the latest on my friend's husband

On Wed, 23 May 2007 21:23:00 GMT, "Steven Vaughan"
<srv@doubletrouble.com> wrote:

>
>>> I ask again- Please provide us (potential cancer patients) with any
>>> information that might be helpful given the information yoyu have thus
>>> far. Correct any data that is erroneous. I'm ASKING you to do this.
>>> Nicely, I think. I've said "please" numerous times.
>>>
>>
>> No, you certainly did not provide a useful opinion
>> I will say this:
>> Small pulmonary nodules are common, and usually benign
>> Having CT scans and PET scans for no good reason is stupid
>> Exrtrapolating your personal experience is dangerous
>> Not everyone lives in the USA
>
>So, discovering 3mm and 4mm pulmonary nodules isn't a good reason for
>follow-up CT? What IS the proper follow-up (if any) in your opinion?
How long since there were discovered? The only way you are going to
get useful information out of a 3-4mm pulmonary nodule is to biopsy
it. PET Scans are only indicated for 10-30mm nodules. At the moment
they nodules are not large enough to have the margins well imaged by
CT. Smoothe margins tend to indicate benign, spiculated tends to be
malignant.

Also does the patient have a history of Coccidiodomycosis,
histoplasmosis, or toxoplasmosis? All 3 fungi have a reputation for
causing pulmonary nodules.
>
>What about my 14mm spiculated nodule that was accidentally found on chest CT
>when I was having a gallbladder attacklast month? (I had both abdomen and
>chest CT's) Rather than the follow-up PET and subsequent finding of a 1.8 cm
>lymph node (2 cm from the nodule in the Mediastinum) with +3.0 SUV uptake in
>addition to the nodule (which shows no uptake) what would you have done? Is
>there a better approach to my nodule than the follow-up CT that I will have
>7 weeks from now? Keep in mind my lymph node is inflammation- still awaiting
>fungal culture results. No bacterial or viral organisms present. Suspected
>to be Sarcoidosis, Histoplasmosis, or other unknown former infection. If so,
>what to do with the nodule that can't be reached by Bronchoscopy? Surgery?
>Radiation? Nothing? Does the fact that I was a smoker for 27 years have a
>bearing on if/how to follow up? How about my age? (42) I'm still confused.
Spiculated lesions should always be followed up. If you cannot reach
it via Bronchoscopy, it probably can be reached by CT guided Needle
Biopsy, or a VAT surgery.
A 14mm spiculated nodule in the lung in someone with a history of
smoking has a really high probability of being 'bad'.... It also
falls within the guidelines for a PET Scan. Because of the high
probability of it being malignant, I'd be reluctant to have it
biopsied.

I am not your physician, but I'd seriously consider having a 14mm
spiculated lesion in a lung removed, and let the pathology decide what
to do next.

(I have a 11-13mm smooth margined nodule in my left lung. I have a
history of Coccidiodomycosis. It was PET scanned, and came back VERY
cold. It has now been CT scanned 3 times. Once more, and if it hasn't
changed, the advice is pretend it isn't there. It has probably been
there for close to 20 years, but the original infection left a golf
ball sized hole in the other lung. Best guess is nobody noticed the
little guy (it isn't at all obvious) in the chest Xray because the
hole was a truly striking feature in the old X-rays (which have
unfortunately all been tossed)...


>
>Thank you for providing info. I appreciate all the info I can get.
>

"J" <nexsw@nvalid,anon> wrote in message
news:4655713A.570B7E35@execulink.com...
> Giuditta wrote:
>
>> "J" <nexsw@nvalid,anon> wrote in message
>> >
>> > http://www.medscape.com/viewarticle/535601
>> > Solitary Pulmonary Nodule: Assessment of a Solitary Pulmonary Nodule
>> > From ACS Surgery Online
>> > Posted 06/07/2006
>> <snip>
>> >
>>
>> I ask the time and get directions on building a clock. Thanks for your
>> time,
>> but I hardly understood a thing you wrote. A simple explanation would do
>> ...
>> in English.
>>
>> Judy
>
> I'll have to find a dumbed down version, some day, just for you..
> Your friend taught you to copy and paste. Ask her to teach you how to
> <snip>,
> please
> J


I actually knew how to copy and paste ... I think that was someone else who
was taught that by a friend unless I mentioned when I was taught that years
back, but you are right, J, I do need a dumbed-down version, and I'm not
being catty or anything. You guys are too smart for me.

