Dad been diagnosed with Squamous cell carcinoma . Need some help, guidance and support please

[Concerned2021]

Hello, it was detected my dad he is 73 had an upper right lobe pulmonary nodule late Feb 22 as part of a pre op for a non cancer related matter . Was recommended that his local hospital followed up on this. Some time passed and only received an appointment 4 weeks ago. Several tests later including a pet scan and lung biopsy it was confirmed he has lung cancer ( type Squamous cell carcinoma) his consultants words were we believe we have caught it in time? but said they wouldn't commit further until he see's the visiting surgeon on Monday. I feel angry that the hospital didn't investigate the nodule before then? or think it was more urgent. Now he is in the system he is being seen to quickly. Or am I right to believe that type of cancer is generally slow growing.I suppose I feel both sad and scared for him. He has been through so many health problems over the years and now this. I just pray when he see's the surgeon that all be OK and he can be successfully treated.Thanks so much for listening xxx

[RoyCastleHelpline Partner Ask the Nurse Roy Castle]

Hello Concerned2021

I am very sorry to hear about the news of your dad’s cancer diagnosis. It will be a distressing and a worrying time for the whole family, and I am sure made worse by the initial delay and completely understandable that you will feel angry.

Many types of lung cancer can be slow growing the medical team involved will look at the results from the tissue collected at biopsy and can discuss the nature of his specific type of cancer.

Have a look back at some previous posts and you will see some very positive stories from people who have gone through surgery.

We have a surgery booklet, I have added the link below, a paper copy can be ordered if you wish.

roycastle.org/app/uploads/2...

We have various other information booklets available online including this one on managing your lung caner diagnosis.

roycastle.org/app/uploads/2...

If you would like to discuss anything at [e-mail], our free phone nurse led helpline number is 0800 358 7200 Monday to Thursday 0900-1700 and Friday 0900-1600

Kindest regards

The Roy Castle Support Team

[Concerned2021 in reply to RoyCastleHelpline]

Thankyou so much for your reply, I will certainly look at the information you’ve provided

[JanetteR57]

it's natural for your thoughts to be all over the place about your dad but many many people have pulmonary nodules found as his was - as an incidental finding from whatever they were investigating. there are specific guidelines on how to manage nodules from the British thoracic society as most are not malignant - they're a bit like moles on the skin where only a small proportion can turn nasty but they're on the inside of the lungs. It's good if he's seeing a surgeon as the majority of UK lung cancer patients are detected too late for surgery to be an option so that suggests they believe it can be removed by surgery which for the majority in the UK is now done via keyhole methods (VATS).In Oct 2010 I went to A&E with strange symptoms for me and a large mass was found on my chest x-ray on my left lung but I was discharged after 7 hours with steroids and antibiotics. The next day I was readmitted and misdiagnosed/mistreated for a week as 'uncontrolled asthma'. With no smoking history I wasn't considered urgent and a scan was booked but then the scanner broke down so it took 5 weeks to even get a scan. then like your dad things moved a little quicker when I was sent for a PET scan then saw a surgeon and had open surgery (upper left lobectomy) just before Xmas. I was told in January that it was a 7cm adenocarcinoma (another type of non small cell cancer). I was back at work and swimming by the end of March. There are 3 lobes in the right lung and 2 in the left and as most of us don't use all our lungs effectively anyway, it is better removed if that's an option.

I've been involved in lung cancer research since end of 2013 and the change in knowledge and treatments available is hard to explain as many believe there are limited or no options.

Age isn't a factor - but fitness for treatment is - there are people in their 80s and 90s who have lung surgery so if he can remain as active as possible that will help.

All I know if once I became more involved and found out how few are clinically eligible for lung surgery I was even more appreciative of the treatment and my life.

Good luck to you both...

[Concerned2021 in reply to JanetteR57]

Dear Janette

Thanks so very much for your lovely and kind reply . I just think as his father , mother and sister passed of cancer and my dad being a former smoker they would have seen him sooner . But I agree that we were always hopeful the nodule was just scar tissue etc . It sounds like you’re doing amazingly well now .

I just feel for my poor dad as he had a bypass in late February and this is how the nodule was discovered. So when I have my positive hat on it’s when I think if he hadn’t have had the bypass they wouldn’t have done the CT scan and X-ray prior to the operation this may not have been picked up xx

[JanetteR57]

I so get it - my dad had bowel cancer twice in his 50s when I was in my 20s and we thought he wouldn't get to 60... but thankfully he survived... he was 92 in February and is my mum's carer (alzheimers) but had another primary bowel cancer in 2016 when he was 86 and also had another major surgery. Nodules can appear for all sorts of reasons - infection, inflammation, scar tissue - my dad had one found incidentally when scanned for his last bowel surgery as they didn't think his heart would withstand the surgery (he needed a stent that's not been replaced). He's had annual scans to keep an eye on it.... but think he'd now be considered too frail for any major treatment.

When I became involved with lung cancer research I met many patients who had survived years - way before today's modern treatments of immunotherapy or targeted treatments but we don't hear much about lung cancer and when we do, it tends to be negative. There are over 200 types of cancer but their treatments and outcomes can be so different and even statistics/information from 5 years ago would be considered out of date in lung cancer. It's natural to have those we've lost in our minds but oncology now is so very different from years ago when everyone was blitzed with the same harsh chemotherapy or radiotherapy and is much more personalised for lung cancer which is why so many tests are done to determine exactly what it is which all take time but the time invested here can mean better outcomes.

Your positive hat mentality is exactly right - so many people's lung tumours are detected from incidental findings or emergency admissions which is why there are now lung health screening pilots being set up around the country to target older people with some smoking history (even if not current smokers) but they would never pick up cases like mine - never smoker, 2 weeks after my 52nd birthday as they're currently configured. I still am thankful that I took myself off to A&E when I did and that the triage doctor sent me for a chest x-ray as the emergency doctor said she wouldn't have sent me for one so at 7cm (like an egg it was described) I don't like to think what might have happened... hang on in there for both your sakes....

[Concerned2021 in reply to JanetteR57]

Your so lovely thanks ! I’ll be glad when he sees the surgeon on Monday and praying that surgery can be an option. You’re right in that if you Google anything to do with lung cancer you don’t see so much positive stuff, this is why I post on a helpful site like this , so people like you can spread some positivity x

[JanetteR57]

If surgery didn't look like a possibility, it's unlikely he'd be seeing one - he'd have been referred to an oncologist instead. I never did have one of those - my surgeon was the lead consultant in my case and is for many who are eligible for surgery.

Try not to google - it will frighten you no end. most of the recent studies and medical research are not well optimised in search engines so all sorts of outdated and inaccurate information is on there. If you want a trusted source of information which is used by healthcare professionals, patients, policy makers and others, have a look at Roy Castle lung cancer foundation website. as the major UK lung cancer charity they keep information updated with clinical input and a patient literature review panel (I'm on that) to ensure it's easy to read, well illustrated and there are also video clips, survivor stories and no end of information about every aspect of being investigated, diagnosed, treatments and living with it.... good luck. roycastle.org/about-lung-ca...

[Concerned2021 in reply to JanetteR57]

You’re a fantastic help , thanks! Yes his consultant said the decision on surgery would be down to the surgeon he will see on Monday . So all being well that will work out well x

[JanetteR57]

Fingers crossed!