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Lung Cancer

Apical spiculated nodular density

09/10/2008

Question:

This lesion measured 1.2cm in greatest dimension on exam of 11/08/2008 and currently measures 1.7 cm on the current study on 6/11/08. Pet scan scheduled for 9/4/2008. What are some of the best treatment options?? Non-small cell carinoma surgically removed Sept 1997. Upper and middle right lobes removed. Condition described as "Mild interval increase in size of left apical spiculated nodular density." The comparative exams were Chest CT`s WO Contrast as I also have Multiple Myeloma. One more new issue is that I have been diagnosed with cancer cells in my prostate and am receiving hormone treatment evn though it is local and has not spread. Myeloma treatment precludes surgery or radiation therapy.

Thanks for whatever advice you can give. Also, I am a 70 year old male that actively works out at the gym almost every day using resistance machines and treadmill that is usually set for 8.0 incline and 3.8 miles per hour for 60 minutes. My Ht is 5`9" and Wt is 168.

Answer:

If this is a early lung cancer in the left upper lobe and the PET scan shows no evidence of disease anywhere else, there are several options.  One is an extended wedge resection of the nodule.  A lobectomy is likely not an option because you've had 2 lobes removed on the other side.  The other option is 3-d radiation therapy.  You would need a biopsy first before radiation to confirm cancer.  Both of these treatments are reasonable options.  I would discussing these options with a thoracic surgeon.

I hope this helps.

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Response by:

Sandra L Starnes, MD Sandra L Starnes, MD
Assistant Professor of Surgery
College of Medicine
University of Cincinnati