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Irregular Opacity In Lung. Had Gemzar Treatments, Radiation. Faced Coilitis Attack. Irregular Opacities Malignant?

Posted on Tue, 14 Aug 2012

Question: Had a 12 hr. whipple procedure done last September? Had 6 gemzar treatments first, then 28 days of radiation and zolodia(7 pills per day), next came the surgery and post surgery had 6 more gemzar treatments. On an er visit to hospital for coilitis attack, an abd.ct was done and the lower right lobe of the lung showed a 1.3cm. irregular opacity. I feel great. My oncologist surgeon/and oncologist both feel that a ct scan can wait til my September checkup and as my oncologist said "even if it was cancer I don't think I would do anything at this time for a 1/2 nodule".....This puzzles me quite frankly. Are all irregular opacities malignant? I feel like I should TRUST them, but I am truly scared that if it is cancer, it will spread further. Can you comment on this?
DO YOU THINK MY DOCTORS ARE RIGHT IN WAITING TO DO THE CHEST CT SCAN IN SEPTEMBER? I HAVE AN MD XXXXXXX AFFILIATE HOSPITAL DOCTOR IN NEW ORLEANS WHO WILL SEE ME AUG.7TH WITH BLOODWORK BEFORE AND SHE AGREED TO DO THE CANCER MARKER BLOODWORK "TO EASE MY MIND" BEFORE I GO TO HOUSTON IN SEPTEMEBER.

Answered by Dr. Ioan Dorian OANA (39 minutes later)

Hello,

Thanks for your query.

Judging the treatment you have followed, I suppose you have suffered from pancreatic cancer.

Not any irregular opacity is malignant, but if your previous CT did not show that nodule, there is a real possibility that nodule to be a sign of metastatic disease.

I agree with your MD XXXXXXX affiliate hospital doctor that you should do "the cancer marker blood work", in this case CA 19-9. How high was first time this marker and when you have done it last time?

I am looking forward to your answer.

If you have any more queries, feel free to ask.

Regards
Dr. Dorian Oana MD, PhD

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ioan Dorian OANA (18 hours later)

I didn't realize I had not said "pancreatic cancer" as the diagnosis. I was stage at Stage II in February 2011. They wanted to shrink the 3.0cm tumor blocking the duct in the head/neck area. After radiation, it was 2.2cm. My previous thoracic CT did show a 4mm nodule in the right middle lobe, but nothing was ever said about the bottom lobe. Would it be advisable to have a CHest CT NOW at the affiliate hospital in New Orleans and then another in September at MD Anderson? Would that be too much radiation? Damned if I do, damned if I don't theory????? Not sure what the ca-19-9 last time, but I think in was 30. Thanks!

Answered by Dr. Ioan Dorian OANA (5 hours later)

Hello,

Thanks for your reply.

First I would do CA 19-9, because if last time it was 30, then it was normal. If now it would be elevated, then for sure I would recommend a CT as soon as possible.

Regarding too much radiation, I would not worry about that at the moment. Not doing a CT scan because you are afraid of radiation could delay a potentially necessary treatment and that would be much more XXXXXXX

If CA 19-9 would be elevated and then the CT would confirm a metastatic disease, you should start a treatment right now. If not, you should repeat CA 19-9 and CT scan after three months.

If you have any more queries, feel free to ask.

Regards
Dr. Dorian Oana MD, PhD

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar