment - which is 2years of three different antibiotics. But before they start this, it looks like they need a little more clinical findings to prove that this would be the correct diagnosis. This is what worries me even more about the chance of lung cancer, and are the consultants just looking at my age (and relatively light smoking history) and thinking just because the chances are low they are ruling it out? As opposed to clinically definitively ruling it out.

I am trying to stay positive but the symptoms although a little non-specific are mentally draining. Haemoptysis, cough, weird chest dull aches, and excessive fatigue continue. Yet still no definitive diagnosis has been made.

I have a second CT scan and second Bronchoscopy scheduled for this week, and then follow up appointment with consultant at the end of the month. It's all a waiting game, which is not helping with the anxiety.

I find myself in a very depressing and helpless situation. I was fit and well until around Nov 2017, exercising 4-8hours a week and then all of sudden hit by this. Makes you realise how life can all of a sudden change.

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How's it going, @Ron2018? It's been five months, I hope you are well.

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Hello all, sorry for the slow update...I will provide an update on my more recent post:

healthunlocked.com/blf/post...

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Ron, you are, in fact, seeing the appropriate specialists. If cancer is suspected in the future they will no doubt do a PET scan , followed by a bronchoscopy if appropriate to get tissue to biopsy. Until something changes to lead your Doctors to these steps, seems you will need to continue to challenge them, yes, but continue to rely on their expertise. Please keep us posted . Wishing you all the best. judg69

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