Lung nodule biopsy.

[jacic64]

Hi, I'm new to this forum but I am on the COPD forum. I have asthma, chronic bronchitis & severe emphysema. I've been really lucky to have been referred for several clinical trials for the above. My recent visit to the hospital for testing showed a lung nodule had almost doubled in size. I had a contrast CT scan about a year ago which showed the nodule glowing red. My consultant at that time said he would like to refer me for a biopsy. I didn't hear anything back from the hospital about the biopsy but I had another appointment booked 6 months later which included another scan. I asked the consultant there if the nodule needed a biopsy & he said it hasn't been recommended on my notes.I went back to the hospital last Tuesday for more tests including another CT scan. I received a phone call the next day saying that the nodule has almost doubled in size and they want me to go in for a bronchospic biopsy next week. They said that they are rushing the results through so hopefully I should hear results within 5-7 days. I'm hoping it's just due to inflammation from so many chest infections but I'm really nervous to be honest. I'm not able to have general anaesthetic due to a high risk of perioperative mortality so if the nodule does need to be removed I'm worried what would be involved.

Sorry for the long post, I'm just feeling a little overwhelmed at the moment!

[Mauranne]

Hello Jacic64

I had a lung biopsy in UK and it was done under local anaesthetic. A CT scanner was used at the same time to check the position of the needle as it went into my lung. I lay on my front and the local anaesthetic was injected into my upper back before starting the procedure. It was done by a surgeon and if I felt any discomfort more anaesthetic was administered. Every now and then I was slid into the scanner to check the position of the biopsy needle. I was nervous of course but it was not painful. It took about 20 minutes in all and afterwards I was put in a bed to rest for a few hours. Soon after the procedure I experienced a sharp pleurisy type of pain in my lung which worried me but it was only for a short while and was soon relieved with paracetamol. It was explained to me that the pain was caused because to take a biopsy of a lung nodule the needle has to be passed through the pleura (the lining of the lung) and that causes a pain similar to that experienced when suffering from pleurisy.

The anticipation of this procedure is the worst part. It was not painful. I was diagnosed with Stage 1 adenocarcinoma of my lung and had a successful VATS removal of the lower lobe of my lung as a result and am now clear of lung cancer. Recovery didn’t take long and I had no chemotherapy or radiotherapy.

I hope this helps you. I know you will be worrying but try not to. As I said previously, the anticipation is the worst part.

Best wishes

Mauranne

[jacic64 in reply to Mauranne]

Hi Marianne, thank you for the reply. I'm having a bronchospic biopsy so hopefully no problems with pleural pain. Happy to hear you're clear of cancer now. I am still hoping it's caused by the frequent chest infections I've had and not cancer.

[JanetteR57]

it's natural to be feeling overwhelmed and no doubt you've already googled lung cancer or lung nodules and scared yourself silly.

Many many people have lung nodules - they're like moles on the skin but on the inside of the lungs. Most are harmless (benign) but there are guidelines (British Thoracic Society) for monitoring those over a certain size and what's called volume doubling time as part of the surveillance pathway. Recent schemes like the targeted lung health checks and similar projects in Manchester, Liverpool and London have revealed just how many people have these along with other projects in Europe and other countries.

Many nodules do react during infections due to inflammation and then resolve (go back down) when the infection/inflammation has been curbed so fingers crossed that's the case for you.

If they're using a bronchoscopy that can either be administered with local anaesthetic (spray at the back of the throat that tastes rather odd - they say banana but didn't taste like banana to me) or general aesthetic (rigid bronchoscopy compared to flexible). I've had both types (had 5 bronchoscopies over the years since my diagnosis and surgery in Dec 2010 to remove a 7cm tumour and half my left lung) as several chest infections (pneumonia, pseudomonas, RSV) created symptoms that had clinicians worried so investigated and did a biopsy in 2012 through bronchoscopy, bronchial lavage (washings) in 2018. The one I had where the respiratory physician could see something on the CT turned out to be scar inflammation at the 'stump' site of surgery after an infection.

For those unable to withstand surgery and if required to remove it, radiotherapy (SABR) ablation can sometimes be used for solitary nodules. The vast majority do not require surgery. Sadly one essential part of investigations is the waiting - waiting for the tests, waiting for results - often leading to more investigatory tests and more waiting - finding a way to cope during these waiting times is crucial. I've always found keeping myself busy helps through distraction. good luck.

[Susie215]

Did they say if the nodule had an irregular shape? Like Spiculated?

[jacic64 in reply to Susie215]

No, they just said it's almost doubled in size. I should have time to ask questions tomorrow I hope.

[RoyCastleHelpline Partner Ask the Nurse Roy Castle]

Hi Jacic64

Welcome to the forum and sorry to hear of the worry with your nodule. There have been excellent replies of which there is not much to add.

It is good that they will rush the results through quickly for you and hope you will not have to wait too long.

You are welcome to contact us if you would like to discuss anything, you can email ask the nurse at [e-mail] or call our free phone nurse led helpline number on 0800 358 7200 Monday to Thursday 0900-1700 and Friday 0900-1600

All the very best

The Roy Castle Support Team

[jacic64]

Quick update, I got the results from the biopsy last night. Not the best news, I have cancer. Good thing is they've caught it quickly so that's definitely in my favour. Just waiting for appointment from local hospital now. I've been recommended for the 2 week pathway so should be quite soon.

[sassassas in reply to jacic64]

Hi jacic64 I'm sorry to hear this. I hope you get a treatment plan in place soon and if its been caught early, that you will quickly be cancer free. x