Have a great day,
Judy

Giuditta wrote:

> "J" <nexsw@nvalid,anon> wrote in message
>
> > Giuditta wrote:
> >
> >> "J" <nexsw@nvalid,anon> wrote in message
> >> >
> >> > http://www.medscape.com/viewarticle/535601
> >> > Solitary Pulmonary Nodule: Assessment of a Solitary Pulmonary Nodule
> >> > From ACS Surgery Online
> >> > Posted 06/07/2006
> >> <snip>
> >> >
> >>
> >> I ask the time and get directions on building a clock. Thanks for your
> >> time,
> >> but I hardly understood a thing you wrote. A simple explanation would do
> >> ...
> >> in English.
> >>
> >> Judy
> >
> > I'll have to find a dumbed down version, some day, just for you..
> > Your friend taught you to copy and paste. Ask her to teach you how to
> > <snip>,
> > please
> > J
>
> I actually knew how to copy and paste ... I think that was someone else who
> was taught that by a friend unless I mentioned when I was taught that years
> back, but you are right, J, I do need a dumbed-down version, and I'm not
> being catty or anything. You guys are too smart for me.
>
> Have a great day,
> Judy

I thought it might be helpful for your friend, Judy.
The excerpt is in my other reply (and can be found in the thread at
talkaboutsupport if you want to send it to her.
J

"J" <nexsw@nvalid,anon> wrote in message
news:4656B5B7.7D175F17@execulink.com...
> Giuditta wrote:
>
>> "J" <nexsw@nvalid,anon> wrote in message
>>
>> > Giuditta wrote:
>> >
>> >> "J" <nexsw@nvalid,anon> wrote in message
>> >> >
>> >> > http://www.medscape.com/viewarticle/535601
>> >> > Solitary Pulmonary Nodule: Assessment of a Solitary Pulmonary Nodule
>> >> > From ACS Surgery Online
>> >> > Posted 06/07/2006
>> >> <snip>
>> >> >
>> >>
>> >> I ask the time and get directions on building a clock. Thanks for your
>> >> time,
>> >> but I hardly understood a thing you wrote. A simple explanation would
>> >> do
>> >> ...
>> >> in English.
>> >>
>> >> Judy
>> >
>> > I'll have to find a dumbed down version, some day, just for you..
>> > Your friend taught you to copy and paste. Ask her to teach you how to
>> > <snip>,
>> > please
>> > J
>>
>> I actually knew how to copy and paste ... I think that was someone else
>> who
>> was taught that by a friend unless I mentioned when I was taught that
>> years
>> back, but you are right, J, I do need a dumbed-down version, and I'm not
>> being catty or anything. You guys are too smart for me.
>>
>> Have a great day,
>> Judy
>
> I thought it might be helpful for your friend, Judy.
> The excerpt is in my other reply (and can be found in the thread at
> talkaboutsupport if you want to send it to her.
> J

I don't subscribe to that newsgroup so wouldn't even know where to look.

J

matt weber wrote:

