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Lung metastasis?

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User
Posted 26 Nov 2019 at 14:10

Good afternoon, everyone

I have had a persistent cough for 4 weeks.  Yesterday, my GP sent me for a chest x-ray.  The surgery called me first thing this morning to say the GP needed to see me this morning to discuss my results.

I have a marble-sized nodule in my left lung.  The x-ray has been forwarded to the lung cancer MDT and my GP has done a two week lung cancer referral.  The report stated that prostate cancer metastasis cannot be confidently excluded.  My GP also advised me to send the x-ray report to my oncologist.  My CNS is excellent and has already been in touch with my oncologist and will get back in touch with me as soon as she has heard anything.

The stats:  T3b Gleason 9 (4+5).  Prostatectomy, salvage radiotherapy and 18 months bicalutimide.  I finished bicalutimide in August 2019, so three months with no cancer treatment.  PSA has been <0.006 since radiotherapy and yesterday was my first post treatment PSA test remained at <0.006.

With such a low PSA, I told the GP it was highly unlikely to be prostate cancer metastasis.  He said it couldn't be ruled out.  That said, what is preferable anyway, metastatic PCa in the lungs or lung cancer itself.  I obviously want neither and hope there is some other explanation.  I also said spread to the lungs would be unusual.  He agreed, but said it does happen.  I also said that spread to soft tissue is serious.  He agreed, and said that aggressive PCa in young men (I'm 49) often does behave aggressively.

Not having a great afternoon.  I'm going to take the dogs out for a long walk in the rain.

Ulsterman

 

User
Posted 26 Nov 2019 at 15:38
Quote you may find reassuring:

"Lung nodules are very common. According to the American Thoracic Society, lung nodules are visible on up to 50% of chest CT scans in adults. Fewer than 5% of lung nodules end up being cancer."

User
Posted 26 Nov 2019 at 21:33

Thank you, everyone, for your quick and yet detailed and considered responses, and for your obvious care, concern and compassion.  What a truly wonderful group of people you are.

I’m coming to the conclusion that this is neither PCa spread to the lungs nor primary lung cancer.  The medics have, quite possibly, over-reacted.

The radiologist knew I had had PCa.  He saw a soft tissue nodule and said metastasis could not be confidently excluded.  He then sent my x-ray and his report directly to the lung cancer MDT coordinator, something my GP said he had never seen happen before.

My GP then followed with a two week lung cancer urgent referral.  He would not rule out metastasis despite my exceptionally low PSA.  He said it could be lung cancer but doubted that, but refused to rule it out.

Based on the fact that I’ve had some sort of throat/chest infection for almost a month, and what I’ve now read about nodules in the lung, it is most likely something related to that infection.

That said, two medics are sufficiently concerned to have referred the matter on, so this will only be settled by the MDT and my own oncologist.  Until then, I can’t have 100% peace of mind.  And Lyn, i’ll Obviously ask them to rule out a different type of prostate cancer.

I’ll keep you all informed as to what happens.

Ulsterman

User
Posted 27 Nov 2019 at 17:45

Got a call from a receptionist at Wexham Park Hospital.  A consultant has looked at the x-ray and wants a CT scan.  This will happen tomorrow (Thursday).  That's quick - they only received the referral yesterday.  I think, as others have said, that it's just a harmless nodule related to my recent chest infection and am hoping the consultants are just being very cautious.

Ulsterman

User
Posted 03 Dec 2019 at 19:44

Got the all clear - thank God that ordeal is over.  The shadow on my lung has completely disappeared.  Thanks for all your support.

Ulsterman

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User
Posted 26 Nov 2019 at 15:28

UM I’d agree that with your PSA it seems really unlikely to be mets. Did the GP offer any alternatives to what it may be.

I’ve got everything crossed that this turns out to be nothing sinister.
Try and stay positive until you know more

Bri

User
Posted 26 Nov 2019 at 15:35
Sorry to read about this new chapter in the saga. I suspect that both you and I know more about PCa than our GPs...

Are you a smoker?

Let’s hope it all works out for the best.

Cheers, John.

User
Posted 26 Nov 2019 at 15:37

Oh Ulsterman,

Really hoping it's not any kind of cancer. PCa does sound unlikely, given your original PCa pushed up your PSA, and this isn't.

Cheers, Andy.

User
Posted 26 Nov 2019 at 15:38
Quote you may find reassuring:

"Lung nodules are very common. According to the American Thoracic Society, lung nodules are visible on up to 50% of chest CT scans in adults. Fewer than 5% of lung nodules end up being cancer."

User
Posted 26 Nov 2019 at 15:54

With such a low PSA it’s unlikely to be PC related. I have fingers crossed that it is a benign finding. A long walk is a good idea despite the rain. Not easy to deal with these findings.

All the best Ulsterman.

