Lung cancer ??
May 11, 2011 | 15,00 EUR | answered by Dr. med. Ralf Berg
I urgently need your professional advice.
For the past few days, I have been feeling a certain pressure in my chest (m/40) along with a slight cough and the feeling that I have to make an extra effort when breathing. Today, I noticed that when I exhale quickly, I make a sound like an asthmatic, but it only happens when I exhale quickly and deeply enough.
Because I am very anxious, I have had the following tests done:
NSE 10 Norm = under 18
Cyfra 21-1 1.89 Norm = under 3.3
CEA 1.6 Norm = under 5
SCC 0.5 Norm = under 2
Pro-GRP 18 Norm = under 38
CRP less than 0.03 Norm = under 0.50
There are x-rays of the lungs from 01/2009, 06/2010, and 11/2010, all of which were clear. However, the lung doctor from 01/2009 mentioned that there might be a cyst at the left hilum. The lung doctor from 06/2010 said that everything looked fine on the new x-ray and there was nothing concerning the hilum. In the x-ray from 11/2010, the radiologist also said everything was fine, but when asked directly about the hilum, he mentioned: Vascular-related mild hilum prominence, no difference from previous images.
One more thing: The Cyfra value of 1.89 is within the normal range, but I have had this value tested several times before, and it has always been between 0.30 and 0.70. Now it's 1.89.
Is this increase in Cyfra 21-1 concerning? Should I be thinking about overlooked lung cancer at the hilum now? Do the sounds when exhaling indicate that something has progressed?
Thank you for your help.
Image No. 1 = X-ray 06/2010
Image No. 2 = X-ray 11/2010
Dear patient,
All the symptoms you have described are more indicative of asthma or a hyperreactive bronchial system rather than a tumor. Even though smokers may not like to hear it, smoking tobacco is the number one risk factor for developing a lung tumor. (I hope you are a non-smoker?)
The tests you should consider having done include:
- Pulmonary function test (possibly with a provocation test)
- If there is also suspicion of restriction, an allergy test may also be necessary.
Regarding tumor markers, (did you really have all of these tests done and pay for them yourself?) it should be noted that none of them are suitable for screening or early detection of a lung tumor, and therefore they are only covered by insurance in special cases. However, they can be useful in monitoring the progress of treatment, such as chemotherapy for a lung tumor. If any of these markers show a significantly positive result (e.g. more than twice the normal value), there is a suspicion of a tumor until proven otherwise. This is not the case for you.
It is important to note that even with normal values, such as in your case, a lung tumor, especially in early stages, cannot be ruled out. Similarly, if a round lesion is observed on an X-ray, it should be considered suspicious of a tumor until proven otherwise or identified as another condition, and further investigation should be pursued. In your case, there are no abnormalities on the X-ray.
The presence of a prominent hilum or a hilum cyst itself does not indicate any disease. However, if the hilum widens due to enlarged lymph nodes from tumor involvement, it may be a sign of a problem. Since this has not been the case for you over nearly 2 years, there is no cause for concern.
Lastly, the sounds you make while exhaling indicate that your bronchial tubes are narrowed. This can be due to a lung infection, an allergic reaction (to pollen/grass), or the development of asthma. I recommend seeing a primary care physician or pulmonologist for a pulmonary function test. Your symptoms can likely be improved with inhalers (asthma sprays) and are likely functional in nature.
I hope this information has been helpful to you.
Best wishes,
R. Berg
