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What Are The Symptoms Of Lung Cancer?
Question: Dear Sir/Madam
I had low grade mucoepidermoid carcinoma on my right parotid 4 years ago. My facial nerve was intact before the surgery and CT scan showed tumor size 2cm on superficial lobe. But during surgery it was found that three(3) branches of facial nerve were inside the tumor but nerve was not damaged. My surgeon removed the tumor by piecemeal excision with preservation of facial nerve and followed by radiation therapy of 32 fractions( 64 gy). Histopathology report shows low grade mucoepidermoid carcinoma with Intra-Cystic component 60%. When I reviewed slide in another hospital it showed LOW GRADE MUCOEPIDERMOID with PERINEURAL INVASION. He marked neural invasion area by pen. Then I went to previous hospital and I showed him the slide. He said the marked part is NOT PERINEURAL INVASION rather NERVE BUNDLE as I had piece-meal excision of tumor and there was nerve damage due to cleaning of nerve by scalpel. From the above fact, it is known that tumor did not enter the nerve sheath but surround the nerve. By definition it was perineural invasion.
During follow-up I was only locally checked by pressing fingers on affected area for local recurrence. I am fine and no evidence of disease.It has been 4 years since then.
What I want to know is
1) How long I have to follow-up and what is the cure rate in my case?
2) Can low grade mucoepidermoid carcinoma metastasize to lungs? I heard different opinion from different doctors and many say it normally does not metastasize as it happens in facial nerve palsy cases.
3) Seven days ago I had throat irritation when I cough, little blood came. After that I coughed several times INTENTIONALLY but nothing came. After that I have been coughing INTENTIONALLY but no blood is coming. Is it typical sign of LUNG CANCER?
Please reply. I am worrying a lot.
I had low grade mucoepidermoid carcinoma on my right parotid 4 years ago. My facial nerve was intact before the surgery and CT scan showed tumor size 2cm on superficial lobe. But during surgery it was found that three(3) branches of facial nerve were inside the tumor but nerve was not damaged. My surgeon removed the tumor by piecemeal excision with preservation of facial nerve and followed by radiation therapy of 32 fractions( 64 gy). Histopathology report shows low grade mucoepidermoid carcinoma with Intra-Cystic component 60%. When I reviewed slide in another hospital it showed LOW GRADE MUCOEPIDERMOID with PERINEURAL INVASION. He marked neural invasion area by pen. Then I went to previous hospital and I showed him the slide. He said the marked part is NOT PERINEURAL INVASION rather NERVE BUNDLE as I had piece-meal excision of tumor and there was nerve damage due to cleaning of nerve by scalpel. From the above fact, it is known that tumor did not enter the nerve sheath but surround the nerve. By definition it was perineural invasion.
During follow-up I was only locally checked by pressing fingers on affected area for local recurrence. I am fine and no evidence of disease.It has been 4 years since then.
What I want to know is
1) How long I have to follow-up and what is the cure rate in my case?
2) Can low grade mucoepidermoid carcinoma metastasize to lungs? I heard different opinion from different doctors and many say it normally does not metastasize as it happens in facial nerve palsy cases.
3) Seven days ago I had throat irritation when I cough, little blood came. After that I coughed several times INTENTIONALLY but nothing came. After that I have been coughing INTENTIONALLY but no blood is coming. Is it typical sign of LUNG CANCER?
Please reply. I am worrying a lot.
Brief Answer:
Please do not worry. Chances of relapse are very low.
Detailed Answer:
Hello dear. I would like to mention a few comments here. First of all a low grade tumor of parotid gland has a very good prognosis. The chances of relapse is very low. But because this is a rare tumor, worldwide there has not been much data available on it so exact survival will be difficult to predict. As a rule of thumb if a cancer does not recur in 5 years, we take it for granted that it has been cured. But because there is a suspicion of perineural invasion ( only this creates a slightly poor factor), there might be a little chance of relapse in future ( but when , nobody knows) so I will advice you to continue your follow up. As years pass away, chances of relapse decreases.
Usually, ow grade cancer do not metastasize, but for that matter any cancer rarely, can behave in a bizarre manner. Practically, almost nil possibility of going to lungs.
Mild blood in cough can be due to several reasons. Most likely rupture of a minisculr blood vessel during coughing , so you need not to be worried. Continuous hemoptysis with chest pain if it there, may or still may not suggest cancer of lung. So relax and be reassured.
Thanks
Please do not worry. Chances of relapse are very low.
Detailed Answer:
Hello dear. I would like to mention a few comments here. First of all a low grade tumor of parotid gland has a very good prognosis. The chances of relapse is very low. But because this is a rare tumor, worldwide there has not been much data available on it so exact survival will be difficult to predict. As a rule of thumb if a cancer does not recur in 5 years, we take it for granted that it has been cured. But because there is a suspicion of perineural invasion ( only this creates a slightly poor factor), there might be a little chance of relapse in future ( but when , nobody knows) so I will advice you to continue your follow up. As years pass away, chances of relapse decreases.
Usually, ow grade cancer do not metastasize, but for that matter any cancer rarely, can behave in a bizarre manner. Practically, almost nil possibility of going to lungs.
