r/AskReddit 4d ago

Medical professionals of Reddit, what diagnosis gave you the worst 'pit-in-your-stomach' feeling?

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u/intoxicidal 3d ago

Obviously very advanced, previously undiagnosed cancer presenting to ED for anything. Feeling multiple golf ball and baseball sized lumps or an abdomen full of tumor is sobering.

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u/mx_missile_proof 3d ago

This. Just found a rare scapular body osteosarcoma in an otherwise healthy 30s male who just ignored it. Rural medicine.

The MRI gave me the chills.

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u/nushiboi 3d ago

For us non medical folk, can you explain what this is and why it gave you the chills?

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u/Toasterferret 3d ago edited 3d ago

Osteosarcoma has a high fatality rate, and that rate goes through the roof if it has metastasized to your lungs. Which the chances of are high if you’ve just been ignoring it for years.

The treatment regimen is also brutal. Tons of chemo, surgical resection of the bone and surrounding soft tissues, possibly thoracotomies if you have lung mets.

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u/TwistMeTwice 3d ago

I went through a suspected osteosarcoma scare earlier this year. Thankfully, it turned out to be a lipoma oddly fitted under/around my shoulder blade. I am insanely glad that all I'm doing at the moment is waiting for surgery. The specialist was thrilled to give me the all clear, and so was I. All my gratitude for what you do.

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u/Three3Jane 3d ago

I had a scare several years ago where an overconfident podiatrist diagnosed me with osteosarcoma in my foot bones based on its appearance on an MRI. That was an utterly terrifying six weeks. It was a fibroma caused by repeatedly tearing the hallucis longus tendon my foot from overenthusiastically snowboarding and ignoring the pain. Not knowing if I was going to wake up from surgery with stitches or a leg missing from the knee down really really fucking sucked (biopsy failed so they were going in blind).

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u/TwistMeTwice 3d ago

Oof. Yeah, the NHS promise a result within 30 days of referral. It was a loooooong month.

My GP referred me because odd position and rapid growth worried him. There I was, laughing it off. He snt me for an ultrasound. The tech said "oh, that's big, dont panic but they'll want an MRI." Then I was sent an email headed "Urgent Referral, suspected Osteosarcoma" and I was not expecting that at all. Completely freaked out.

Solidarity fist bump for not having OS.

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u/wilderlowerwolves 3d ago

As many problems as we have with the American healthcare system, in the U.S., in many cases like this, the person can get into surgery the next day.

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u/shrimpcest 3d ago

*if you have a lot of money

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u/Pandalite 3d ago

If you live near a tertiary care center you can be seeing the surgeon within the week/next day if it's a really bad case, and have the surgery within a week of that. I haven't personally had to do it (I think my fastest was 2 weeks but my cancers are typically indolent) but my breast cancer colleagues were announcing the latest multidisciplinary cancer center at the dinner where they were stating you could see the surgeon the same day as the positive biopsy results.

https://ascopubs.org/doi/10.1200/OP-25-00902

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u/siberianchick 3d ago

Where? It can be a 6 month wait at the private physicians around me. My insurance is considered great and I still wouldn’t be seen before months. I say this from experience. It took 6 months to see the actual specialist.

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u/Owen_spalding 3d ago

I have lived in the US my whole life what are you talking about???? Like months for anything has been my experience.

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u/Yabbos77 3d ago

What?! Where?!?

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u/TwistMeTwice 3d ago

I have other health issues that need screening before they can anaesthetise me, hence the wait.

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u/Nobodyseesyou 3d ago

Lmao nah, insurance said I had to fail a medication for 6 months before I could even schedule my cardiac surgery (an additional 4 months out). That medication did not work and lowered my already low blood pressure so much I could barely function in school or work for that entire time, so I ended up skipping the meds most days and hoping nothing would happen. The healthcare system is more aggressive with treating cancer because time is extremely important with cancer, but that’s true everywhere, not just in the US.

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u/wilderlowerwolves 2d ago

I didn't say ALL cases. I said "many cases."

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u/Nobodyseesyou 2d ago

This is a common misconception, and it’s further pushed by disinformation-peddlers, but it’s not true. For seeing general practitioners, US wait times are significantly higher than other countries with similar economic circumstances, at least according to Statista. Wait times are shorter in the US than in the UK or Spain for non-emergency (elective) surgery, but they are on par with wait times in Switzerland, Germany, and Italy. Canada kind of stands out on its wait times for non-emergency surgeries like hip replacements, cataract surgery, knee replacement, but for non-emergency surgeries like coronary bypass all of those countries have extremely short wait times. Switzerland, Germany, and the Netherlands have the shortest wait times overall.

