Please forgive me for posting here but I feel that some of you are friends. Everyone else, feel free to skip this post.
I met DH in 1987 at the Experimental Nuclear Magnetic Resonance Conference. We have been together ever since and married in 1993. I still love him like a teenager.
DH is a brilliant Ph.D. chemist with a kind, easygoing personality. We met at age 35. His only flaw – he smoked. That would normally be a disqualifier for me but he is such a great guy and it isn’t easy to find one at age 35. I always knew this would eventually become a problem. His father died at age 65 of emphysema though the rest of his western pioneer family lived into their 90s. DH developed a smoker’s cough and eventually stopped his trail volunteering because he became out of breath with exertion.
DH hates going to the doctor. When I made an appointment to a pulmonologist for him a few years ago he canceled the appointment and became so enraged that he threw a coffee cup against the wall and broke a hole. (Extremely uncharacteristic.) He ordered me to never make another appointment for him.
Now that we are on Medicare I convinced him to get a free CT scan which is specifically designed for long-time smokers. He got one in January as a 50 year, pack a day smoker. He is now age 72.
The 1/25/2025 CT scan had these findings.
FINDINGS: Nodules:
Right upper lobe: 24 mm x 12 mm. This nodule is spiculated and one of the spicules is attached to the pleura.
Right middle lobe: 4 mm. 6 mm. 3 mm.
Right lower lobe: 5 mm likely fissural node.
Left upper lobe: 8 mm low density. Spiculated.
Left lower lobe: None.
Emphysema: Present.
Pleural effusions: None.
Lymphadenopathy: None.
Pericardial effusions: None.
Coronary calcification: Present.
Other findings: The ascending aorta is 34 mm. Volume loss is noted in right upper lobe and left upper lobe with tenting of the fissures. (This volume loss is caused by emphysema. DH’s father died after surgery meant to reduce the emphysema-damaged lung volume.)
New bilateral upper lobe nodules right larger than left compared to 02/24/2022. LUNG RADS 4B: A PET-CT should be considered. [end quote]
DH’s PCP (a nurse practitioner) said that she couldn’t order a PET scan due to the expense. We had to see a pulmonologist to order the PET scan which needs to be cleared with Medicare because it’s a $7,000 test.
The local pulmonologists were all booked solid and I had to fight to get an appointment which was last week – 3 months after the CT scan. I like the pulmonologist who seems very enthusiastic about getting fast treatment for DH. I have spent the past few days setting up appointments for DH.
DH will finally get pulmonary function testing today. He has pushed back against every suggestion but he will do what he is told because otherwise he is doomed. He will get a PET-CT next week and I have set up an appointment with an interventional pulmonologist who will biopsy the two nodules in the upper lobes using a robotic Ion machine.
DH has a serious problem.
We still need more data but from the look of things so far he has lung cancer in both lungs. It’s not clear whether these are new, separate cancers or metastases.
Because of his emphysema his lung volume is already smaller so he can’t afford to have pieces taken out. The cancers are probably on both sides. He may be inoperable. If the PET scan shows that the small, scattered nodules are malignant he will certainly be inoperable.
ChatGPT says that bilateral lung cancer in a man his age could be fatal in 6 to 9 months if untreated. It’s already been 3 months since his CT scan in January.
We need to get the data from the pulmonary function test, PET-CT scan and biopsies. Early lung cancer is effectively treatable by chemo if certain mutations are present in the cancer. But we don’t know if this is an early cancer. It hasn’t been staged yet.
Fortunately we have Medicare and supplemental. But some chemo drugs aren’t covered since they are not infused in a hospital. They can be very, very expensive. But the issue isn’t cost – right now it’s life and death.
Lung cancer is the leading cause of cancer death in the U.S. Approximately 124,730 AMERICAN LIVES are lost annually to lung cancer.
Wendy
