An image of a needle used in a needle biopsy of the lung

My Needle Biopsy Experience

We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.

To be honest, I was somewhat confused about what a needle biopsy entailed. When I was diagnosed about three and a half years ago, I had biopsies done of my hip and a lymph node, both of which were much more easily accessible than the tumor in my lung. But the term “needle biopsy” was floated a number of times as a future possibility. It was not until I signed up for a clinical trial that one was actually put on my schedule.

A less invasive option

There are several forms of lung biopsies performed for various reasons. An open biopsy is a surgical procedure that involves making a chest incision and removing tissue under general anesthesia. A bronchoscopy is performed by feeding a flexible tube through the mouth or nose and into the lungs. Then either a needle or forceps is used to collect tissue through the tube. Typically, patients are given local anesthesia and a special drug that causes selective amnesia of the actual event. The needle biopsy, by comparison, seems less invasive.

Guided by a CT scanner to ensure that no arteries are in the way, a needle biopsy is conducted much as the name implies: a needle is inserted directly into the lung. The CT scanner is used to line up the location of the tumor and the outer skin is marked. A local anesthetic such as lidocaine is used to numb the skin and the muscle tissue around the area of insertion. This may require several small injections prior to the biopsy. Then the needle is inserted directly into the lung where the tumor is located.

Obseriving my own biopsy

In my case, the tumor was located close to the front of my lung, so the needle was guided between my ribs and I was able to watch. This involved leaving what appeared to be a long tube extending from my chest while another device was inserted for collection. Several samples were taken through the very narrow needle before it was removed. After the samples were completed, the needle was quickly and easily removed.

I was required to remain on my back, relaxed on my gurney, and was wheeled back to a hospital room for observation. While the needle biopsy is a very common and fairly straightforward procedure, there are common complications that might arise. Among these is a pneumothorax, or collapsed lung caused by an air pocket in the chest cavity outside of the lung. If everything goes according to plan and no complications develop, the patient is generally able to go home within a few hours and return to more or less normal activity. While the discomfort may take a few days to wear off, over the counter pain medication is most likely enough.

Meanwhile, in the recovery room…

Over the next couple of hours, I had several X-rays taken of my chest cavity. Unfortunately, between the first and second X-ray, I also had a rough bout of coughing which resulted in a small amount of air escaping my lung and forming a pocket in the chest cavity outside the incision point. When it failed to go away on its own after a few hours, it was determined that I needed to have a vent inserted — another relatively painless experience which I will detail in my next article.


You can read more about Jeffrey’s biopsy and pneumothorax experience by clicking here.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The LungCancer.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (13)
  • svet
    5 months ago

    Dear Jeffrey, how did they first detect your lung cancer? I understand you had shortness of breath, but what else? Any other symptoms?

    I am 42 years old. I’ve had shortness of breath..since…well, forever. I had tuberculosis, pneumonia, and bronchitis when I was 10, so I assumed it’s a leftover from that… I went to the doc recently due to some pain in the upper stomach (under the ribs), they did an x-ray which incidentally revealed some nodules in the lungs and lymphs…then I had 2 CT scan, then a PET scan (during which 2 spots lit: one in the left lung and one between the lungs) – yet, the docs were not sure yet… so, yesterday, I had a needle biopsy and am currently expecting the results…

    I don’t feel anything… I feel fine. I don’t feel sick, my shortness of breath is not excessive – just sometimes and as usual (since forever) … and I don’t know what to make of all this… What do you think?

    PS. I’ve never smoked and, like you, I have been pretty healthy… well, minus the tons of pasta I like to eat… 🙂

  • Jeffrey Poehlmann moderator author
    5 months ago

    The full genetic workup I mention is for when they take your biopsied material and run a genetic panel on the tissue. The lab will check for any mutations in the cell DNA that can be acted upon with targeted drugs or possibly with immunotherapy drugs if none of the major targetable mutations are present and other protein markers (PD-L or PD-L1) are expressed in high enough percentages. This is a complicated bit of science, obviously, but your oncologist SHOULD order this along with the standard biopsy.

    If you are confused about what lit up on the PET scan, you should have access to the radiology report which you can go over with your oncologist. A “regular” doctor or general practitioner is not the person most likely to know about all the intricacies of cancer medicine. Hopefully, if you don’t have one already, you will consult with an oncologist soon. And very likely you will like having a second opinion from another — preferably from a research hospital where they may have access to the most recent studies and clinical trials.

