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Medical Forum / Diseases and Disorders / Cancer / December 2004Throat Cancer
My brother was sent to an ENT doctor a few weeks back after losing his voice. The ENT doctor put a camera down his throat and found a lump that he said he was certain was cancer. My brother had a biopsy two weeks ago and was told last week that the lump was benign. However today he had an appointment with the ENT doctor who said he wasn't happy with the result of the biopsy and he has arranged for another biopsy along with a body scan. Is this normal? I find it difficult to understand why the ENT doctor has arranged for another biopsy, can biopsies be wrong? Thanks in advance Tony > My brother was sent to an ENT doctor a few weeks back after losing his > voice. The ENT doctor put a camera down his throat and found a lump that [quoted text clipped - 15 lines] > Thanks in advance > Tony Tony, Sorry to hear about your brother. Another biopsy isn't a bad idea. And a body scan is good. I'm no doctor, just have first hand experience. So yes I would say it very normal. And yes biopsies can be wrong. Jill > My brother was sent to an ENT doctor a few weeks back after losing his > voice. The ENT doctor put a camera down his throat and found a lump that he [quoted text clipped - 11 lines] > I find it difficult to understand why the ENT doctor has arranged for > another biopsy, can biopsies be wrong? Needle biopsies can miss the mark. They may do more or do some excisions, under anesthesia, to get more tissue. (is my non-expert understanding) Better safe than sorry. If it is throat cancer, watch for posts by Willy - he's currently got throat cancer. You can find his current/previous posts by using the archive searcher http://groups-beta.google.com/advanced_search?q=& unless you can find them currently on the newsgroup. Keep in touch and let us know. J >My brother was sent to an ENT doctor a few weeks back after losing his >voice. The ENT doctor put a camera down his throat and found a lump that he [quoted text clipped - 11 lines] >I find it difficult to understand why the ENT doctor has arranged for >another biopsy, can biopsies be wrong? No, not exactly, but it wouldn't be the first time that the biospy needle missed the tumor altogether, or that someone thinks is the most interesting part of the tumor. Pathologists have also been known to make mistakes, and so do ENT's. Some tumors that look very ugly and very aggressive turn out to be benign in spite of appearance to the contrary. I knew one guy who used to take biopsy samples in pairs, and send each to a different pathology lab for examination... >Thanks in advance >Tony > >My brother was sent to an ENT doctor a few weeks back after losing his > >voice.? The ENT doctor put a camera down his throat and found a lump that he [quoted text clipped - 19 lines] > send each to a different pathology lab for examination... > ? Forgive the? 'butt in'? here, but i've been the recipient of two incorrect, positive biopsies on benign targets. Just couldn't believe it, so paid for the seconds myself. Insurance outfit was willing to accept the first? opinions. Sadly, tissue studies can be wrong in either direction.?? My husband got a clean bill just six months before he died. Two may definitely be a good idea. Dorothy ? > However today he had an appointment with the ENT doctor who said he wasn't > happy with the result of the biopsy and he has arranged for another biopsy > along with a body scan. I'm not sure at all why the body scan, unless he had worrisome signs or symptoms. J >> However today he had an appointment with the ENT doctor who said he >> wasn't [quoted text clipped - 5 lines] > symptoms. > J J, They did a whole body scan on me. And then I just went back for a PET & CAT scan. Hugs, Jill > >> However today he had an appointment with the ENT doctor who said he > >> wasn't [quoted text clipped - 7 lines] > J, > They did a whole body scan on me. You're right, Jill. Thanks for pointing that out. Hugs J > They did a whole body scan on me. And then I just went > back for a PET & CAT scan. Hugs Jill, I hope you will update us in your thread, when you get the results. J - watching out for Jill. >> However today he had an appointment with the ENT doctor who said he >> wasn't [quoted text clipped - 5 lines] > symptoms. > J J, They may also want the scan to have something to compare it to at a later date. More Hugs, Jill As someone mentioned, pathologists can also be wrong. You might see about getting a second opinion on the original slides. What exactly was the ENT unhappy about? Did you get a copy of the pathology report? bj > My brother was sent to an ENT doctor a few weeks back after losing his > voice. The ENT doctor put a camera down his throat and found a lump that [quoted text clipped - 15 lines] > Thanks in advance > Tony > As someone mentioned, pathologists can also be wrong. You might see about > getting a second opinion on the original slides. What exactly was the ENT > unhappy about? Did you get a copy of the pathology report? > bj It's pretty uncommon for pathologists to miss cancer on a biopsy. It's much more likely that the biopsy was "unrepresentative" >> As someone mentioned, pathologists can also be wrong. You might see about >> getting a second opinion on the original slides. What exactly was the ENT [quoted text clipped - 3 lines] > It's pretty uncommon for pathologists to miss cancer on a biopsy. It's > much more likely that the biopsy was "unrepresentative" It may be uncommon, but there are a number of thyroid cancer patients I've "met" (online, support group) who have had misses that were found positive when sent to a more expert (at reading thyroid slides & recognizing thyroid cancer) pathologist. Some have had two or even three opinions before getting a definite diagnosis. One doctor (who specializes in thyca) has even found that a patient he treated actually had a positive result years earlier -- but it wasn't recognized, so the patient wasn't treated until things got worse & more obvious -- re-reading the original slides showed the cancer was there at the original FNA. My own FNA report was "suspicious". I sometimes wonder if a more expert pathologist would have read it as "cancer" (which it was). bj >>> As someone mentioned, pathologists can also be wrong. You might see >>> about [quoted text clipped - 12 lines] > cancer) pathologist. Some have had two or even three opinions before > getting a definite diagnosis. That's a special situation. The call between well differentiated thyroid cancer and an adenoma is often a very difficult one, even for the expert. It's an exception, though. > One doctor (who specializes in thyca) has even found that a patient he > treated actually had a positive result years earlier -- but it wasn't [quoted text clipped - 5 lines] > pathologist would have read it as "cancer" (which it was). > bj FNA is not the same as a formal biopsy. It is often difficult to be dogmatic about cancer on an FNA. A "real" biopsy is a different issue Well since I only had the FNA, that leaves me wondering why my doctor was satisfied with just doing that only? I have a large multinodular goiter and antibodies - Hashimoto type. Had the radioactive iodine scan that showed no hot or cold spots but poor uptake. And another question: How big a chunk or procedure for a regular biopsy? eveline > >>> As someone mentioned, pathologists can also be wrong. You might see > >>> about [quoted text clipped - 29 lines] > FNA is not the same as a formal biopsy. It is often difficult to be dogmatic > about cancer on an FNA. A "real" biopsy is a different issue > Well since I only had the FNA, that leaves me wondering why my doctor was > satisfied with just doing that only? [quoted text clipped - 4 lines] > > eveline FNA is only part of the picture. Nodule in the thyroid needs FNA plus ultrasound plus I131 scan None of the tests is conclusive. If any of these are suspicious though, at least a partial thyroidectomy is in order. That gives a very good sample for pathology. If cancer is confirmed, a completion thyroidectomy is indicated. It's not really possible to do a biopsy of the thyroid without doing a formal thyroid surgery. Cancers in the mouth or throat, however, can certainly be biopsied readily Thanks! Did have the ultrasound also. Evidently no test suspicious enough so far to indicate a reason for formal throat surgery. eveline > > Well since I only had the FNA, that leaves me wondering why my doctor was > > satisfied with just doing that only? [quoted text clipped - 14 lines] > formal thyroid surgery. Cancers in the mouth or throat, however, can > certainly be biopsied readily Thanks for the replies. You've made things clearer for me. Regards Tony |
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