Mild blood in cough can be due to several reasons. Most likely rupture of a minisculr blood vessel during coughing , so you need not to be worried. Continuous hemoptysis with chest pain if it there, may or still may not suggest cancer of lung. So relax and be reassured.
Thanks
Above answer was peer-reviewed by :
Dr. Yogesh D
Sir
1) I have heard perineural invasion causes early recurrence. Is it true?
In my case 3 branches of facial nerve was inside the tumor but nerve was not damaged but only formication (sansation of ant crawling on skin) was observed.
But according to one histopathology report, it says inside the nerve bundle no tumor was found but it encircled it.
2)Can it have same result as perineural spread( facial nerve paralysis)?
Because even though low grade, facial nerve palsy causes worse prognosis and distance metastasis.
3)Should my slide be review once again?
I have intra-cystic component 60% and extensive mucin in lumen.
4) Which factor causes abnormal behavior of tumor?
Please reply. I think you can understand my concern.
1) I have heard perineural invasion causes early recurrence. Is it true?
In my case 3 branches of facial nerve was inside the tumor but nerve was not damaged but only formication (sansation of ant crawling on skin) was observed.
But according to one histopathology report, it says inside the nerve bundle no tumor was found but it encircled it.
2)Can it have same result as perineural spread( facial nerve paralysis)?
Because even though low grade, facial nerve palsy causes worse prognosis and distance metastasis.
3)Should my slide be review once again?
I have intra-cystic component 60% and extensive mucin in lumen.
4) Which factor causes abnormal behavior of tumor?
Please reply. I think you can understand my concern.
Brief Answer:
re assured once again.
Detailed Answer:
Hello dear.
Yes it is true that perineural invasion is a risk factor but you have received radiotherapy and thus risk of local recurrence will be low.
Mere encircling will not be classified as invasion.
You need not to worry. In case of doubt you can get reviewed your slide from an expert onco-pathologist in your area.
Since you do not have nerve palsy. I think you are in safe zone. Moreover 4 years have elapsed and you are fine. Again a good sign.
Abnormal behavior of tumor is not easy to predict as it is a rare tumor and worldwide not many data regarding its long term behavior is available.
Taking all the points I think you are safe.
Hope you are relax.. Take care dear.
re assured once again.
Detailed Answer:
Hello dear.
Yes it is true that perineural invasion is a risk factor but you have received radiotherapy and thus risk of local recurrence will be low.
Mere encircling will not be classified as invasion.
You need not to worry. In case of doubt you can get reviewed your slide from an expert onco-pathologist in your area.
Since you do not have nerve palsy. I think you are in safe zone. Moreover 4 years have elapsed and you are fine. Again a good sign.
Abnormal behavior of tumor is not easy to predict as it is a rare tumor and worldwide not many data regarding its long term behavior is available.
Taking all the points I think you are safe.
Hope you are relax.. Take care dear.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank You very much Sir
I have last sets of questions
1) Can I still get distant metastasis considering perineural invasion? If yes, what is the chance? Have you ever seen these type of cases?
2) I have severe GERD from last 2 years. So I want to know how fast the esophageal cancer grows? Can one gets symptom of esophageal cancer within 1 year of incident of esophageal cancer(SCC) in upper part of esophagus becase sometimes I have burning sensation of upper part of esophagus and cough not continuous but comes and goes.
Thank You Sir.
I have last sets of questions
1) Can I still get distant metastasis considering perineural invasion? If yes, what is the chance? Have you ever seen these type of cases?
2) I have severe GERD from last 2 years. So I want to know how fast the esophageal cancer grows? Can one gets symptom of esophageal cancer within 1 year of incident of esophageal cancer(SCC) in upper part of esophagus becase sometimes I have burning sensation of upper part of esophagus and cough not continuous but comes and goes.
Thank You Sir.
Brief Answer:
You have very low risk
Detailed Answer:
Hello dear. Considering perineural invasion, you will first get a local site recurrence if at all( the risk is very low as i already mentioned). Risk of distant mets will be further very low. Exact chance nobody can tell as there are no well powered studies to study such tumors with predefined condition of perineural invasion.
2. For the esophageal cancer to develop from GERD, first XXXXXXX esophagus has to develop which is considered a premalignant condition. Only a long standing GERD (more than 3 to 5 years) develops XXXXXXX Then XXXXXXX develops cancer at the rate of 1 person in 1000 XXXXXXX per year. So again a slow process. Please egt yourself treated for GERD. Relax once again.
You have very low risk
Detailed Answer:
Hello dear. Considering perineural invasion, you will first get a local site recurrence if at all( the risk is very low as i already mentioned). Risk of distant mets will be further very low. Exact chance nobody can tell as there are no well powered studies to study such tumors with predefined condition of perineural invasion.
2. For the esophageal cancer to develop from GERD, first XXXXXXX esophagus has to develop which is considered a premalignant condition. Only a long standing GERD (more than 3 to 5 years) develops XXXXXXX Then XXXXXXX develops cancer at the rate of 1 person in 1000 XXXXXXX per year. So again a slow process. Please egt yourself treated for GERD. Relax once again.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
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