Oncology (General Cancer)/Scared


Good morning.  My father developed a cough in the past two weeks.  He's asymptomatic in every regard except for this.  He finally relented and went to see an MD yesterday, due to my mother's high-pressured insistence.  The primary care physician was going to send him on his way after a cursory exam, a script for antibiotics in hand--just in case it was pneumonia.  My father requested a chest Xray, knowing that would be the safest way to arrive home, where my mother sat, waiting to hit him with twelve billion questions about his visit.  When the doctor looked at the X ray with my father she announced, "The radiologist isn't going to like this."  My father let that comment go without one single query.  Not one.  When facing me last night, and my barrage of questions he said that it was probably pneumonia and looked like strings.  Strings?  It looked like strings???

My father has a call in to that doctor's office today, requesting to be notified with results when the radiologist reads the images.  

In the interim, I am trying to freak out.  He smoked for 25 years, stopping about fifteen years ago.  He is 71.  He's had an utterly unremarkable medical history, except for a tiny cancer in his prostate, that was caught super early about ten years ago.  Prostate was removed, and no other therapy was required. (His Urologist was Mayo trained.)

My question is could the PCP have been able to distinguish between pneumonia or a cancerous lesion?  And, can lung cancer look like 'strings' on an X ray?

Thank you so much for your time.

Although a plain chest x-ray can usually point towards either pneumonia or cancer, most of the time we would eventually do a CT scan.  If it looks like pneumonia and there are other symptoms, it isn't unreasonable to treat with antibiotics for a couple of weeks and check again, depending on circumstances.  Persistent abnormalities in the lungs need to be further investigated, especially in former and current smokers.  As for "strings" early cancerous lesions often do show fine projections,  but localized pneumonia can as well.  By all means urge your father to follow up and get the information he needs, and keep me posted.  If he's reluctant to talk to the doctor maybe he would give a written release so that you could be the one receiving the information.  I've had men who've done that because they didn't want to think about their health.  It's not ideal but it might be good in your case.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.


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.


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.

American Society of Clinical Oncology

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

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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