Oncology (General Cancer)/Shadow on right lung.

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QUESTION: I have had a cough for a couple of months. I may have a little tickle once or twice a day. However recently a chest x ray showed a shadow on my right lung. I have also noticed that when I am eating sometimes I have to swallow hard to get the food down and when finished I burp a lot. I had my gall bladder removed earlier this year. My doctor says that I do not have any of the "red flag" signs and has prescribed a course of antibiotics with another x ray in 6 weeks. I thought things like this had to be treated quickly.

ANSWER: A "shadow on the lung" could be a lot of things, and it sounds like you doctor (and the radiologist who must have read the x-ray) feel that it is sufficiently like an infection to treat it that way and see if it goes away.  You won't lose anything by this strategy.  As for the swallowing issue, that could be related to a hiatal hernia or possibly some local esophagitis from reflux.  If that symptom set persists, I would see a GI doctor to consider an endoscopy.  That might be more serious than the lung thing.  It is important that if the follow up x-ray still shows something you should have a CT scan with and without contrast as the next step.  Hope this helps.  

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your answer to my original question. I had an endoscopy prior to having my gall bladder removed earlier this year which showed a cyst on my liver and scar tissue from an ulcer both of which I knew nothing about. Could something else now have developed or would the start of something else have shown up then?

Answer
If you had scar tissue from an ulcer, that could be the problem.  It might act up now and then, or depending on the location it might be causing "sphincter incompetence" -- hiatal hernia symptoms.  If you were my patient and had a recent endoscopy I would probably try a trial of prilosec or zantac (over the counter) to see if the symptoms disappeared.  If they didn't I might want it looked in to more.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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