 

Ido4

User
Posted 26 Nov 2019 at 16:03

I'm not sure what a nodule is but your psa is incredibly low.  I had a hip pain that I was convinced was a secondary but they kept saying with such a low psa, <0.05, it's very unlikely.  Anyway after several months it went.

My dad was told he'd a cancer from an x-ray but it wasn't.  I'd think a small lung cancer would be operable.  I'm very sorry to read it.  All the best, Peter

User
Posted 26 Nov 2019 at 16:05
Hi mate , did you have full body CT at any stage of your treatment as it should have shown up back then ?? But I agree psa is low now so shouldn’t be spread unless it was spread initially if you know what I mean. Secondary bone and lung cancers are easier to treat than primaries in those areas but are still incurable. My fingers are well crossed for you. I got soaked also today twice !
User
Posted 26 Nov 2019 at 16:21

I can imagine how you must be feeling at the moment although as others have said benign nodules are pretty common. We are in a similar situation with worry as husband had  a recent  abdominal /pelvic CT scan. Amongst other incidental findings the radiologist has reported minor scarring / atelectasis at bases of his lungs. He hasn't had a chance to discuss with GP yet but we are worried as cancer can be a cause of this although his PSA is still currently < 0.03 so unlikely to be PCa.

I do hope you get good news soon that it's just a benign nodule and you can get on with life.

Best Wishes

Ann

User
Posted 26 Nov 2019 at 18:56
As you said to the GP, this is almost certainly not a PCa met and statistically, is more likely to be benign rather than a primary tumour. If (if) it turns out to be cancer, it might be worth you having some genetic counselling as two primaries coupled with your young age when you were dx with PCa is worth pursuing in case you have that weird gene that makes you susceptible to multiple cancers. If (if) it is a met, they may want to check that it is still adenocarcinoma rather than one of the less common low PSA producing ones which like lungs. If (if) it turns out to be primary lung cancer, that is quite treatable these days and they are able to just remove the affected part of the lung in many cases.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 26 Nov 2019 at 21:33

Thank you, everyone, for your quick and yet detailed and considered responses, and for your obvious care, concern and compassion.  What a truly wonderful group of people you are.

I’m coming to the conclusion that this is neither PCa spread to the lungs nor primary lung cancer.  The medics have, quite possibly, over-reacted.

The radiologist knew I had had PCa.  He saw a soft tissue nodule and said metastasis could not be confidently excluded.  He then sent my x-ray and his report directly to the lung cancer MDT coordinator, something my GP said he had never seen happen before.

My GP then followed with a two week lung cancer urgent referral.  He would not rule out metastasis despite my exceptionally low PSA.  He said it could be lung cancer but doubted that, but refused to rule it out.

Based on the fact that I’ve had some sort of throat/chest infection for almost a month, and what I’ve now read about nodules in the lung, it is most likely something related to that infection.

That said, two medics are sufficiently concerned to have referred the matter on, so this will only be settled by the MDT and my own oncologist.  Until then, I can’t have 100% peace of mind.  And Lyn, i’ll Obviously ask them to rule out a different type of prostate cancer.

I’ll keep you all informed as to what happens.

Ulsterman

User
Posted 26 Nov 2019 at 21:41

Lyn - following the Mill on the Soar get together in summer 2018, the professor who spoke put me in touch with the Marsden where a study into DNA and PCa is taking place.  I submitted my DNA a few months ago but was told it would take a long time for any feedback, but at least some level of genetic testing is taking place.

User
Posted 26 Nov 2019 at 22:26
👍
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Nov 2019 at 00:02
Sorry you are now having this concern. Has the cough been accompanied by cold symptoms or of a chest infection? Have you been coughing up Phlegm? An unexplained cough only for several weeks I would find more worrying, particularly with what radiologist says.
Barry
User
Posted 27 Nov 2019 at 10:28

Hi UM,

Sorry to hear you've been hit by this. Hope you get it sorted quickly.

I agree with what others have said that based on your stats and treatment to date it's very unlikely to be pca related. 

Flexi

User
Posted 27 Nov 2019 at 12:10

Hi Walter,

Very unlikely, in my opinion.  At least being checked out.   I had to check some original posts (as I don't post a great deal).   Over 3 yrs since your 'dx' journey due to 'Lions' eh ?

Incidentally, how severe and persistent has the cough been ? ie This could be inflammation or local infection.  I had a night cough (ie had major dry cough lasting a couple of mins, each night)  lasting about 8 weeks in this summer, a colleague in office had very similar (we both lost voice for a couple of days).  No one else in family or friends had anything similar. It didn't effect my energy levels, and no other flu/cold like symptoms.     I don't have allergies or COPD.   