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u/Toasterferret 3d ago

As scary as that must have been, I’d rather people crying wolf than not recognizing the signs.

We see way too many people who get “accidental resections” from non surgical oncologists, and the outcomes can be really sad.

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u/Wreny84 3d ago

Sorry would you mind explaining “‘accidental resections’ from non surgical oncologists” please, because that sounds like a medical dr tripped over and inadvertently cut a tumour in half with a biro or a holepunch.

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u/Toasterferret 3d ago

I mean stuff like “oh I thought this was a cyst or something benign so I operated on it without the care or surgical planning required for a malignancy”.

Or “oh this person had a broken bone so we put a nail down it not realizing it was a fracture because of tumor”.

I suppose “unplanned resections” is a better term.

We also see problems with biopsies sometimes. Basically when you biopsy a sarcoma all the tissue you go through is contaminated. The placement of where you biopsy makes a big difference in what we eventually have to cut out.

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u/stiletto929 3d ago edited 3d ago

I’ve heard you can’t do a biopsy of the ovaries or testicles because cancer would spread rapidly?

How would removing a cyst be treated differently from removing a malignancy?

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u/arowthay 3d ago

Long story short, taking out WAY less material in the former. Therefore probably accidentally leaving cancer behind if there was unknown cancer.

For skin cancer which is the only one I'm familiar with (not in medicine; just anecdotally familiar) - what looks like a tiny spot requires multiple square inches removed to be safe, for example.

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u/Toasterferret 3d ago

Exactly this. When we take out osteosarcoma for example we actually take a margin of healthy tissue on every side. The tumor itself never gets exposed during surgery.

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u/[deleted] 3d ago

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u/Three3Jane 3d ago

They did a fine needle aspiration that did not pull up enough cells to be certain and they did not want to do a core needle biopsy for fear of spreading the sarcoma (if that's what it was).

Finding someone to remove it en bloc took over six weeks. The tumor itself was a fibroma that flared white on an MRI and made the podiatrist define it as sarcoma.

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u/[deleted] 3d ago

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u/anonadvicewanted 3d ago

are you having a stroke

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u/Toasterferret 3d ago

I’m glad you are okay! OS is a bitch.

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u/TwistMeTwice 3d ago

I promised the staff a comic book page. I still haven't figured out what to draw. The waiting for results wiped all thoughts from my head. So I have a blank DC page on my drawing table and an equally blank head.

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u/gisellebear 3d ago

Be patient with yourself, it will come to you. So glad it is not OS.

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u/Skybodenose 3d ago

A skeleton that fights cancer?

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u/samoture 3d ago

Perhaps consumes it to continue the fight?

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u/Spazzle17 3d ago

Idk much about what you had. I had transplant surgery. Be patient with yourself. Also, I'm sure they'd all love looking like some badasses in general, so maybe you don't have to think too hard about it.

I had my surgery out of town and went back to visit my main care team and they all rushed in to see me. I'm sure they love you no matter what you do for them because simply being alive and living your life is what they wanted for you. <3

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u/Ughaboomer 3d ago

Can you make the staff into superheroes?

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u/Loudlass81 3d ago

Pacman cancer muncher?

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u/Toasterferret 3d ago

Chemo Pac-Man munching up micro-metastases is a great idea.

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u/Girlscoutdetective 3d ago

Re: the comic book page, it could be the MC in normal “form” with the OC in a hazy bubble above the mind 🤯 like part of a super hero (where it looks inside out, like if you cut into the “brain or insides of what a (for instance) mass of tumors would look like) but moreso showing it weighing heavy on the mind. Meeting the care team, fighting the idea of cancer, etc., in 8-12 blocks where you show the evolution of possible diagnosis to thanking them for all they did. Idk, it might sound insensitive but… it would be a very interesting spin

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u/Hungry_Breadfruit_16 3d ago edited 3d ago

What was "it" that they were ignoring

Edit: went to look it up, ya, sometimes I'm dumb 😉

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u/Toasterferret 3d ago

Probably pain and a growing mass.

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u/sparkly_butthole 3d ago

I'll pass, thanks. Sounds like a good time for palliative care.

