New 7mm lung nodule
I am a little over 3 years into remission. I’ve had lung nodules since my first CT following treatment, all 4mm or less, none have changed. A CT a week ago showed a new 7mm nodule. I had also lost 12 pounds in 3 months. I could see a little concern on my provider’s face. I’m now waiting 4 weeks for another CT to check growth. I have had a recent cough, assuming it’s due to all of the germs floating around. It’s the longest wait ever! After the CT I have to wait 2 days to see the doc for results.
Has anyone else had something similar, positive or negative outcome? I’m not a big worrier, but I’m terrible at waiting.
Thank you in advance!
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cshell911, I'm sorry that you have to join the stressful lung nodule surveillance group. The good news is that only 5% of lung nodules turn out to be primary or recurrent cancer. Malignant nodules tend to grow very quickly so repeat CT is the usual procedure and biopsy is only done after rapid increase in size. There are protocols called fleischner criteria used by pulmonologists to set up scanning/biopsy timelines which depend on nodule size, growth rate, appearance and past medical history (including another cancer.) Most nodules are caused by infection or inflammation, sometimes Covid. Inflammatory nodules can grow but do so at a slower rate.
The unintentional weight loss is concerning but could have other causes. I lost 10 pounds in 2 months and had what I can only describe as a frequent violent cough. My PCP was afraid it was lung cancer but the CT showed that my entire right lung was full of consolidation, fibrosis and a few nodules. My RO diagnosed radiation induced pulmonary fibrosis, a rare late side effect of rads. A pulmonologist who specializes in interstitial lung disease treated me with high dose prednisone to stop the progressive scarring before it reached my left lung. RIPF can be fatal but the odds against it starting up again are better than those of a malignancy so I'll take it.
The wait is nerve wracking but is necessary for diagnosis. I hope your CT shows stability.
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Hi cshell, Ugh lung nodule surveillance is totally tortuous, I'm sorry you are dealing with this. So maggie gave you great facts regarding nodules so i won't repeat that. I will just add some of my own experience.
I started with a 3 small (2mm-4mm) lung nodules and was scanned per protocol every 3 months. Obviously it is important to follow them closely, if they remain stable for 2 years radiologist's consider them benign. My 3 nodules grew slowly over 9 months and did wind up being lung metastasis. Cancer can be slow growing or rapid. Typically they prefer to have the nodule at least 8mm to attempt a biopsy to get adequate tissue. My largest nodule after 9 months was 8mm and they considered it borderline size to get an adequate biopsy. My oncologist and myself agreed these were most likely mets and action was needed. I then saw a thoracic surgeon who felt I was a good candidate for a wedge resection. Due to it's size and easy location being on the outer edge of the lung I had a successful surgery to get a diagnosis. I'm sorry I'm sharing a negative experience but that was my honest experience. Please remain hopeful, no two cancers are alike!
I also wish you have a stable CT to ease your mind a little. Sending positive vibes your way, wrapped in a hug.
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my mom has 2 nodules as well doctor recommendation is to keep an eye
PET scan said highly suspicious for one of them but due to small size and age of my mom they decided not to do any intervention for lungs
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update:
My lung mass shrunk! Follow ups in 3 months!!!
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cshell911, Great news! It's such a relief after all the worrying. My next CT is in May (like your next scan) so I'll have to wait until then to see what is happening. I'm hoping my nodules are related to all the inflammation in my lung.
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Yaaaaay, great news cshell! So happy to hear good news.
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yay! Wonderful news
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cshell,that's great news.
How long have all of you been watching nodules? And how often do you scan?
MO has been watching a year and scans only every 6 months. It's a grade 1 so slow growing. Kinda pissed he didn't have me on a targeted therapy like ibrance. Kept saying I didn't need it. Oh yeah? Then why is it in lungs?
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Gailmary, I'm being treated by an ILD pulmonologist who follows protocols called fleischner criteria to determine the scan intervals. My RO sent me to him when I developed a rare side effect from radiation and my doctors decided that he would treat anything to do with my lungs. I'm an unusual case of the cure being worse than the disease.
Biopsy and non-systemic treatment of lung nodules is very dependent on their location. Cookie posted that she was able to have a wedge resection which removes the mets from the body but the location and size have to be favorable for that. If my nodules are ever identified as bc then my only treatment options are AIs and SERDs. If they turned out to be lung cancer I'd have to decide whether to have surgery (my only possible but risky option) so I'm going with the strong probability they are a result of all the inflammation in my lung.
Oral meds and chemo are systemic rather than specific to a location so MOs tend to stick with what seems to be generally working. You could always get a second opinion to see if you are a good surgical candidate or should be using a targeted therapy.
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My lung nodules were scanned every 3 months up until my surgery that diagnosed me with definitive lung mets. Gailmary do you have multiple nodules? How big are they? It's my understanding that typically will do a biopsy if large enough to see if indeed they are related to breast cancer. Also to see if the hormone receptors have changed.
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