Chest Surgeon nomenclature?

korusgirl · Regular Joined: 25 Apr 2005 Posts: 26

I had an appt. with what I believed was a chest surgeon, specializing in lungs yesterday. I was referred by my pulmonologist and he made the appointment for me.
When I arrived, I was surprised to see that the only thing listed on the info sign at the elevator on the 4th floor which is where I was told he was located, was a cardiac center and rehab.
I have a 2cm lesion in upper left lobe periphery which lit up on a Pet scan last week. I wonder if I am being paranoid, but during the visit, I asked him how many of these operations he has done and he said several dozen and all turned out very good. I really expected to hear he had done several hundred of them and my question is, are there chest surgeons (thoracic surgeons) who specialize only in lung surgery or is it a dual specialty of cardiac and lung?
My last question is on his recommendation that I have an excisional? biopsy(I think that is what he called it) where they take out the tumor and some tissue around it calling it a wedge biopsy and immediately have it tested and if it comes back cancerous, they will take out the entire lobe.
Naturally, zillions of questions come to mind after you leave the docs office. Even tho I went armed with written notes, I failed to ask why not a needle biopsy. Does anyone know why this wouldnt be done before opening you up?
Now I am nervous thinking I wont be aware of the procedure until I wake up and I'm not toooooo comfortable with that scenario.! Isn't it better for the surgeon to know what type of tumor he is dealing with before opening your lung up? I'm sure, iknowing beforehand, would have an impact on how the surgeons proceeds with the operation when it is scheduled.
I am a newbie here and I have a question concerning things that I have heard or read in the past regarding cancer whereby chemo implants were put in patients or radioactive seeds were implanted for some types of cancers. Is this still done and if so, is it done with lung cancer?
Lastly, has anyone viewing this board been treated or had family members treated at Cancer Treatment Centers?
Joyce in Upstate NY

leo · Site Admin Joined: 23 Sep 2004 Posts: 1574

Joyce

I understand your concerns. There are surgeons that specialize in thoracic surgery. Cardiac surgeons usually do not take care of thoracic diseases, unless they have some other form of training.

What you're having (a wedge biopsy) is a common procedure that will not only establish the diagnosis during the surgery and guide on whether more surgery is needed right away or close you up. Depending on the location of the nodule, characteristics, etc, it may be (a) too difficult to reach (too deep, too close to vital structures, blood vessels etc), (b) the likelihood of malignancy is high enough, i.e. the doctors think that based on imaging and your history it is so likely that it is cancerous that they'll just not believe if a needle biopsy is negative. So the best thing is to remove the entire nodule and examine it. The wedge biopsy is an excellent technique for this.
Usually what they do is discuss possible scenarios beforehand:
- if the nodule is benign --> end of surgery
- if the nodule is malignant ---> something else, more extensive exploration etc.

Yes, it is anxiety provoking, but they can not wake you up during this as you will be intubated and one of the lungs will be collapsed due to the chest cavity being opened.

best regards,
Leo
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Leonardo F - Webmaster Cancer Forums
Disclaimer: this information is for informational purposes only. It is not medical advice.

korusgirl · Regular Joined: 25 Apr 2005 Posts: 26

Thank you Leo for that information. It makes much more sense to me now as to the reasons for doing a wedge biopsy.
I have another question, if you read this, that I am just thinking of this afternoon: I read on the forums that many persons have chemo and radiation before surgery. Why wasn't that mentioned to me. Could you give me some ideas? I just read on the forum about someone who had that first before he had surgery and his node was the same size as mine.
Thank you so much Leo
Joyce Upstate NY

Cee · New User Joined: 10 Jul 2005 Posts: 2

Hi, I'm new to this forum. I wished I came across this site before you went into surgery. In 2003 I was diagnosed with lung cancer. I had no symptoms at all. I had a routine physical and the doctor just sugested a x-ray, and that started it all. I could have answered a lot of your questions. I had a lobe removed. They thought it was stage I non small cell, but turned out to be stage IV. I had chemo and when that was finished I went back into the hospital to have a stage I non small cell removed from my other lung. You may still be in the hospital right now. Please put a message up when you get home and feel up to it.

To everyone out there fighting this.....your family and friends are wonderful, but it's God who's there when you are the most frightened and need courage and strength. All the times when you just can't seem to explain how you feel to someone, He's there to listen and comfort.

I would love to help anyone out there that may be going through what I've already been through, and I could sure use some help to from anyone thats been through the same thing. The doctors feel my lungs are ok now, but I have pretty bad pain in the rib area for two years now and it doesn't seem to be getting any better. I also have a questionable lymph node in my sternum area which I will be getting radiation soon for. If anyone has had radiation in that area, could you please tell me about the side effects. Also I am going to a acupuncturist next week and will let everyone know if thats helpful with pain.

One more word of advise. The spots on my lungs were followed for 2 years before appearing positive on a pet scan. If I could turn back time, I would have had a lung biopsy right away instead of following these spots with routine ct scans and pet scans. By the time it showed positive on the pet scan, unbeknowned to me it was already stage IV. Also if you don't feel real confident with your oncologist and surgeon, find a new one. There are wonderful doctors out there. Don't just settle, because your scared.

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