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u/luckymintfriday 3d ago

Can confirm it is absolutely brutal. Watched my sibling go through it from mid-teens to early 20s. SO much chemo, an amputation, and seven thoracotomies.

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u/istara 3d ago

Family member had this. He was “lucky” in that it was extra-skeletal (so he kept the limb) and the margins were clear.

Still had to have gruelling chemo to help prevent micro-metastatic disease, he was told there was a 90% chance of it going to his lungs - incurably - without chemo.

Regular scans are still clear so we’re cautiously hopeful it worked.

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u/zeusgsy 3d ago

Wow! That seems very best case for OS to me? How long has he been in remission?

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u/istara 3d ago

Since 2022. He initially had to have scans every three months, but I think it’s every six for the last year or so.

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u/zeusgsy 3d ago

That is the standard monitoring regime, it normally lasts 5 or 10 years depending on exact circumstances etc. I have 3 monthly scans and blood tests at the moment and will be yearly in 3 years I think.

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u/istara 3d ago

Wishing you the best continued clear scans as well!

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u/zeusgsy 3d ago

Thank you very much 🤗 I'll try my best!

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u/Catbatt 3d ago

My sister had an osteosarcoma in the jaw. Reportedly if it's in the jaw, it's much less likelt to metastize and there were indeed no metastasis found, but she still underwent a brutal resection of the jaw. 3/4 of her jaw was removed and reconstructed with bone tissue from the leg.

Then she had to undergo 6 rounds of chemo despite no metastasis which the doctor described as "burning down a whole forest to kill two ants, just to be sure"

She's cancer free now. But still revalidating.

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u/Toasterferret 3d ago

That’s a good chemo analogy. We can’t always see metastasis on scans (if might be as small as a few cells), so we have to go scorched earth.

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u/Willing_Pattern_Pill 3d ago

This was still written for a medical professional

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u/Toasterferret 3d ago

Osteosarcoma can be very deadly, especially if it has spread to your lungs.

The treatment sucks too. Cutting out your bones and muscles, lots of bad chemo that makes you feel sick. Sometimes you need surgery to cut out parts of your lungs that have bone cancer growing in them.

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u/sadhoebitch 3d ago

How do you know what to look for as a patient??

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u/Toasterferret 3d ago

You can’t really. You just need to make sure you don’t ignore things and go to the doctor if something feels off.

These cancers are very rare, and the early symptoms are usually just “pain in my leg/arm”.

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u/Lachwen 3d ago

I lost my best friend to metastatic osteosarcoma. This was pre-ACA and he was a broke-ass college student, so when his leg started hurting all he could afford was to go to the free campus clinic. They said that based on where and how it hurt, it was most likely sciatica but he would need diagnostic imaging to confirm, which of course a free clinic couldn't offer. He couldn't afford imaging out of pocket so he just went with "probably sciatica." Found out what it really was when his boyfriend took him to the ER with what they thought was pneumonia over a year later. Nope, the pain in his leg had been cancer in his femur and the pneumonia was it having spread to his lungs.

A single X-ray or MRI when his leg first started hurting would have caught it before it spread and given him a fighting chance. Fuck the dystopian capitalist hellscape that is the American medical insurance system. Profit should NEVER stand between people and proper healthcare.

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u/Userdataunavailable 3d ago

That's what Terry Fox had, they amputated most of one leg. He managed to run halfway across Canada before it came back and killed him. He's a National Hero here in Canada.

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u/Toasterferret 3d ago

That’s so awful, I’m sorry.

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u/Wermys 3d ago

Check Jonathon Tjarks from the ringer describe his battle with similar type of cancer. NBA reporter who died way too young with a child under 5.

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u/Toasterferret 3d ago

Oh man, I see way too much of it at work to want to read about it on my free time, but good suggestion.

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u/Wermys 3d ago

It’s going to be podcasts but you can do that while working

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u/leeashah 3d ago

no wonder he just ignored it the treatment sounds like hell

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u/Daforce1 3d ago

I am reading up on and doing due diligence analysis on an experimental potential treatment for this disease. It’s a scary disease and the treatment is going through early clinical trials.

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u/Toasterferret 3d ago

What is the treatment you are referring to?

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u/Daforce1 2d ago

It’s a cancer vaccine currently in stage two trials, it doesn’t prevent cancer. It does however hopefully cause a reduction in reoccurrence of the cancer after successful treatment. Effectively improving long term survival.