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Suggest Treatment For Lung Cancer

Posted on Sat, 22 Jul 2017

Question: Hi, I have a question that my doctors currently are investigating. I have an enlarged thyroid with a large nodule and some smaller ones and the ultrasound showed all the features of malignancy (with more than 80% chance of being cancer). The original thyroid biopsy was benign however that was a while ago and since they want to remove the thyroid they aren't doing another one. I am waiting to have the thyroid removed however a CT scan showed multiple spots on my lungs up to 3cm (peripheral, with cavitation). The radiology report states it is most likely thyroid cancer which has spread to the lungs, however my doctors don't necessarily agree. They did a PET scan where the thyroid did not light up but the lung spots did light up. I've been told thyroid cancer doesn't always show up on PET scans. My question is, is it likely this is thyroid cancer that has spread to the lungs, or could it be thyroid cancer and lung cancer. They now want to work out what the lung spots are first however they believe a lung biopsy is dangerous due to my weight. My BMI is 64 so I am very large and they are worried about a collapsed lung I believe. I am worried about waiting too long to get this sorted out. Please could you tell me what the chances are of thyroid cancer that has spread, or just thyroid cancer or just lung cancer or both? Also, I have never smoked however I have always lived with smokers and have been around smokers a lot. Thanks, XXXXXXX

Answered by Dr. Deepak Sundriyal (5 hours later)

Brief Answer:
Hello dear. It can be from thyroid

Detailed Answer:
Hello dear. I have gone through the details. So a thyroid carcinoma can very well throw metastasis to lungs. The possibility of primary lung cancer is slightly unlikely as lung cancer usually grows in size more than 3 cm before throwing metastasis. However, it can be very well a seperate lung caner as tumors sometimes behave bizarre.
Only way to confirm it is a lung biopsy. As i can see, you have written lung lesions are peripheral, a biopsy can be performed safely if the interventional radiologist is an expert.
Lung cancer can be seen in non smokers too but not to afraid you. Sometimes even lung lesions can be just tubercular. Only answer is biopsy.
Thanks and regards
Feel free to ask further

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Deepak Sundriyal (1 hour later)

Thanks very much for your reply. So it is still possible for this to be thyroid cancer that has spread to lungs even though thyroid didn't light up on PET scan?

Answered by Dr. Deepak Sundriyal (6 minutes later)

Brief Answer:
Hello. Yes it is possible

Detailed Answer:
Hello. It is possible as tumor and its mets may behave differently and we have seen this quite a often.
Thanks and regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Deepak Sundriyal (31 minutes later)

Thanks very much

Answered by Dr. Deepak Sundriyal (0 minute later)

Brief Answer:
God bless you

Detailed Answer:
You are welcome

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Deepak Sundriyal (10 hours later)

One more question. Could you let me know what type of lung infections might show up on the PET scan?

Answered by Dr. Deepak Sundriyal (12 minutes later)

Brief Answer:
Hello. Any infection can lit up

Detailed Answer:
Hello again dear.

So any infection can be picked up on PET-CT but tuberculosis and sarcoidosis are the most confusing
ones with tumors.

Thanks

Above answer was peer-reviewed by : Dr. Arnab Banerjee