Hi All
I am new here and hoping for some more information, also whilst awaiting diagnoses I have been doing a lot of googling, and found so little on my type. Especially in my age group. Most posts about mine seem to be on behalf of older relatives. Apparently it's rare, and rare as hens teeth in my age group. (34 year old female). So by sharing my story here I hope to raise awareness and should anybody find themselves where I am now, they can google for some information.
I just got diagnosed yesterday (Maundy Thursday).
I also want to raise awareness to get checked, if it's not normal for you, please do not dismiss it as I did and leave it and just think it's part of getting older.
I should start by saying I am slightly more complicated as I also have an autoimmune disorder called hidradenitis suppurativa (HS I call it as spelling and saying it is a mission). This is pretty harmless, extremely painful and embarrassing condition that causes abscesses in sweat gland areas. It is not relevant to my story so do not get hung up on it, other than it helped my cancer hide behind it as I blamed this for some of the symptoms.
I noticed some stinging type sensations under my arm initially, this is not abnormal for me as I also get frequent cellulitis infections as part of my HS. It is my left axilla that is predominantly affected with the right rarely coming to the party. The stinging was on the right so I could not understand why I had no abscess, no bright red skin, no thickening. I dismissed it, it came and went intermittently I kept an eye but it never came to anything.
Around August 2017 I then noticed sleeping at night was uncomfortable to lie on my right side. This went on for a while at least a month or two and wasn't improving. I had gone numb where I was getting the stinging under my arm. Again I did not think too much of this as I had had numerous surgeries to drain abscesses and had noticed nerve damage/loss of sensation in the badly affected left so assumed it was that.
I had also been getting a lot of headaches, which I had mentioned to the doctor previously, they ran bloods and said I was low normal so put me on iron to boost me a little. This did stop the headaches.
Another thing I had noticed and was rather annoyed about is embarrassingly I did not link it and despite them saying always get checked and I didn't. My right breast had changed shape slightly. I felt like I looked a bit sagged, not being by any means are large chested woman I was most put out, but just thought ah that is what they mean about your 30s.
My other weird quirky symptom which again I didn't link is I suddenly started suffering from indigestion/belching which I had never ever had problems with in my life. I just got some indigestion remedies to try and help.
The most scary symptom for me in these couple of months was on and off 3 times the whole right side of my face went numb for a few minutes at a time. It felt just like I had had a dental local anaesthetic. Half my tongue felt thick and floppy my nose was numb down one side and my cheek. At this point I started to google and freaked myself out as it kept saying potentially MS for my symptoms. (just the numbness I didn't think to link the rest at this point). I had also noticed the numbness across my chest and at times down my arm in to my little finger and ring finger.
October 2017 I finally I went to my doctor about another one of my friendly abscesses and brought up the pain in my right chest/numbness across my chest and back of my arm and numbness of face. He suggested a trapped nerve. I was referred for an xray.
I had this the report said I had a very slight narrowing between two neck vertebra and a bone spur. Accepting this must be the cause I went to a chiro to resolve. My insurance would fund 4 sessions which I had and only felt mild benefits.
I went back to the GP and asked what to do for the best, there had been mention of an MRI but as the Chiro had mildly helped I went for physio which was unlimited on my insurance.
I had seven sessions in total, in the middle I had 3 sessions of acupuncture in one week and that really made me feel better I was getting more and more pain by now and so fed up as I had gone in October and it was now January/February. I thought finally I would be fixed, then we slowed back down to once a week and the pain was intolerable again.
The physio agreed he had done all he could and referred me back to my GP and pain specialist who would organise an MRI and maybe an injection to the nerve if needed.
I sore the pain man who was lovely, organised an MRI of my neck suspecting a protruding disc. February 2018 I went for my MRI so relieved I would finally be getting fixed. He said that a couple of my symptoms didn't fit that diagnosis but some people are wired differently, He also said that after six months a protruding disc should have healed itself by now, or very near to it.
It was a Wednesday and I was to meet with him the following Monday to discuss. Within half an hour of getting out of the MRI I had a text to ask me to go that evening to see him and bring someone with me. It was at that point my world came crashing down. I knew I was in for bad news and something serious had been found. I was very tearful at first but then went into a seriously calm slightly surreal state about it.
I went to see him as requested and he was gutted I could tell to tell me that the MRI of my neck had actually picked up a mass on the Apex of my lung. I now know that this is a Pancoast Tumor and that it ties exactly with my symptoms.
Also in hindsight looking at my MRI and comparing it to my Xray, it was there all along on my Xray and it was missed! It should have been found 4 months earlier. I am angry about that at times, but also realise being angry won't change it. It was missed and a four month earlier diagnosis could have made all the difference. I had read tumours double in size in four months. But it wasn't and it can't be changed.