> On Wed, 23 May 2007 21:23:00 GMT, "Steven Vaughan"
> <srv@doubletrouble.com> wrote:
>
> >
> >So, discovering 3mm and 4mm pulmonary nodules isn't a good reason for
> >follow-up CT? What IS the proper follow-up (if any) in your opinion?
> How long since there were discovered? The only way you are going to
> get useful information out of a 3-4mm pulmonary nodule is to biopsy
> it. PET Scans are only indicated for 10-30mm nodules. At the moment
> they nodules are not large enough to have the margins well imaged by
> CT. Smoothe margins tend to indicate benign, spiculated tends to be
> malignant.
>
> Also does the patient have a history of Coccidiodomycosis,
> histoplasmosis, or toxoplasmosis? All 3 fungi have a reputation for
> causing pulmonary nodules.
> >
> >What about my 14mm spiculated nodule that was accidentally found on chest CT
> >when I was having a gallbladder attacklast month? (I had both abdomen and
> >chest CT's) Rather than the follow-up PET and subsequent finding of a 1.8 cm
> >lymph node (2 cm from the nodule in the Mediastinum) with +3.0 SUV uptake in
> >addition to the nodule (which shows no uptake) what would you have done? Is
> >there a better approach to my nodule than the follow-up CT that I will have
> >7 weeks from now? Keep in mind my lymph node is inflammation- still awaiting
> >fungal culture results. No bacterial or viral organisms present. Suspected
> >to be Sarcoidosis, Histoplasmosis, or other unknown former infection. If so,
> >what to do with the nodule that can't be reached by Bronchoscopy? Surgery?
> >Radiation? Nothing? Does the fact that I was a smoker for 27 years have a
> >bearing on if/how to follow up? How about my age? (42) I'm still confused.
> Spiculated lesions should always be followed up. If you cannot reach
> it via Bronchoscopy, it probably can be reached by CT guided Needle
> Biopsy, or a VAT surgery.
> A 14mm spiculated nodule in the lung in someone with a history of
> smoking has a really high probability of being 'bad'.... It also
> falls within the guidelines for a PET Scan. Because of the high
> probability of it being malignant, I'd be reluctant to have it
> biopsied.
>
> I am not your physician, but I'd seriously consider having a 14mm
> spiculated lesion in a lung removed, and let the pathology decide what
> to do next.

Thanks Matt.
Good luck to Steven
J

Steph wrote:

> Many of the people who post here are not in the US, and the profligate
> wastage of CT scan and PET scan resources which is common to the American
> system is not a part of other public health care systems (even ones with
> better outcomes than the US, like the Canadian system)

Hi Steph,
Just for the record my impression is that, most of the time, the majority of
posters here are Americans.
So did you mean to write "Many of the people who post here are in the US"?
J - wondering

On May 24, 10:42 am, "Steph" <s...@vancouvers.island> wrote:

" The advice and care they get there is sometimes excellent, but
often appalling."

Come, now, surely you don't have first hand knowledge of advice and
care for all these people.
>From reading many of your posts, I gather you are not much for
Chemo....and that radiation is the treatment you feel is usually most
appropriate.
I would stack Dana Farber, MDAnderson against any cancer treatment
places in the world. People come from all over the world for their
diagnosis and treatments. They are world famous. I have heard of
McGill...but not on the same level.

We also do not have VAT!
We do have States Rights.
Yes, we are different....but I would not say one is really better than
the other.

"turtletrot1" <turtletrot1@bellsouth.net> wrote in message
news:1180532743.022052.272140@m36g2000hse.googlegr oups.com...
> On May 24, 10:42 am, "Steph" <s...@vancouvers.island> wrote:
>
> " The advice and care they get there is sometimes excellent, but
> often appalling."
>
> Come, now, surely you don't have first hand knowledge of advice and
> care for all these people.

No, I have much first hand knowledge

>>From reading many of your posts, I gather you are not much for
> Chemo....and that radiation is the treatment you feel is usually most
> appropriate.

Nonsense. If I had a germ cell tumour or a lymphoma, I'd be first in the
queue for my chemo. It's the data which is "not much for chemo" in the
majority of common cancers.

> I would stack Dana Farber, MDAnderson against any cancer treatment
> places in the world.

You have first hand experience of cancer care in other places in the world?

> People come from all over the world for their
> diagnosis and treatments. They are world famous. I have heard of
> McGill...but not on the same level.
>

> We also do not have VAT!
> We do have States Rights.
> Yes, we are different....but I would not say one is really better than
> the other.

"J" <nexsw@nvalid,anon> wrote in message
news:465CBDBF.67304177@execulink.com...
> Steph wrote:
>
>> Many of the people who post here are not in the US, and the profligate
>> wastage of CT scan and PET scan resources which is common to the American
>> system is not a part of other public health care systems (even ones with
>> better outcomes than the US, like the Canadian system)
>
> Hi Steph,
> Just for the record my impression is that, most of the time, the majority
> of
> posters here are Americans.
> So did you mean to write "Many of the people who post here are in the US"?
> J - wondering
>

No, I meant what I wrote