No biopsy possible

[ferntreegully]

Hi there. I just wondered if there is anyone out there who has not been able to give biopsy tissue because the tumour(s) were either inaccessible or were sitting too near either main blood vessels or other risky areas. I have had two operations to remove two tumours. One operation removed aright lobe (cancer) and a wedge resection (Not cancer) the other op again on right lung was a vats wedge resection(cancer). Neither time biopsy possible. I now have another tumour this time on the left lung and again it is not possible to do a biopsy and this time the treatment offered will be radiotherapy. As the only conclusive proof that it is cancer is a tissue biopsy I am feeling a little concerned that if it is not cancer that I will have gone through a treatment which will cause some ongoing symptoms and will reduce the effectiveness of my 'good' lung also.

Anyone been or is in the same situation and how are you dealing with it? Thank you.

[JanetteR57]

I had a left upper lobectomy in Dec 2010 and no biopsy was done as the 'mass' showed clearly on chest x-ray, CT and PET and whatever it was it needed removing surgically. it turned out to be a 7cm adenocarcinoma. If you had surgery previously, tissue would have been taken at the time of surgery to ascertain the biological characteristics in order to give you a confirmed diagnosis. The pathology determines the type of follow on treatment (if any) that is given. There are different types of radiotherapy and some are very targeted at the tumour itself sparing the surrounding tissues. There was a section on 'Surgeon's at the Edge of Life' filmed at Birmingham's QE hospital last night on BBC 2 near the end showing cyberknife which isn't a knife at all but a targeted radiotherapy beam used in lung cancer, usually under the name of SABR. For anyone who has heard the term, it is interesting to see how it is applied. I'm guessing it will be available on IPlayer. There are other forms of radiotherapy used in lung cancer - not all are as damaging as the older forms of radiotherapy that was less targeted. SABR results are as good clinically as surgery for many patients unable to have surgery and has now been used in the UK for several years although there are not many centres across the UK so travel is usually involved. Many centres offer radiotherapy. There is a useful information booklet on Roy Castle website under 'how we help', 'information', 'lung cancer treatments' 'radiotherapy' that has more information. It won't be aimed at the 'good lung' and with surgery, people lose half, a third, two thirds or even a whole lung yet do ok. good luck.

[ferntreegully in reply to JanetteR57]

Thank you for your reply. Maybe I wasn't clear ...the three tumours on my right lung could not be 'biopsied' The tissue from biopsies are tested and give the evidence required that they are cancers. CT with contrast nor PET scans can give that certainty as inflamed areas which are not cancerous show up the same way as cancerous areas .....so one takes the chance that the tumours are cancerous. They may not be and significant surgery or treatment may have been for nothing. In my case two of the three were cancerous (tissue sent to pathology whilst I was on the operating table)...but may not have been.

The radiotherapy I am being offered now is for a nodule on my left lung which again cannot be biopsied and consultant respiratory physician has pointed out that like surgery a good area (good margin) around the tumour is taken away or treated also.

I am really asking if anyone has or has had tumours treated with radiotherapy which could not be biopsied, and they were told they are most likely cancerous but may not be? and did they go ahead with the radiation treatment?

Thank you for the information on SABR .... is very interesting. I shall make enquries with physician..

[RoyCastleHelpline Partner Ask the Nurse Roy Castle]

Dear ferntreegully

Sorry to hear you have another tumour and hope you do hear from others who have had a similar experience. It is understandable your concerns about the need for this if they do not know what it is, however it would be worse if nothing was done and the tumour grew or spread.

It may be worthwhile discussing this with your lung cancer specialist nurse or even your GP, or you can call us on our freephone nurse helpline number is 0800 358 7200.

This is the link for our booklet on radiotherapy from The Roy Castle Lung Cancer Foundation: roycastle.org/system/file_u...

Kind regards

The Roy Castle Support Team

[ferntreegully in reply to RoyCastleHelpline]

Thank you for your helpful message and for the link to the booklet.

[SunshineAhead]

where is the tumor on your left lung located? Mine was a cavitating bottom left lobe tumor right next to the pleura so was considered one of the worse spots but a PET scan confirmed it was cancer not a biopsy. A CT guided biopsy was completed to indicate what cancer type later confirmed as squamous cell. Maybe they are concerned at the risk because of your previous history and there is a serious increased risk having another biopsy on the left lung. I think it would be worth having a word with your cancer specialist nurse who will be totally versed in your case and very knowledgeable and helpful to you. Good luck