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Lung Nodules


Lorin

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My Mom was recently xrayed to rule out Pneumonia and two small nodules, less than 1 cm, were found on her right lung. A cat scan showed three additional nodules. Im presuming smaller than first two as they didn't show up on xray. She is 78 years old and has energy and outlook equivalent to someone much younger. Non smoker, weighlifter, gardener, traveler. But years ago a benign breast biopsy really set her back more than expected. My question is, at this early stage is it realistic to wait a few months to monitor for growth before proceeding with biopsies? Im wanting input on non invasive first steps but read in another forum that more testing and scans is important to know what you are dealing with. 

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Hi Lorin, 

My mom's original lung cancer diagnosis began with 2 nodules. They were quite small and her doc suggested to wait to see if they grew. Nodules can occur for other reasons than cancer - rheumatoid arthritis, for example, can cause them. It seems as though spiculated nodules (those with pointy edges like a star) tend to be cancerous more often than smooth nodules. Since my mom was a former smoker, we weren't surprised that her spiculated nodules grew and were cancerous. But non-cancerous nodules can grow too. 

So, to answer your question, your mom's doc may suggest waiting to biopsy and just watch the nodules, especially if she is having some lung issues already. I would definitely ask their suggestion. There are some "less evasive" biopsy options available these days, depending on where the nodules are located. My mom had a needle biopsy done and it was no big deal for her.

I am sure you will soon hear from others on this forum with advice as well. This is a great place to get questions answered and advice on all things lung cancer. 

Take care,

Steff

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Welcome Lorin,

A non invasive test that she might consider is a PET scan.  Here is information about it. Select the words Positron Emission Tomography.  My go-to-source for information on lung nodules is an excellent Cleveland Clinic article here.  You'll note there are many different kinds and they form for many different reasons.  Bottom line - not all nodules are cancer but in my opinion, all nodules deserve attention.  

If the nodules are 1 cm or less in size, a needle biopsy becomes very difficult.  So a watch and wait, with emphasis on watch, may be warranted.  But, I'd have a PET scan to ease everyone's mind.

Stay the course.

Tom

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Hi Lorin,

I'm a fairly energetic and very independent 72 year old. Last year, I was having a a routine surveillance CT scan for another (non-lung) cancer that I was treated for in 2011. They found a nodule in my right lung. They could tell that it was probably slow growing since I'd been having regular CTs and they hadn't seen it before. So we agreed to wait 3 months and re-scan. It had grown very slowly. Because it wasn't in a location where it could not be biopsied by needle or by scope, I had to have it taken out  (along with the restof my lower right lobe) to see what it was. In fact, it was a stage 1A adenocarcinoma. From the scans, the various doctors thought that it looked like a cancer--as Steff says, they can tell a lot by appearance. Seems like non-cancerous nodules can grow, too, but cancers are more likely to.

Has your mom had any other chest x-rays or CTs in the past year or two that they could look back at to see if they could see anything starting to appear? In my case, because it initially appeared to be pretty slow, it seemed OK to wait 3 months to see what it was going to do. When they saw it was growing, they also did a PET scan and it didn't light up at all, apparently because it was so small and slow.  

Also, are your mom''s nodules all in the same lobe, or different places? And are they places that can be easily biopsied? I'm not sure there are any sure cut and dried answers about waiting, but I think there are some questions to ask.

I had my lobe removed by VATS (video assisted thorascopic surgery) a year ago this month. I spent one night in the hospital and came home with a chest tube in. My recovery was pretty fast.  The fact thaI I'm active and in pretty good shape probably helped. l  will have CTs every 6 months for 5 years to watch for possible recurrences. I'm due for one in a couple of weeks.

So, I hope your mom's nodules are benign. If not, lung cancer is highly treatable and curable, especially if found early.  Please convey well wishes to your mom and post more to let us know how you're both doing, what other questions you have and how we can support you both.

Bridget O

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15 hours ago, Tom Galli said:

Welcome Lorin,

A non invasive test that she might consider is a PET scan.  Here is information about it. Select the words Positron Emission Tomography.  My go-to-source for information on lung nodules is an excellent Cleveland Clinic article here.  You'll note there are many different kinds and they form for many different reasons.  Bottom line - not all nodules are cancer but in my opinion, all nodules deserve attention.  

If the nodules are 1 cm or less in size, a needle biopsy becomes very difficult.  So a watch and wait, with emphasis on watch, may be warranted.  But, I'd have a PET scan to ease everyone's mind.

