Yesterday Christine drove me to the hospital so i would arrive with Mom and Dad at the arrival time (30 minutes in advance of the appointment). It did take some time to sort through finding Mom's identifier in Dad's wallet and to go from check-in station to check-in station, but not 30 minutes worth. (I need to remember that those lead times can be necessary due to how they "preprocess" patients.)
We were not too late seeing the nurse and being ushered to the consult room (1pm for 12:45pm appointment?). And perhaps not long to see the resident. The resident who met with us gave us lots of general statements about process (ending at 2 pm), then the surgeon came in and asked how Mom had handled the biopsy. When dad replied she was tired for a couple days, the surgeon stated Mom wouldn't be suitable for surgery. He noted the risk surgery has for triggering a pulmonary fibrosis flare (15-20%) and that such a flare could be fatal. He's the first to mention pulmonary fibrosis, and did so with the assumption that we knew all about it. He also showed the CT scan to us: first we'd seen of it.
(Ended around 2:20pm)
I was cranky that it wasn't a team appointment with a pulmologist present, as our primary care provider had kept saying we would have when she put off my questions. My sister is going to push to get some assessments from the pulmologist.
The surgeon was able to arrange for us to see the radiologist in the same waiting room. (With another wait -- better than starting from scratch!) We saw the resident again, and then the radiologist. The challenging decision is whether to biopsy (needle between ribs, through the chest wall into the lung). The biopsy has a risk of lung collapse, but also allows them to add markers (fiduciary or fiducial marker) to target the nodule. It seems worth it, and i suppose we can hope that the biopsy comes back negative.
They ALL seemed somewhat hesitant to be confident it was cancer, while still confident we shouldn't wait around. Everyone seemed mystified why mom would have cancer as there were no significant risk factors or family history. She doesn't seem to have any indications for causes of non-cancerous nodules, either.
Once the biopsy on the lower, larger nodule is complete, there's a wait of a week for another CT scan, then they develop a treatment plan. The second nodule is too far to be included in the same treatment. It's very small and they are even more uncertain as to whether it's a primary or secondary cancer, or something else altogether.
In short, assuming the biopsy indicates cancer, Mom will receive the highly targeted radiation treatments for the larger nodule. The radiation treatment plan for the smaller nodule is still to be determined: wait and see or go ahead with a second series of treatments.