It’s pithy summaries like this from journeymen in every field that keep my coming back here every day.
It’s darn hard for laymen to get a sense of perspective on any issue in any field not their own. Google, wiki, et al, provide simultaneously far too much info and far too little context for understanding.
Thank you. Not only to QtM and not only for this post, but also all the other medical pros who’ve contributed here and in so many other medical threads.
30+ years ago, when I was still on active duty, I went to sick call about some painful “female problems.” If you’ve never been in the military, I need to mention that you don’t get to pick which doctor you see for something like this - you get who you get. And the guy I got was a total ass. He hit me right away with the big C when he ordered further tests, telling my my uterus was the size of a grapefruit and a bunch of other stuff that scared the crap out of me.
Fortunately, for the post-test follow-up, I saw a different doctor who didn’t have his head up his ass, and it turns out I had an ovarian cyst. Surgery went fine and I lived happily ever after. But boy, did the first guy mess with my mind. He obviously didn’t pay attention in the part of doctor school about delivering possible bad news.
All this to say, I know where you’re coming from, and YAY!!! I misread your thread title at first and almost didn’t open it because I don’t like sad news. So again, YAY!!!
IF imaging studies can resolve the type of cyst involved into a benign category (i.e. pseudocyst, which is a space surrounding non-epithelialized tissue, typically seen in the setting of pancreatitis or trauma), then specialist input wouldn’t be needed. Borderline situations might require putting a fine needle into the cyst under imaging guidance to get fluid for chemical and cytologic analysis (the latter being something I do fairly routinely), which is not something one’s family doc/internist is typically equipped for.
Echoing Qadgop, the news should still come as a big relief to the OP (as opposed to the finding of a solid mass suspicious for carcinoma).
Yeah, that would be a real fun procedure to do in my office. :eek:
Jackmannii, would you needle the cyst based just on CT results, or would you want an MRI image too? I rely on the radiologist myself; if the radiology report says “consider MRI to better define the lesion”, I get the MRI done before sending the patient to someone like you. But if that’s a waste of resources, perhaps I should rethink . . .
It’s not up to me. I just get the call to the bullpen, I don’t decide on the pitching change.
Typically the patient has already had a CT or MRI (often both) before pathology gets involved. A gastroenterologist does EUS (endoscopic ultrasound) to pinpoint the lesion and stick a needle in it. We do immediate onsite evaluation of specimen adequacy and give a preliminary diagnosis.
Johns Hopkins has a pancreatic cyst clinic where patients can get this workup done in a (presumably) efficient manner. And here’s a worksheet used to differentiate cystic lesions (with which cytologic findings can be correlated).
Thank you for that article. I’m going to go over it several times so I’m prepared for future discussions with the doctors.
As to why it took so long, I mentioned already partly my fault for not pushing harder for action and someone screwed up in making the referral. Why didn’t the first doctor order the MRI? Beats me, he’s a urologist, certainly should have been familiar with this situation. He may have been operating on the assumption that my insurance required a referral to a specialist (it doesn’t, I can see any specialist without a referral), but that doesn’t explain why he didn’t order the MRI himself. Then for whatever stupid reason the surgeon’s office insisted I needed an appointment to see him before he would do anything, possibly a legitimate insurance requirement or just a practice to make money. And then after all that it was over a week before I could get the MRI done which makes no sense to me. But I have to take the blame for trying to put this all out of mind instead of getting on the phone and insisting it all get done immediately. I’ve actually done that for others, done it for myself in others for all sorts of less potentially dire circumstances, yet this time I fell into an avoidance mode.
Quartz, I’m sorry to hear about your father. I’m aware this isn’t the end of the story, it may not even be the end of the beginning of this story, there’s a lot of follow up ahead.
I’m SO glad you had such a good outcome! Congratulations!
I know the feeling you’re having: It sounds like survivor’s guilt. I did have cancer, but as far as cancers go, it was a “good” :rolleyes: one to have and the indications are I’ll be fine for a very long time (knock wood). But there are people with variations on this cancer who aren’t so lucky, who suffer terribly and then DIE, and it’s so hard to not that feel that guilt.
But now, we’ve been in different shoes and have empathy for what others face, and maybe we’ll make a difference because of it.