Lung cancer panic - help!

[pirossapkaskukta]

Hi! I'm a chronic HA sufferer, I had cancer fears constantly in the last 2 years. This round is about lung cancer, and I'm terribly frightened. I'm a 39 yo woman, mother of two, ex-smoker (10 years, quit 10 years ago, since then only occassionally). My symptoms started in February 2020, with chest and upper back pains (dull, constant & sometimes sharp, breath-related + it gets worse when I'm laughing or yelling). Only in right side. At the beginning I had mild cough, but it went away. Sometimes I have shortness of breath, but I think is because of anxiety since I can do my workout program perfectly, without breathing symptoms. I don't have other symptoms, no reflux, no GERD, no asthma - only this constant dull pain here or there in my chest and back. When this whole thing started, I was convinced (on the very first day) that I have lung cancer - but COVID came, and I couldn't go to the doctors. In May I went for a chest X-ray, which was normal (+ I have a clear CT scan from July 2019, but I think it is irrelevant). My symptoms didn't go away, so in July I called a pulmonologist (telemedicine LOL), who told me that in my age, with my symptoms, with my not very heavy history of smoking the chances are practically 0 for lung cancer. I asked him about repeating x-ray or CT scan, but he told me that he wouldn't recommend it since there's no reason for them. He said that my symptoms are due to musculoskeletal or psychological causes, so relax. And guess what... I did relax. I had 3 whole weeks without symptoms - after 5 months of suffering and panicing it was a huge relief! But all came back after 3 weeks, and it is much worse now. Pain in chest, back (breathing/yelling/laughing/moving-related, nothing at night), super-high anxiety levels, I can't bear it anymore. What do you think? Please help me with your opinion, because I'm going mad.

[Fishmanpa]

Cancer is an uncontrolled growth of abnormal cells. It doesn't come and go nor does it stop once it starts.

Positive thoughts

[WiseMonkey]

You had the symptoms when you had the X-ray and CT scan and they were negative, so there's no point in repeating then. I think your pulmonologist is correct, your symptoms are musculoskeletal. This is rational thinking.

Also like FMP said cancer symptoms don't come and go or stop and start again

[pirossapkaskukta]

Thank you guys. I know I shouldn't be worried but I am. It doesn't feel musculoskeletal but lungs :-( I am trying to keep positive but it's not easy...

[NoraB]

In May I went for a chest X-ray, which was normal (+ I have a clear CT scan from July 2019, but I think it is irrelevant).

Why would a normal chest X-ray and CT scan be irrelevant?

[pirossapkaskukta]

Why would a normal chest X-ray and CT scan be irrelevant?

The CT scan is irrelevant because it was taken 8 months before my symptoms started. The x-ray is not very reliable: 20-25% of lung cancers doesn't show up on x-ray :-( So a negative x-ray is not an "all clear" sign, especially with persistent symptoms.

[panic_down_under]

The CT scan is irrelevant because it was taken 8 months before my symptoms started.

Yes, it is relevant. Depending on how far apart the CT scan slicers were scans can detect nodules at 1-2mm in diametre. Subject to their subtype, lung cancers (l/c) at worst double at between about 70-200 days for men, taking about twice as long in women (about 16% of these cancers double in under 180 days, 36% at between 180-365 days and 47% take longer than a year).

So in 8 months even the fastest growing nodule of say 0.5mm, i.e. half the minimum detectable size, on the day of the scan would have grown to only about 2mm in females, or 7-8mm in males, nowhere near big enough to cause any symptoms, and this assumes a constant maximum growth rate which is rarely the case. Plus, the symptoms you describe are not typical of l/c.

X-rays can be unreliable with small nodules, but a routine x-ray picked up the 10-12mm nodule in my left lung without difficulty although it was suggestive of a pleural plaque, i.e. mesothelioma, not a l/c nodule.

so in July I called a pulmonologist (telemedicine LOL), who told me that in my age, with my symptoms, with my not very heavy history of smoking the chances are practically 0 for lung cancer. I asked him about repeating x-ray or CT scan, but he told me that he wouldn't recommend it since there's no reason for them.

Very wise as x-rays, and particularly CT scans have risks. Because I am at high risk of relapse I have a low dose x-ray every 2-3 years and a CT scan every decade (after which no x-rays for 5 years) and even that is probably more than is wise, imo.

What do you think? Please help me with your opinion, because I'm going mad.

Have you been assessed for an anxiety disorder? If not, I suggest you talk to your GP about this.

[pirossapkaskukta]

I am very grateful for your words, especially for data, it is reassuring. Yes, I have all kind of anxiety disorders: GAD, HA, PTSD, panic attacks. That's why I am here: trying to find some relief, but it's not easy: anxiety goes with thousands of "what-if-s". What if the CT scan / x-ray wasn't accurate; what if my cancer is growing faster than average; what if I spend my time in peace because of the pulmonologist's opinion, and my LC will metastase... and so on. I know it sounds silly, my whole family thinks the same, but I am terrified.

[panic_down_under]

I know it sounds silly, my whole family thinks the same, but I am terrified.

Is your health anxiety being treated? If not, please talk to your GP asap. Anxiety/stress can be as serious a health issue as the one you think you have.

[NoraB]

The CT scan is irrelevant because it was taken 8 months before my symptoms started. The x-ray is not very reliable: 20-25% of lung cancers doesn't show up on x-ray :-( So a negative x-ray is not an "all clear" sign, especially with persistent symptoms.

Why did you have a CT scan on your chest when you had no symptoms?

My FIL has lung cancer and the imaging lit up his tumours like a Christmas tree!

Our brains are wired to the negative bias so when you are scaring yourself shitless on the internet - you are focusing on worst (and least likely) case scenarios. 20 - 25% might not show up on an X ray but they will show up on an MRI and yours was clear. My cervical spine MRI - along with the disc disintegration and mild nerve impingement - showed a teensie 'lesion' which, granted, flared up my HA for a day or so, but I got a letter through from a consultant saying it's nowt. It's most likely something that is commonly found on routine scans of, er, older people. It's literally too small to tell, so I'm getting a re-scan in a few months. No problemo. I'm now a pro at being scanned. My point is that it's miniscule, and the scan picked it up, so you need to trust that the scan would have found lung cancer if there is anything to find.