    I suggest that it is a “good” thing that you only had two (or one) spot light up because it indicates the cancer has not spread, or at least has not spread far. For example, and not as a comparison of any sort, I had six or more areas light up, because my cancer had spread through a number of bones and organs. In many ways it does not matter if it is one or sixteen spots — cancer sucks and it is nerve-wracking not knowing what you are going to do about it. Although until you have the biopsy, you don’t know that you even have cancer (which is also nerve-wracking). But if it is cancer that you are dealing with and only one or two spots lit up, that means it could POSSIBLY be easier to treat and remove before it spreads. There is a chance for surgery or radiotherapy to kill the areas where those spots are, with a strong possibility of three months or so of chemo and/or other chemical therapy to hunt down any rogue cells still in your body. Of course, this is something to discuss with an oncologist, not with me. And it will all depend on what that biopsy actually shows.

    https://lungcancer.net/treatment/

    I hope
    https://lungcancer.net/diagnosis/antibody-molecular-testing/

    https://lungcancer.net/genetic-abnormalities/

    I hope that these links help.
    All the best,
    Jeffrey

  • Jeffrey Poehlmann moderator author
    5 months ago

    Svet,
    I am glad to hear the news. Thank you for the kind words. All the best to you!
    Jeffrey

  • svet
    5 months ago

    Hello Jeffrey,

    I just wanted to let you know that my biopsy results came back negative for malignant cells. The doc said that – even though my PET scan lit up positive at one or two places, my biopsy results are benign… I hope that they are correct. I will still go to see the oncologist and schedule up a follow up test as my doc wants to keep an eye on that asymmetric mass …

    Thank you so much for all you do! Your articles, perspective, and information are just priceless…

    I don’t pray much, but I will try to send as much love, light, and positive vibes your way as I can.

  • Jeffrey Poehlmann moderator author
    5 months ago

    Always feel free to come back here for more support if that does happen.

    All the best to you.

  • Jeffrey Poehlmann moderator author
    5 months ago

    Always feel free to come back for more support if that happens. Best of luck to you.

  • svet
    5 months ago

    Thank you, Jeffrey. I will surely use all the information that you provided if I am given a cancer diagnosis..

    Thank you. <3

  • Jeffrey Poehlmann moderator author
    5 months ago

    Svet,

    The process of diagnosis can be an odd and winding road to be sure. It took three months from the point where I got my X-ray that showed a mass until I had a biopsy of my left hip bone to determine that it was, in fact, cancer. Then I had another month or so before a second biopsy to get lymph tissue that could be used to identify any genetic characteristics that might be treatable. A long, stressful process, which I was highly relieved by in the end when I at the very least had a real game plan in place.

    But to answer your question, I really had no clear “symptoms” of lung cancer. My shortness of breath was caused by an infection, not my cancer, and exacerbated by the lung collapsing a small amount, which was possibly due to the tumor growing. I was already on antibiotics when I had my X-ray and I was already improving as a result, so I very nearly did not get that X-ray. Of course, I am glad that I did.

    Look, I was only a few years older than you when this happened, and the doctors all thought that it was highly unlikely that cancer was the cause of the mass, so they wanted to take the time to rule everything else out first. But you cannot really know without a biopsy. If you’ve only got two spots lighting up, that sounds really good. Even if it is cancer, chances are that you will be able to get it out of your system before it spreads. And they may not even be cancerous. If they are, make sure that a full genetic workup is done because some of these new therapies are simply amazing and could ensure that you have a long and healthy life.

    Best of luck to you. Please keep us posted.

    Warmly, Jeffrey

  • svet
    5 months ago

    Dear Jeffrey,

    thank you for your reply. Your story, attitude, and encouragement to others are amazing. Truly. I wish you many happy years ahead!

    May I ask you a couple of more questions. What is “full genetic workup”? Who do I ask for this? My doctor? You think that if “only” two spots lit up that this is good news? (My doctor told me, in fact, that only one lit up at the PET scan, but the radiologist who performed the biopsy said that there were two, so I was a little confused…)

    Thank you. Love and light to you.

  • Palmdalegirl
    6 months ago

    I’ve always felt that I handle pain very well, but my experience with two needle biopsies, and two collapsed lungs,”not at the same time”, and having a chest tube put in each time is very different to your experience. I’m glad you did so well with yours

  • Jeffrey Poehlmann moderator author
    6 months ago

    As I understand it, these procedures have quite a lot to do with where in the lung the tumor is — I think I was fairly fortunate with regard to the location of mine. There are also several different procedures that are used, perhaps not all being equal.

    I’m sorry to hear that your dual experiences were difficult. Hopefully you will never have to deal with that again. But know that we are thinking of you and wishing you well.

    Best,
    Jeffrey, LungCancer.net team member

  • Moira Cistola moderator
    6 months ago

    I’I look forward to hearing how they vented you! I’m so glad that worked out for you!

  • Jeffrey Poehlmann moderator author
    6 months ago

    The follow up should be published here soon — it was quite interesting to have a small balloon attached to a tube sticking out of my chest… But I don’t want to give away all the exciting details.

    – Jeffrey, LungCancer.net team member.

  • Poll