Colon Cancer NED but lung nodules being monitored

[Chickleen]

I was diagnosed with colon cancer during a colonoscopy last year in July.  Underwent colon tumor removal and colon resection last year in August, and since 8 of 18 lymph nodes were positive, I underwent 6 months of chemotherapy (capecitabine) finishing Feb of this year.   All of my scans have always showed small stuff in my lungs but all doctors have always said oh that's normal, it's a midwestern fungus that everybody has in their lungs, no worries.  But my oncologist has always been leary of it and has kept a close eye on my lungs with every scan.  They never lit up on any pet scans and he is considering me NED ever since colon cancer removal surgery last August.  Here is the weird thing... they completely went away during clean up chemotherapy.   So my oncologist is wondering if it is just fungus or something like that, why did it disappear with chemotherapy?  So since nothing is there, all is good.. .but then on my last 3 month scan this month there are some tiny nodules back in the lungs... very tiny, but there.  So... oncologist is saying not to worry at this point because they are too tiny to do anything with like biopsy etc..  but we will keep a close eye on them with my 3 month pet scans.  I'm extremely nervous about it and am just basically wondering if anybody else has had something like this happen... lung nodules that disappear with chemotherapy for colon cancer, then come back but very tiny, when chemo is over and if so, what did they turn out to be?

Thanks so much for any response!

[BridgetO]

Hi Chicleen and welcome.  I've never had anything like that. I had an advanced gynecologic cancer  a few years back and was having routine CT scans to watch for recurrence or metastasis. In one of these a small nodule was found and watched for a few months. It grew slowly. Nothing lit up on the PET scan and due to it's location it couldn't be biopsied without surrgery. I had a lobectomy and the nodule turned out to be a stage 1a adenocarcinoma.

The reason I'm writing all of this is I'm wondering whether you've seen a   pulmonologist. My pulmonologist was really good. She was able to look the CT and tell a lot. at some stable spots I'd had for years and tell me they were probably scars from Valley Fever, a disease endemic where I grew up but which I'd neve been diagonnosed with. She was alson able to say that the slow-growing nodule had a high probabiltiy of being cancer, though it could be an infection or inflammation, and if it was cancer it looked more like a primary lung cancer than a metastasis from my earlier cancer. She could really tell a lot by looking at the series of CTs I'd had. So, if you've been seeing an oncologist only, I suggest you see a pulmonologist for an opinion.

Best wishes

Bridget O

[Tom Galli]

Chickleen,

I certainly have information on lung cancer nodules.  First, let's understand lung (pulmonary) nodules. They appear and disappear for many reasons and most are not cancer.  Here is my go to source that explains the mysteries of lung nodules.  I'll give you a short synopsis of my here-today-gone-tomorrow nodule crisis.

After my right lung was removed to resect a large tumor in my main stem bronchus, I endured a year's worth of additional surgery to address suture problems. That stopped my clean-up chemotherapy.  After recovery, a scan showed 3 new nodules in my left (only) lung.  I received 6 infusions of Taxol and Carboplatin.  Midway through treatment,  2 nodules disappeared.  A post therapy scan showed no nodules!  I was put on a 3-month diagnostic CT scan schedule.  The first scan showed a very small nodule, and that earned me a monthly CT scan schedule.  The next scan showed nothing, the following showed 2 small nodules, and the next showed 3 small nodules.  Then a PET scan (then a new diagnostic technology in 2004) showed SUV uptake on all nodules at less than 2 or not metastatic. Three months later, a second PET showed the middle nodule with an SUV above 8 and the other two nodules with SUVs at around 6.  I restarted chemotherapy.

After the second regime of chemo, the here-today-gone-tomorrow scan results repeated till finally one tumor was confirmed metastatic disease.  A CyberKnife fried it in 2007 and I've been NED since.

So my lung cancer nodules did disappear after chemo and played hid and seek on repeat scans.  It was a maddening experience, and I came down with a very bad case of Scanziety!  I hope your tiny nodules disappear for good.

Stay the course.

Tom

 

[Chickleen]

THANK YOU for the replies, I appreciate all the insight and information.