In Hospital for a Suspected Lung Cancer

Salut! It's Yoko.

I have a suspected lung cancer, and I was admitted yesterday for surgery tomorrow.

For anyone in a similar situation, or anyone curious about their health, I've put together what happened so far.

A shadow shows up on a lung CT

At the beginning of March, three friends and I went to a clinic in Ginza called Medical Check Studio to get brain MRIs.

Since I became a freelancer I no longer get an annual health checkup, so I wanted to have my body checked once a year,
and the fact that they hand over all the brain MRI image data to look at sounded fun, so I did it out of curiosity.

One of my friends said she might add the optional lung CT,
so I thought, "Maybe I'll add that too?" and had a lung CT done as well.

The exam took only about 15 minutes and was over in no time.

You could see the images right away, so we showed each other our scans over tea.

We joked about whether my head was misshapen, lol, and went our separate ways that day.

Five days later, I got an email saying the results were in.

I logged in to the Medical Check Studio page and there it was: the words lung cancer.

What?? No way. And what on earth is Part-solid GGO?
I googled it immediately.

It's what's commonly called a "shadow on the lung," also known as a ground-glass nodule.

At Medical Check Studio, where I had the exam, a Part-solid GGO is classified as "lung cancer (cannot be ruled out)" or "lung cancer (strongly suspected)",

and an article from the National Cancer Center (in Japanese) says that ground-glass nodules can progress and become cancerous...

At this point I still thought it was probably a leftover from pneumonia or something, but just in case I went back for a follow-up at Medical Check Studio.

The doctor there said,

"Hmm, there is a shadow about 8 to 9 mm in your left lung, but it may be fine to just keep an eye on it. Shall I write you a referral?"

I figured a specialist hospital would be better, so I took the referral and went straight to the Cancer Institute Hospital of JFCR in Ariake.

It was very crowded and I waited nearly an hour, but I was seen in internal medicine.

The doctor there also recommended watching it.

This was my first lung CT, and nothing had ever been flagged on past chest X-rays, so there was no way to tell when it had appeared.

At the end of June I booked another lung CT and had it taken.

The shadow on my lung doesn't go away...

In July, when I went to hear the CT results, the doctor looked troubled.

"The shadow is still there. If it were inflammation, it would have cleared up within a month. Please see the surgery department."

(Surgery? Does that mean they'll cut me open?)
Can't you test it with a needle or something?

"It's too small to reach with a needle, and there's a risk of pneumothorax, so we can't test it."

I still couldn't believe it, and my anxiety kept growing...

No definitive diagnosis is possible

I booked right away and met the surgeon three days later.

After a quick greeting, looking at the CT, the doctor said one thing.

"It is highly likely to be lung cancer."

I blurted out, "Seriously...?"

The doctor replied, "Seriously." lol

In TV dramas, doctors deliver a cancer diagnosis with a grave expression, right?

Reality is like this, ha.

The doctor drew a picture of a lung and explained what state mine was in.

It was most likely lung adenocarcinoma.

There is a denser area in the middle of the ground-glass nodule, called the invasive part, and that is not good.

The nodule sits in the middle of the lung, so a thoracoscopic biopsy or needle biopsy isn't possible, and it's too small for a blood test.
So there's no way to confirm whether it's cancer.

Surgery would be either a partial resection or removal of a lobe (the upper lobe of the left lung, the top part of the lung).

With a lobectomy, my lung capacity would drop by 20%...
(For reference, below 50% lung capacity is bedridden level. With rehab, 5 to 10% apparently comes back.)

Even at this point I was full of "Really?",
and with no knowledge about cancer, I couldn't decide on surgery right away.

After that, to try to find out whether it was cancer, I had a PET-CT (a CT where cancerous areas light up), but... nothing lit up...

When I met the doctor again and asked what the probability of cancer was,

"99%!" was the answer...

At odds like that, surgery was the only option, I resigned myself, and I booked the operation.
And that brings us to today.

Nobody explains the big picture of cancer treatment

In the end I had three or four appointments before the surgery date was set,
but the surgeons seem busy, and each appointment lasted about 15 minutes. All they talked about was whether to cut or not.

They don't answer unless you ask, and they don't touch on treatments outside their specialty,
so I asked questions with the shaky knowledge I'd gathered myself, about radiation therapy, laser treatment, chemotherapy, molecular targeted drugs and more,
looking for options other than cutting.

But the standard treatment for early-stage cancer is surgery after all.

Many of the things I suggested were still at the clinical trial stage, and given the location and stage of the nodule, I was told there was no alternative treatment that applied.

I'm a bit of a nerd who likes looking things up, but some people might put their complete trust in the doctor.

Still, with no knowledge of cancer treatment and no symptoms, could you suddenly decide on surgery that might cost you 20% of your lung function?
I think that's very hard.

Less burdensome treatments and tests are being developed every day, and in an age when one in two people gets cancer, someone with fast-progressing disease may not even have time to agonize, so I think we need to keep up with the latest knowledge in daily life...

To be continued in the hospital stay edition.
(Maybe the surgery will be over by the time I write it...)