He advised I would need to go for several more MRIs of my brachial plexus, thorasic inlut, my spine, chest and head ( I had also been getting a lot of headaches so they were now being ultra precautious). with contrast and a thorasic CT with contrast.
These showed the mass as suspicious and of about 9cm with enlarged lymph nodes.
I was then referred for lung function tests, blood tests a lung biopsy and a PET scan which I had to travel to the UK for was we have limited facilities in my small island.
The biopsy confirmed it was positive for cancer, I have Adenocarcinoma the most common type. The PET scan showed some other 'hot' areas areas for concern. So I need to have more tests, though the enlarged lymph nodes in other areas I think will all be due to my HS as the areas are both Axillas, my groin (which I have had an ultrasound on and need to have a biopsy on to be sure) and my bowels, which seem fine but need a polyp removed, so likely what the scan was finding.
Providing none of these other areas are affected I am a stage III B and they believe at least an N2 as the node in right side looks malignant, so does the node of my Trachea and they are questioning the left side node which would make it an N3.
If it's spread elsewhere I will be a stage 4. Here is a post to how the TNM stages are spilt over the different stages and how they categorise them. cancer relief lung cancer stages
They believe due to the multi layer node involvement it is inoperable, which I am a little relieved about as it's major lung removing surgery and potentially ribs too.
I will have to go back to England to see the Oncology specialist there hopefully within a week or two, by which all my other areas results will hopefully be in. But all being well it looks like I will receive Chemoradiation. I have been told it will be the highest dose they give. Which is where my questions come in please, how long for, how often? We do not have radiation facilities where I am from so again this would have to be done in the UK. I need to plan around this life/animals/work etc and do not relish being in a place for too long where non of my home comforts or friends/family are.
Sorry it was long, I wanted it to be as informative as possible for anybody else going through a pancoast diagnosis.
But please the main point of my post was, laying all those symptoms together it's obvious, but them appearing separately over several months and being such a rare lung cancer (only 5% of all) and usually affecting men in their 60/70s I am the hen's teeth diagnosis that you see people dismissing all over the internet when people google and panic that they have shoulder pain. Get checked, if it's not normal for you, just check it out!
Hi Margaret
Thank you for your reply. I do hope you are doing ok.
This is a good suggestion, I did ask this today and the nurse was not sure. However, I now have her email address and was just sitting down to compile a list of questions to email her to ask.
She has also said she has spoken to Southampton and can arrange a call to the surgeon tomorrow or Friday to go through any further questions I may have which I think is a good idea.
I had thought of so many and as usually happens meetings can take a different route to what you expect and my mind went blank.
Thank you for your support.
Hi, I had surgery in 2016 after chem radio therapy - the surgeon told me the night before surgery that they may need to remove two lobes but wouldn't know until they were operating.... They only removed one.
Prior to surgery my oncologist told me that if I was a member of his family he would recommend I had the surgery. Hearing that was good enough to convince me to go ahead. Two years down the line my lungs remain free of cancer but I did have a spread to the brain which has low been removed.
Cancer truly is a rollercoaster ride but not a fun one!
be kind to you, and think about the advice you give to others - what would you say to someone else in your position? You have a lot to consider - or not, do what is good for you x
thank you so much for the advise and positivity you give to us on this ride - now take strength and have faith innyourself to make the right decisions for you!
we are all with you x
DianaA
Hi Gina
On a slightly different tack can I say how much I admire you for your ability to answer everyone who replies to your posts. With so much going on with your health I think it's amazing that you always find the time to give a full, considered reply. Its a pity more posters dont follow your example.
Well done kid - Phil xx
That is so true. personally I am in the midst of a dilemma on whether to accept chemoradiotherapy (their preferred option) or just radiotherapy (as I’m so afraid of chemotherapy). The side effects and risks of chemotherapy terrify me.
these moment consume your every thought and scrap of energy.
i hope that if I can get my way through this I will be able to give time to those who need support and encouragement.
That would be my intention and Gina I so hope you find the right decision.
Hi Gina,
I was looking around for information on pancoast tumours and found a website that looks really useful. It is called Cancer Grace. One of the moderator's has a husband who had a pancoast tumour that was difficult to deal with but who seems to be, dare I say it, "cured" or if we are less optimistic, doing very well many years after his diagnosis. The Cancer Grace website looks great in the fact that the moderators will answer any queries and have on hand a team of oncologists that they can call on for additional help. I have just looked and the moderator that may be able to provide the experience her husband had is called Janine. From her bio, there was some involvement of his spine from the pancoast tumour.
It might be worth just dropping them a note and it seems a genuine site with the unique feature of having input from some very benevolent oncologists.
You do help others so much, it would be great to see you get some help back.
I don't know if I am allowed to mention this other site, but won't be offended if this post needs to be taken down. I hope that your thinking is starting to converge on an approach from your given options (if all the options have been presented to you at this stage).
