Suggest treatment for lung cancer

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Posted on Thu, 20 Apr 2017 in Cancer
Question: Hi Dr.Rynne,
My mother recently died & I was told her death was as a result of Stage 4 lung cancer. My mother was at the doctors every 6 months over the last few years & her lungs were always clear.
The result of the Cytopathogy Report state:
Right pleural fluid, THINPREP & CELL BLOCK
No malignant cells identified
Reactive mesothelial & inflammatory cells noted

Are we saying cancer ?
doctor
Answered by Dr. Kaushal Bhavsar 2 hours later
Brief Answer:
No, this report is not saying cancer.

Detailed Answer:
Thanks for your question on HealthcareMagic.
I can understand your concern.

I have gone through the report you have mentioned.
This report is not suggestive of cancer. This pleural fluid is normal without any indication of malignancy.

You said that she was having lung cancer.
Do you have any CT thorax report?

Hope I have solved your query. I will be happy to help you further.
Thanks.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Kaushal Bhavsar 26 hours later
I was never told my mother had lung cancer until her last day in the hospital. She had no symptoms of lung cancer that I knew of & I saw her daily. That is why I am so confused. They even sent her to a rehab facility for PT from her bowel surgery. I wasn't told anything concerning her lungs except she has some fluid at the bottom of her lung; but they were not concerned about it.
In answer to your question, my mother had to have a CT scan when she first entered the hospital before this past Christmas, 2016 (Dec 20th). (She died on XXXXXXX 22, 2017.)
Upon entering the hospital, They discovered she had a mass in her bowel & was operated on a day later. Mass was Stage 2 cancer & surgery was successful. When they did the CT scan on her bowel, they noted :
Lung/ Right basilar small infiltrate present. Small right basilar effusion present.
Liver///Biliary Tree: pneumoblia present. Could be related to prior sphincterolomy. Thoracic procedure. Gall bladder (surgically absent); spleen, pancreas, adrenal glands & kidneys were all Normal. GI tract showed mass.
Later chest x-ray advised no pneumothorax. Moderate degenerative changes in the thoracic spine.
I'm sorry I have no medical knowledge: I hope I am sending the right information you need. Thank you for your help.
doctor
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
She was mostly having GI cancer.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I have gone through the reports you have mentioned. Yes, you have sent me correct information.
By this, I think she was having GI (gastrointestinal - bowel) cancer which was spread to lung (infiltration) and bone (spine).
So I don't think she was having stage 4 lung cancer.
Do you have biopsy report of bowel mass?
I will be happy to help you further. Thanks.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Kaushal Bhavsar 12 hours later
Dr. Blavsar,
The only pathology report I was given on the bowel advised they were requiring a test: BRAF. According to the report,
Reason for Referral: Malignant Neoplasm of Colon
Test : BRAF Mutation
Results: Detected (c 1799T>A (p V600F)

The surgeon told me after the surgery that the mass was Stage 2 cancer. The lymph nodes around the mass were clear of cancer cells. He thought the prognosis was good for my mom. He would have suggested kemo as a precaution, but did not recommend it due to her age.
I'm not clear on what you mean when you say no Stage 4 cancer in the lung, but she had cancer in the lung. Is there a difference ?
You are helping me more than you'll ever know. I thank you.
doctor
Answered by Dr. Kaushal Bhavsar 24 minutes later
Brief Answer:
I said she might be having metastasis in lung.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Sorry for confusion.
I mean to say that she was not having primary lung cancer so no question about stage 4 lung cancer.
She had infiltration on CT thorax. This might be due to metastasis in lung from bowel mass (primary tumour).
So she might be having metastasis in lung but not lung cancer for sure.
Hope I am clear now.
If not feel free to ask anything.
I will be happy to help you further. Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Kaushal Bhavsar 11 hours later
Dr. Bhavsar,
I thank you for clearing up my confusion on the difference. I understand now that the cancer had spread from the bowel & had settled in other areas of her body; including her lungs.
You have answered my question & my concerns for which I am grateful. Thank you so much for your help.
doctor
Answered by Dr. Kaushal Bhavsar 11 minutes later
Brief Answer:
I am glad that my advice is helping you.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
It's good that my advice is helping you.
It's always encouraging for doctors to hear positive feedback from patients.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Thanks.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

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