Enlarged hilar node, biopsy/bronchoscopy...anybody?

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3/13/2018 6:41pm
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SO SCARED!! December CT scan showed a 1.1 cm hilar lymph node which Dr. Amaria was not concerned about then. Yesterday's scan showed it had doubled in size so will have a biopsy next week via bronchoscopy at MDA.So scared, bc it means the Opdivo isn't working if this is positive for recurrence. Oncologist here not crazy about surgery or radiation if its positive and wasn't sure I have enough "disease" for a trial. What questions should I ask the pulmonologist? Oncologist? Has anyone had this procedure? What to expect? Thank you in advance.

Hi Michelle,

Sorry for the lesion and the fear such a thing causes!!!  Nodes can do weird things and not all of them are melanoma.  Still, it is important to know what you are dealing with so a biopsy should get you the answers you need.  I had a bronch years ago for what turned out to be melanoma within my bronchus...so that's a little different from what you are dealing with, but the procedure itself was not too bad.  While I'm sure different place do things slightly differently, here's the basic deal:  Usually under conscious sedation (though you may have complete anesthesia...you just need to ask) the flexible bronchoscope is placed down the patient's bronchus (windpipe) and under fluoroscopy is directed to the place of interest.  There is a channel in the bronchoscope the doc can send through a little doo dad that in your case will push through the bronchus wall and take a pinch of the node to be examined.  My only problem after were sore chest muscles from coughing....however, I have asthma so that complicated things a little.  Most folks report no problems after.

As to what to do next...first you need to see what you are really dealing with.  If it is melanoma, I have lots of data on my blog about the benefit of radiation WITH immunotherapy.  I would certainly talk to my doc about that and find out why he would not find that a good idea.  Additionally, there are many folks who...despite a good result from immunotherapy in every other way....develop or retain this one persistent lesion.  Look up stuff from "Jubes" on this forum.  She developed a lesion in her lung after having done very well on immunotherapy...had it surgically removed....did NOT restart treatment and is doing great.  Then...if those things are not options for you, I know that those of us here and your docs will move mountains to find you a therapy to meet your needs!  

Hang in there!  Keep us posted.   I wish you my best.  Celeste

Thank you, Celeste! She said radiation would be too close to the heart but I intend on asking the pulmonologist tomorrow at our consultation.I knew of your posts about immuno with radiation so that's why I asked her. I want that bad thing out of there yesterday. Thank you again for responding. You're a hero to so many of us.❤