The results from the PET scan add a lot of confusion as it appeared to me that it was initially reported as no evidence of active disease, yet had such a hot area. Is it still the case that this has a good chance of being no evidence of active disease but some other reaction?
Good luck on your thinking and do what you need to.
Bob
I concur.
Gina it amazes me how you have the time to not only answer your own posts, but comment on most of everybody else’s. Not only do you work, look after your horses, and deal with all the rubbish this disease brings you, all the recent tests and now this awful decision you have to make, you do a wonderful job as a community champ. So I think everyone will join me in thanking you, for just being you. Never forget how awesome you are. Xx
I absolutely agree. Thinking of you and happy Valentine’s Day with whatever you’re doing.
Hi Gina ,
Hope the chat with the surgeon has been arranged and your question list is full. The timescales are very tight to make a decision and possibly get things organised.
I also think you are amazing and caring and thoughtful and a worthy champion for this group .
Ok suck up over!
Hope you get the answers you need and not more questions that you want answers to.
Albondigas x
Hi Gina
Have just read through all the latest posts regarding your predicament. Unfortunately I have no words of wisdom to offer and agree with most posts stating to just go through with your gut feeling. When you have had a certain understanding that your cancer was cured and then in hindsight after being given the latest facts you are now questioning the information you were given or lead to believe was not accurate it must be so difficult for you to trust completely in the guidance being given regarding the option of surgery! I would place your trust in yourself Gina.
Your advice and the help that you provide in this community is appreciated by so many. Your posts are always empathetic and supportive. I hope that you have someone close to whom you can discuss this dilemma at length other than your lung nurse? After very recent events regarding losses of loved ones all I can say is that you must listen to your inner self and sometimes we just have to go with our emotions and feelings and trust them. Sometimes we are given all the facts and information as they are interpreted by the medical experts but nothing is ever guaranteed. I imagine that one throughout the course of the day you probably change your mind several times as to whether or not to have the surgery? And I imagine your gut feeling remains fairly constant?
Hoping you get further clarification on the questions you need answering Gina and that you are not left in this turmoil for much longer.
Love Debbie x
Aww thank you all for such lovely kind comments. I truly am reading all of your replies and appreciate all of the ideas/support and kindness.
I am feeling the love today after that, very apt as it is valentines day.
I have had a chat with the surgeon further today and have been assured the risk of paralysis is more so to my brachial plexus and re triggering/worsening the horners syndrome and not from the spinal scrape I had thought.
That if the middle lobe does look suspicious that it too would be removed.
I tried to ask again about the likelihood of recurrence if I did proceed, it very artfully diverted to a different question and said basically we discussed you and considered what are the chances of you being alive in five years time (at which point they consider cure) if you have the surgery and if you do not. We decided that you have more chance if you do have the surgery. This did make me wonder if this is still aimed at hope to cure rather than hope to buy time.
Surgeons should be politicians eh. I did stick in the what would he do if me but that one he didn't remind me if had asked. Though I understand they couldn't answer that anyway.
I asked about the likelihood of the complications we discussed, some long term some not. He said 1 in ten have one complication of some sort.
Re the site you mentioned that is really helpful thank you Bob. I will go and have a look tomorrow or over the weekend.
About the hotspots, yes the tumour areas are very hot. I did ask what range they go up to but the person was not sure. I tried to google and couldn't get a clear answer but I think 20 is the highest.
Though worth noting my skin disorder also lights up the PET scan in infected areas and they show as a 7! So puts it a little into context that non cancerous areas can also show as hot, though of course the 20 can't really be talked down by that reasoning. The middle lobe of 5 a little, especially as they said it did not show on the CT so could well be damage rather than cancer.
I am still undecided though veering more towards giving it a go.
I did also ask if not having the upper lobe and rib would mean if I did recur potential less pain as less crushing. They of course could not answer this. I was trying to find some firmish positives to something they are being very vague about the benefits or quantifying the ones they are suggesting they could be.
Just the oncologist to chase on the alternative treatment options. It does seem for now I would be put back on watch and wait for now if not.
Again thank you all for all the love and support.
Re the champ thing, the reason I said yes when I was approached is because when I first came, it took a long time to get an answer to my first (this post) when I first arrived at a time I felt very alone. I did not want anyone to ever feel that way when they came here so I am pleased to hear that you feel like I am doing ok at this. You always are a bit nervous that you could get it wrong.
Bob I am sorry to hear you do not post much. Of course anybody can use the forum as they wish. Some like to just read and that is absolutely fine. But if there is ever anything anyone wants to post about please do. Doesn't even have to be cancer related. Some light hearted general chat is also nice too. Speaking of I may pop over and post my lovely sunny Jersey photos.
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