Such a massive pleural effusion developed over just the last ten days—right after we started immunotherapy with pembrolizumab. We were really hoping for some progress, especially since his PD-L1 expression was over 90%... But it looks like the treatment actually triggered this effusion instead.
Thanks for the reply. But still... I’m going to push back if they won't handle it. 🙂 Assuming, of course, that the tests actually back up what the ER doctor claimed after just listening through a stethoscope.
My dad started immunotherapy last week—pembrolizumab, with a 90% PD-L1 score—for lung cancer that's spread to his liver. He’s also dealing with intense pain in his left shoulder, arm, and elbow... since the adenocarcinoma is in the upper left. The pain comes in waves, often followed by these scary episodes where he just can't catch his breath. His oncologist says the shoulder pain is just the tumor acting up, so he prescribed opioids—but they've been rough on him... making him feel totally numb and killing his appetite. He saw an orthopedist today and got a block in his shoulder, which actually worked for the pain. But then tonight, the breathing issues came back out of nowhere... he was struggling just to get air. I called 911, the paramedics arrived, and the doctor says his entire left lung is filled with fluid—pleural effusion. We're currently waiting at the hospital for more tests. So, my question is: does it make sense to push for a drainage procedure—thoracentesis, I think it's called—just to help him breathe easier? When I brought it up to the oncologist, he just waved me off like it wasn't necessary...
So, I have a 20-year-old son—bless his heart—with a high B12 level at 707 pmol/L. Two years ago, he was sitting at 650 pmol/L. His folate levels are normal, and his thyroid hormones look fine too. He isn't taking any supplements right now—though he was a few years back. The kid feels completely fine, no symptoms at all. But Dr. Google is out here making everything sound terrifying... Has anyone else dealt with elevated B12 before?
Thanks for the detailed breakdown. So it basically boils down to us having to "hope" his cancer has already metastasized just so he can qualify for immunotherapy—which, from what I can see, actually works... Or maybe there’s some kind of clinical trial available, if those even exist here in the States?
Thanks for the info. I'll keep it all in mind—for now, we’re just waiting to see if there’s any metastasis in the liver... hoping that if it hasn't spread, shrinking the tumor with radiation might open the door for surgery or ablation later on.
Hi everyone. My dad was recently diagnosed with lung cancer, and there's a suspicion it might have spread to his liver. The diagnosis came via bronchoscopy—they "found some malignant cells"—along with a confirmed PD-L1 mutation (90% of the cells), plus a CT scan showing a suspicious lung lesion about 4 x 4 cm and a questionable spot on the liver. They haven't pinned down the exact type of carcinoma yet because there weren't enough malignant cells in the sample. He’s 79, had a heart attack back in 2010, and we've actually been watching this specific lung lesion since 2010 (back when it was just 1x1 cm)... his thoracic surgeon kept insisting it was benign because it grew so slowly. And now, here we are... Dad is actually doing okay physically—no symptoms at all, considering the suspected stage. He hasn't lost weight, no cough, no pain. So, here's the thing... We saw the oncologist today, and first things first, he ordered an MRI of the liver to rule out metastasis. He mentioned that if the liver is clear, the plan is radiation, maybe chemo if Dad can handle it at his age. But if the metastasis is confirmed, then they move to immunotherapy, since he has that 90% PD-L1 expression. I'm wondering why we can't just jump straight to immunotherapy regardless of what that liver scan shows? I asked the oncologist, and he said immunotherapy is specifically for metastatic carcinoma. From what I've read, immunotherapy (Keytruda, or pembrolizumab) shows pretty good outcomes and life extension for cancers with high PD-L1 expression. Is this just the doctor's preference, or should we be seeking a second opinion, or perhaps getting a biopsy... or is this just how it works? It feels like we're missing a window for immunotherapy given that PD-L1 level...
I've got an inguinal hernia surgery scheduled for December 15th. My bloodwork and coagulation panels are from November 7th. Do you think those results will still be valid for the surgery, or should I get everything redone right before the big day? I really want to avoid showing up at the hospital only to find out they need more tests—would hate to have to head back home for unfinished business...
We're running into an issue because my little one isn't just being uncooperative—she’s actually pulling away and fighting us when they try to draw blood... it makes the whole thing incredibly stressful for her and for us. It’s tough, and sometimes honestly feels impossible to get the needle in even when we're holding her arm steady...
Maybe give Emla cream or those Emla patches a shot...
