› Forums › General Melanoma Community › Need some advice
- This topic has 12 replies, 4 voices, and was last updated 10 years, 1 month ago by
casagrayson.
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- November 5, 2015 at 11:01 pm
My husband is a Stage 1 melanoma patient. He has had two primaries, both on his head. For the last six months, he has had a bad cough. He finally went for an upper GI because his GP thought it might be reflux. The test showed nothing abnormal. The GP then sent him for a chest CT. We got a call from the GP's office that said "everything is normal". I asked for a copy of the radiologist report, and here is the part that concerns me:
"There are two tiny peripheral sub pleural nodules measuring approximately 2mm, one in the right upper lobe and one in the left upper lobe. The post-contrast images show no evidence of abnormal enhancement.
Opinion: No significant abnormality. No acute disease."
My question is, should I be concerned? Should we press the doctor for some other test, or should I ask for a second opinion from another radiologist? Are these nodules so small that there's no chance they are metastatis? I don't want to be an alarmist, but he hasn't felt well for a while and is so very tired of the coughing and fatigue.
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- November 5, 2015 at 11:09 pm
Benign lung modules are extremely common. Lots of people have them and never know about them because they don't get scanned. If the radiologist isn't saying something more sinister like possible mets or indicating continual followup, I wouldn't be concerned. BTW, they are too small for biopsy so the most you could do is ask for a followup CT some time in the future to rule out growth. However, at that size even a followup CT might show some change because most CTs use 5mm slices and a new scan might line up differently from this scan. (Does this make sense?)
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- November 5, 2015 at 11:09 pm
Benign lung modules are extremely common. Lots of people have them and never know about them because they don't get scanned. If the radiologist isn't saying something more sinister like possible mets or indicating continual followup, I wouldn't be concerned. BTW, they are too small for biopsy so the most you could do is ask for a followup CT some time in the future to rule out growth. However, at that size even a followup CT might show some change because most CTs use 5mm slices and a new scan might line up differently from this scan. (Does this make sense?)
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- November 5, 2015 at 11:09 pm
Benign lung modules are extremely common. Lots of people have them and never know about them because they don't get scanned. If the radiologist isn't saying something more sinister like possible mets or indicating continual followup, I wouldn't be concerned. BTW, they are too small for biopsy so the most you could do is ask for a followup CT some time in the future to rule out growth. However, at that size even a followup CT might show some change because most CTs use 5mm slices and a new scan might line up differently from this scan. (Does this make sense?)
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- November 9, 2015 at 6:33 am
Casa: You are understandably concerned if your husband has had good health up until ~6 mo ago & develops a cough with fatigue, gastroesophogeal reflux is ruled out and the 2 pulmonary spots are considered benign. I presume the common post nasal drip cause was ruled out and also pneumonia. These all were ruled out in a friend of mine, then in her 50's, when, finally, it was discovered that one of her carotid arteries was 90% occluded, the cause of her persistent cough. But beyond that, I would suggest pushing for a thorough work up appropriate for his age and symptoms of unknown cause if it hasn't been done inc labs. If he isn't a smoker, heavy alcohol user, no work history exposure to potential toxic substances, carcinogens, no other melanoma skin sites ID'd, then something less obvious is possibly going on. If your health care plan permits you might want to see a different more proactive doctor. Best wishes getting this solved and back to good health. A.L.
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- November 9, 2015 at 6:33 am
Casa: You are understandably concerned if your husband has had good health up until ~6 mo ago & develops a cough with fatigue, gastroesophogeal reflux is ruled out and the 2 pulmonary spots are considered benign. I presume the common post nasal drip cause was ruled out and also pneumonia. These all were ruled out in a friend of mine, then in her 50's, when, finally, it was discovered that one of her carotid arteries was 90% occluded, the cause of her persistent cough. But beyond that, I would suggest pushing for a thorough work up appropriate for his age and symptoms of unknown cause if it hasn't been done inc labs. If he isn't a smoker, heavy alcohol user, no work history exposure to potential toxic substances, carcinogens, no other melanoma skin sites ID'd, then something less obvious is possibly going on. If your health care plan permits you might want to see a different more proactive doctor. Best wishes getting this solved and back to good health. A.L.
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- November 11, 2015 at 3:52 am
Thank you so much, Anita. I hadn't considered the carotid artery scenario. He is going to an ENT next week, but I'm quite sure that this isn't a post-nasal drip cause. Our GP saw nothing to suggest that, and I've had enough of that to spot it. The only other thing that I can think of to check on is mesothelioma (as he had great exposure to asbestos in his 20s) — although I would assume that the chest CT would have shown something that serious.
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- November 11, 2015 at 3:52 am
Thank you so much, Anita. I hadn't considered the carotid artery scenario. He is going to an ENT next week, but I'm quite sure that this isn't a post-nasal drip cause. Our GP saw nothing to suggest that, and I've had enough of that to spot it. The only other thing that I can think of to check on is mesothelioma (as he had great exposure to asbestos in his 20s) — although I would assume that the chest CT would have shown something that serious.
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- November 11, 2015 at 3:52 am
Thank you so much, Anita. I hadn't considered the carotid artery scenario. He is going to an ENT next week, but I'm quite sure that this isn't a post-nasal drip cause. Our GP saw nothing to suggest that, and I've had enough of that to spot it. The only other thing that I can think of to check on is mesothelioma (as he had great exposure to asbestos in his 20s) — although I would assume that the chest CT would have shown something that serious.
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- November 9, 2015 at 6:33 am
Casa: You are understandably concerned if your husband has had good health up until ~6 mo ago & develops a cough with fatigue, gastroesophogeal reflux is ruled out and the 2 pulmonary spots are considered benign. I presume the common post nasal drip cause was ruled out and also pneumonia. These all were ruled out in a friend of mine, then in her 50's, when, finally, it was discovered that one of her carotid arteries was 90% occluded, the cause of her persistent cough. But beyond that, I would suggest pushing for a thorough work up appropriate for his age and symptoms of unknown cause if it hasn't been done inc labs. If he isn't a smoker, heavy alcohol user, no work history exposure to potential toxic substances, carcinogens, no other melanoma skin sites ID'd, then something less obvious is possibly going on. If your health care plan permits you might want to see a different more proactive doctor. Best wishes getting this solved and back to good health. A.L.
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