The chest physician Ms L and the surgeon Mr M were both present, plus two third-year students.
The biopsy showed lymphocytes but that doesn’t indicate the nature of the abnormality. The histopathologist at first thought it was lymphoma but that seems unlikely. Mr M said it was ‘a fairly meaty lung cancer if that’s what it is’, but the best approach would be a further CT-assisted biopsy, now arranged for Friday April 7.
Mr M would also request a PET scan, (positron emission tomography), which is only done at St Thomas’s. Many cancer cells are metabolically active and take up radioactive glucose which is injected into the body an hour before the scan, so that the cancer shows up on the image. A whole body PET scan may also detect whether the cancer is in one area, or has spread to other organs. (The CT scan hadn’t shown any sign of spread).
There were likely to be significant adhesions in the lung from the 1995 bypass, making surgery more difficult, but lessening the risk of pneumothorax or collapsed lung.
The MRI scan is scheduled for April 13. This would give a clear view of the nerves and blood vessels at the top of the neck. It produces a more detailed picture than a CT scan, and allows the images to be taken from almost any angle, as opposed to the CT scan which only displays a horizontal section.
The likely end product is surgical removal of the abnormality within a week of the MRI scan, ie by April 18
Note dated March 16, updated March 25
Chest X-ray March 10 revealed an abnormality at the top of the right lung. Monday March 16 I saw consultant Dr Rebecca Lyall at King's who ordered blood tests an a CT scan. This was done Tuesday March 14 and confirmed that there is a tumour, which Dr Lyall had discussed with Dr Marrinan the chest surgeon with a view to its removal. The good news was that the scan didn't show any signs that the tumour had spread to other parts of the body.
Dr Lyall has ordered a MRI scan for April 11 which will show more detail and in particular, how near the tumour is to nerves.
Lung function tests were done on March 17 at 12.00 and after that, a pre-assessmeny for the CT-assisted biopsy which is scheduled for 09.00 March 24,
The consultant's note read 'Looks like R apical lung cancer. No other evidence of spread. Waiting histo'. Jf this is confirmed by the biopsy they probably won't hang about.