My results came back fine—looks like this cold isn't anything major. But now, my dad had his tumor markers checked because of a shadow on his lungs he’s been monitoring for 12 years... it hasn't changed at all. We're just worried about the high CEA marker: A year ago it was at 12, so he went through the whole works—colonoscopy, endoscopy, ultrasound—and everything was totally clear. Nothing found. He's also dealt with ankylosing spondylitis his entire life. Any idea what else could cause the CEA to be that high?
I'm getting bloodwork done for some upcoming surgery, but I've got this stuffy nose—just that classic sinus drainage down the back of my throat... otherwise, I feel fine. Will this congestion mess with my KKS, or should I hold off on the KKS for now? Since this happens to me every single fall and winter... 🙂
Man, 53 years old. These numbers are all below the reference range, so he's starting to freak out a bit... The blood work was done while he was dealing with a cold—runny nose and everything... Any reason to actually worry here?
Thanks a million, man—really appreciate the kindness... A little sarcasm is always welcome, but I think my sense of humor sensors were clearly offline yesterday—after spending five hours camping out in the ER... 🙂
My bad on the units—I'm not at my mom's right now to double-check the exact number, but I know the D-Dimer reference value on the report was 550. They didn't bother testing dimers at the hospital since this result came in earlier this morning. When I said CD, I meant color Doppler... not computer peripherals.
Could I get some thoughts on this lab result? My mom, who's 74, had her D-Dimer checked because of some knee pain and slight swelling. The results showed a D-Dimer level of 1800—everything else in her bloodwork looked perfectly normal, though. Her primary care doctor—he was worried about potential thrombosis—sent her straight to the ER yesterday. While she was there, they ran an EKG, a chest X-ray, and a venous ultrasound on her right leg (where the knee is acting up). All those tests came back clear, and they sent her home after explaining that they’ve ruled out any DVT. They just told her to follow up with her regular doctor... I'm still a little uneasy about that high D-Dimer value—what else could cause it? And is a leg ultrasound enough to be certain we've ruled out deep vein thrombosis?...
So, we did the X-ray out in that Small town, USA today—comparing it to the scan from a year and a half ago shows the lesion is stationary, hasn't moved an inch. After keeping an eye on this for 11 years, the surgeon says the changes are basically nonexistent... Regarding the CEA marker, the surgeon mentioned it doesn't really have much to do with the lungs for diagnostic purposes—could be caused by a whole host of other things like rheumatoid arthritis or spondylitis... but he still wants us to get a GI workup just to rule out the digestive system. For what it's worth, the last colonoscopy five years back was totally clear.
Looking for some thoughts on my dad's latest labs—he's 78.
Tumor markers pulled:
CEA -> 11.5 ng/ml (normal < 5)
NSE -> 12.7 ng/ml (normal < 16.3)
CYFRA 21-1 -> 1.6 ng/ml (normal 3.3)
We're running these markers for a follow-up with his thoracic surgeon... we've been watching a shadow in his lung about 25 mm in diameter. We've actually been tracking this since 2010—so 11 years now—and it’s grown from 11 mm to 25 mm during that time.
My dad doesn't smoke, and he isn't showing any cancer-related symptoms.
He does deal with chronic osteoarthritis (he's due for a hip replacement soon) and ankylosing spondylitis. He's also a heart patient—survived a myocardial infarction back in 2010, which was also when they first spotted the shadow.
Since we have to wait for the surgical appointment, I was wondering if anyone knows if that CEA elevation could be linked to the arthritis or spondylitis... or if that lung lesion is finally starting to change after all these years.
I’m looking for some insight on my father's recent labs—he's 78... Tumor markers pulled: CEA -> 11.5 ng/ml (normal < 5) NSE -> 12.7 ng/ml (normal < 16.3) CYFRA 21-1 -> 1.6 ng/ml (normal 3.3)
We're running these markers for a follow-up with his thoracic surgeon—they've been monitoring a lung shadow about 25 mm in diameter. It's been there since 2010 (11 years now), and over that time, it grew from 11 mm to 25 mm... My dad doesn't smoke, and he isn't showing any cancer-related symptoms. He does deal with long-term osteoarthritis (he's actually due for a hip replacement) and ankylosing spondylitis. He also has heart issues—survived a myocardial infarction back in 2010 (right when they first spotted this shadow). Since we have to wait for the surgeon's appointment, can anyone tell me if this CEA elevation could be linked to his arthritis or spondylitis... or is it possible this lesion has finally started changing after all these years?
Hey everyone—my mom had a colonoscopy under anesthesia yesterday morning, and everything seemed fine at first. But then, last night and through the early hours, she started dealing with this itching all over her back. Could this be a side effect from the Propofol... and is it something we need to worry about—like, should we be heading to the doctor right away?