Stay the course.

Tom

Thank you so muchTom!

I have been rapidly absorbing a lot of information on MPNs but have not found an article as helpful or as detailed as the link you sent.  I  want to be as knowledgeable as possible before my Mom's first oncologist appointment and appreciate that you have helped me feel more prepared for whatever is ahead.

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15 hours ago, BridgetO said:

Hi Lorin,

I'm a fairly energetic and very independent 72 year old. Last year, I was having a a routine surveillance CT scan for another (non-lung) cancer that I was treated for in 2011. They found a nodule in my right lung. They could tell that it was probably slow growing since I'd been having regular CTs and they hadn't seen it before. So we agreed to wait 3 months and re-scan. It had grown very slowly. Because it wasn't in a location where it could be biopsied by needle or by scope, I had to have it taken out  (along with the restof my lower right lobe) to see what it was. In fact, it was a stage 1A adenocarcinoma. From the scans, the various doctors thought that it looked like a cancer--as Steff says, they can tell a lot by appearance. Seems like non-cancerous nodules can grow, too, but cancers are more likely to.

Has your mom had any other chest x-rays or CTs in the past year or two that they could look back at to see if they could see anything starting to appear? In my case, because it initially appeared to be pretty slow, it seemed OK to wait 3 months to see what it was going to do. When they saw it was growing, they also did a PET scan and it didn't light up at all, apparently because it was so small and slow.  

Also, are your mom''s nodules all in the same lobe, or different places? And are they places that can be easily biopsied? I'm not sure there are any sure cut and dried answers about waiting, but I think there are some questions to ask.

I had my lobe removed by VATS (video assisted thorascopic surgery) a year ago this month. I spent one night in the hospital and came home with a chest tube in. My recovery was pretty fast.  The fact thaI I'm active and in pretty good shape probably helped. l  will have CTs every 6 months for 5 years to watch for possible recurrences. I'm due for one in a couple of weeks.

So, I hope your mom's nodules are benign. If not, lung cancer is highly treatable and curable, especially if found early.  Please convey well wishes to your mom and post more to let us know how you're both doing, what other questions you have and how we can support you both.

Bridget O

Thank you Bridgette,

I couldnt foresee how calming and reassuring this forum would be. I just knew i needed to reach out to others to help figure out the best next steps.  Now I know how much I really needed words of reassurance. Your outlook and experience is inspiring. How long have you been receiving medical support or monitoring for cancer?  

I will get to view all of my Mom's medical records on Wednesday. She did have an xray within past two years and there was previously nothing of concern. The nodules are all on right lung. I don't know if they are in a good location for biopsy but it sounds like only one is a size (1 cm) that would make it easier to do. I am hoping her doctor agrees that a PET scan makes sense. I still need to read up in the specialist she was referred to. 

My Mom lives in a city in south texas that had to evacuate during hurricane Harvey.  When she returned there was still not electricity, drinking water and the city was in various stages of clean up. Her home sustained minimal damage compared to others but still a lot of stress to deal with during a hot humid month like Aigust. And not enough electricians, carpenter's, etc, so progress for everyone  has been slow going.  In October there was finally someone available to help clear out her damaged  privacy fence. Being as independent as she is, she decided to burn some of the leftover debris herself. Im sure she inhaled smoke, possibly mold and who knows what else, because she immediately became sick.  Four days later, she was at the doctors office with a very bad respiratory infection. Her doctor feared possible pneumonia and that is what prompted the xray. 

Your thoracic surgery one year ago, including chest tube, sounds incredibly serious and yet you seem to have recuperated fairly quickly. If my Mom's nodules are not benign, I hope she is as strong as you. Thankyou for your kind words  Bridgette. I will likely use the forum when I get stuck and need more experienced opinions. Im glad you are here.

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Hi Lorin,

Wow, your mom has been through a lot with the hurricane!

To answer your question, I've been under  treatment or monnitoring now for almost 10 years.  In 2008, had treatment for an early stage breast cancer. In 2011, was diagnosed with a rare and aggressive form of cervical cancer and the treatment for that was major and recovery from treatment was much longer. and more difficult. In comparison, the lung cancer treatment was easy!  I now have No Evidence of Disease (NED) on all 3 unrelated cancers. I do have some long term side effects from the cervical cancer treatment, but they don't slow me down much and my life today is good.

You'll find a lot of hope and encouragement on this site.

Bridget

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