All the very best,   Cheers Gordon

 

User
Posted 27 Nov 2019 at 14:44

Yes, i should have made it clear that I had a bad throat infection 4 weeks ago and the cough has not gone away.  I therefore think that the nodule in my lungs is something left over from my infection and nothing to do with cancer.  However, the radiologist and the GP both knew that too, and I am still on the two week lung cancer pathway.  So, in my rationale, risk-assessing moments, I conclude that the medics are being overly cautious.  In my less rationale moments, I think, what if????  Remember though, when I was diagnosed, everyone was telling me it was highly unlikely that a 46 year white man with no symptoms and no family history was going to have PCa.  I had a pT3b and G9!

Anyway, the sooner my appointment comes through the better, so we at least know what we're dealing with.

Ulsterman

User
Posted 27 Nov 2019 at 15:16

This points out that the modules are quite common. If you had a chest/lung infection it’s in all likelihood a result of that


https://www.liverpoolccg.nhs.uk/media/1283/lung-health-clinic-nodules-information-leaflet.pdf

User
Posted 27 Nov 2019 at 17:45

Got a call from a receptionist at Wexham Park Hospital.  A consultant has looked at the x-ray and wants a CT scan.  This will happen tomorrow (Thursday).  That's quick - they only received the referral yesterday.  I think, as others have said, that it's just a harmless nodule related to my recent chest infection and am hoping the consultants are just being very cautious.

Ulsterman

User
Posted 27 Nov 2019 at 17:47

Thanks for that leaflet, Brian.  Very helpful.

User
Posted 27 Nov 2019 at 17:55
Fingers crossed for you x
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 Nov 2019 at 20:56

I’m keeping everything crossed for you that this is just part of your infection xx

Debbie xxx
User
Posted 01 Dec 2019 at 02:16

We've been told lung nodules are common.  My husband has one as well and they continue to watch it, but say it is unremarkable and not concerned about it.  I hope that is the conclusion for yours as well.  I understand how any new 'development' on this journey is so nerve wracking and causes anxiety.  I hope you get positive news.  Very fortunate they are acting so quickly.  

Saint Paul

User
Posted 01 Dec 2019 at 02:40

Wishing you the very best of luck. 

Steve 

User
Posted 02 Dec 2019 at 13:41

I phoned the appointments number at my hospital and explained that I was on the two week lung cancer pathway and had had a CT scan last week.  I asked if they had any idea when I might be sent for as I was trying to plan my diary. 

I was told the two week referral had been retracted and passed over to urology.  I asked what that meant and was told that no one from the lung team needed to see me as I did not have a lung condition.

Does that mean they’ve seen something in my lungs that urology needs to deal with, or does it mean it has been passed to them simply to rule things out?  My CNS is chasing things up for me, but I obviously am worried that it might be spread to the lungs.

ulsterman

 

User
Posted 02 Dec 2019 at 14:24
Well only guessing but it seems to me that if they thought they had seen a lung tumour on the CT, they wouldn't be able tell whether it was a lung primary or a PCa secondary just from looking.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 02 Dec 2019 at 16:14

The lung specialist who ordered the CT scan is seeing me tomorrow.  Turns out they know me - I teach their children!

Ulsterman

Edited by member 02 Dec 2019 at 18:04  | Reason: Not specified

User
Posted 02 Dec 2019 at 19:03
Hopefully, you haven't given any of them a detention recently 🤣

I will have everything crossed for you.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 02 Dec 2019 at 20:48
Fingers crossed all is well
User
Posted 03 Dec 2019 at 19:44

Got the all clear - thank God that ordeal is over.  The shadow on my lung has completely disappeared.  Thanks for all your support.

Ulsterman

User
Posted 03 Dec 2019 at 21:21
Great relief for you!
Barry
User
Posted 03 Dec 2019 at 21:23
Great news mate especially before Xmas. Now enjoy lol
User
Posted 03 Dec 2019 at 21:36

Fantastic Ulsterman.

User
Posted 03 Dec 2019 at 22:14
❤
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 03 Dec 2019 at 22:50
👌👌
User
Posted 03 Dec 2019 at 23:07
Phew
User
Posted 04 Dec 2019 at 05:46
Excellent news Ulsterman
User
Posted 04 Dec 2019 at 09:03

👍

Flexi

User
Posted 04 Dec 2019 at 09:51

What a relief. Great news Ulsterman.

Ido4

User
Posted 04 Dec 2019 at 15:29
Well done!
User
Posted 04 Dec 2019 at 21:04

That is fabulous news ❤️❤️ Xxx

Debbie xxx
User
Posted 04 Dec 2019 at 21:11

Great news. Relax and enjoy the festive season now.

User
Posted 04 Dec 2019 at 21:15

So pleased for you , fantastic

Dream like you have forever, live like you only have today Avatar is me doing the 600 mile Camino de Santiago May 2019

User
Posted 04 Dec 2019 at 22:38
Great to read such positive news. fab!
User
Posted 05 Dec 2019 at 03:51
How strange!

Perhaps the shadow was a fall of soot that you coughed up. Probably down to the ‘Climate Emergency’.

All the best.

Cheers, John.

 
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