Is the mediastinoscopy necessary when there is no distant metastatic disease?
I have sent you the pet scan info and then from that the thoracic surgeon will do his procedure 1) bronchoscopy. 2)mediastinoscopy 3) lung surgery. Is the mediastinoscopy necessary when the pet scan said there was no evidence of distant metastatic disease.
A medianstinoscopy is a procedure in which a tube a mediastinoscope is inserted through the chest wall to examine the area between the lungs (the mediastinum). The mediastinum contains the heart, the esophagus, the trachea, lymph nodes, and blood vessels. During this procedure doctors are able to look for tumors or enlarged lymph nodes, and take samples (biopsies) to look for cancer or other conditions.
A mediastinoscopy is recommended most often as a method to help determine the stage of lung cancer to see if, how far, and to what regions a cancer may have spread. An accurate understanding of the stage of a lung cancer is very important in helping doctors recommend the best options for treatment.
Though PET scan is showing no evidence of distant metastases PET CT scan sometimes can falsely be positive in inflammatory processes and falsely be negative in lung tumours with low metabolic activity such as bronchioloalveolar carcinoma or carcinoid tumours.
So in my view since the presence of mediastinal nodal metastases is a key factor in determining tumour resectability, lymph node sampling by mediastinoscopy is recommended.
Hope i have answered your query
Early stage of disease
Medianstinoscopy is only being done as a precautionary measure to confirm the findings of PET CT as sometimes PET CT scan gives false positive results and the presence of mediastinal nodal metastases is a key factor in determining tumour resectability.
In my opinion you have caught the disease early and since you do not have distant metastases and as all your vital organs are working properly u do not need to worry as surgery causes cure rates of 60% to 80% and 5 year survival rates as high as 50%.
Hope I have answered your query.
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