6mm Nodule

[Angie2]

I'm new to this set of forums, and this is my first post. During a recent hospital stay, imaging revealed a 6mm nodule in the right upper lobe.  I was told to wait 6 months, then have another CT scan to determine any growth.  I have a close friend with the same circumstances 1-1/2 years ago.  after two 6 month ct scans with now growth, he has now been diagnosed with terminal stage 4 lung cancer.  It is also in his lymph glands.  I want to avoid a similar fate, and made an appointment with Moffitt Cancer Center in Tampa.  My question is am I being overly cautious, and will Moffitt possibly consider a biopsy now?  The anxiety of waiting six months is appealing.

[Steff]

Hi Angie,

The waiting is one of the worst parts of anyone's cancer journey.  Are you being overly cautious? -Yes, but this is your life we are talking about, what's wrong with being overly cautious? 

When my mom's nodules were being monitored, she had scans every 3 months, which is what I typically hear of.  You may want to question the length of time between scans.  Relatively small nodules like you have can be tough to biopsy, so that may not be an option right now.  Some folks have been offered a wedge resection or lobectomy because the nodule was suspicious enough to warrant it and the procedure would likely not have lasting negative effects.  Once the nodule is removed, it can then be tested for cancer and further procedures/treatments can be discussed.

If you are thinking about wanting a second opinion, go for it, you have nothing to lose.  You can also ask for justification from your current docs as to why 6 months between scans versus 3 months, etc.  

Have you had a PET scan or just the CT?  If no PET scan, I would ask why not.

One final note, people get lung nodules for many different reasons besides lung cancer.  Sometimes they show up because of pneumonia or another lung infection. People with rheumatoid arthiris or other autoimmune disorders get them.  So, your nodule may be related to something else and could never grow or actually go away.  But I think you have every reason to be concerned and have every right to question what your docs are doing and not doing.

Hope this helps a bit,

Steff

[Lisa L]

Hi Angie, I am going through the same thing.  Ct scan In dec. for something else found a 9mm spiculated nodule in lingual, scared me to death I’m former smoker dad passed away from Lung cancer and I’m 52.  They scheduled me for a pet-ct Scan 3 weeks later and there was no uptake on the nodule or anywhere and said nodule was 8mm so that was good but with that said sometimes pet does not pick up on small nodules, have they told you more about your nodule like is it spiculated, non calcified?  I got a great pulmonologist and he scheduled another ct scan 4 months later which was  end of April, the ct said 9.7mm slightly spiculated nodule.  3 different machines had 3 different sizes and you will find they can be off 1mm give or take so because it did not look like any real growth and no uptake my pulm doc has another ct sched for july which at that time looks like he will do a biopsy.  I understand your fear, I often wonder if I’m doing the right thing especially when I hear about your friend, did he get a pet?  Or did he continue to follow the nodule after the 2 scans? I have tried to put it out of my mind until scans come up and it’s hard to do.  

[Curt]

Hi Angie.  Welcome.  Hearing you have a lung nodule is scary stuff.  Your friend’s story makes it all the much more scary.  I found out I had an 8mm nodule much the same way you did, by accident.  I completely freaked out.  Here’s the reality.  6mm is REALLY small.  It’s probably too small to biopsy.  I was told that a PET scan isn’t done for anything smaller than 1 cm.  I had some additional factors (significant family history) and was able to get one done.  Watching for growth with scans every six months is standard protocol for monitoring nodules.  If you have other factors like previous smoker, history of other cancers or family history that may convince them to do the scans every three months.   Having lung nodules is a pretty common thing.  Having it be cancerous is not all that common.  The majority of them are nothing.  That’s not to say you should ignore it.  You should keep up with the scans and get a second opinion if you feel strongly about it.  Just don’t go jumping off the deep end because of it.  

[Tom Galli]

Angie,

Six millimeters is about the size of a lead pencil eraser and as others have said, it is a small needle biopsy target and small nodules often do not provide accurate results from PET scans.

However, Steff has the right tone in her response to you: "this is your life we are talking about."  Indeed a second opinion is where I'd go.  Notice I said small nodules often do not provide accurate results.  Yours may provide an accurate result or at least accurate enough to confirm metastatic cancer.  If doctors are reluctant to order a PET, a 3 month CT scan, as Katie suggested, is the interval I'd be looking for.

To bolster Curt's comments about small nodules, here is my go to resource that describes the types and causes of pulmonary nodules.  As you can see, they occur for many reasons and most are not cancer.  Let's hope yours is nothing.

Stay the course.

Tom

[DanielleJW]

Hi Angie 👋 

I also had CT scan for something unrelated that just caught the bottom of the my lungs and found a nodule ... then I had to do another scan of whole lungs that found another 2 nodules. I was fully freaked out !!! Because there was nothing to check it against I waited 3 (agonising) months for the next scan and that showed no change .... now I’ve just had another CT scan after a further 6 months and it doesn’t look like there’s any change .. the size hasn’t changed anyway so now I will wait 12 mths and recheck.... 

I was feeling like you like come on let’s do something now about this...however now I see the merit on not doing anything invasive until they can see a reason to do so. Because the lungs are constantly moving it would be very hard to get a result on a tiny nodule. I’m not talking you out of anything.... you should do whatever you feel is right for you as we all should.... but it’s also good to get lots of information and different perspectives so you can make the best decision for yourself.

Much love & light to you 💖

Dx

 

 

[Pattymac]

I’m a newbie to this site, but my story sounds much like many of you! My nodules were found when I had a nasty upper respiratory infection on New Year’s Eve!! Happy New Year....right?? not to repeat my story, my daughter posted a few days ago about it! My father died when I was 12 of lung cancer when he was 46 years old, that was 50 years ago, my question is what the heck are they doing to cure this dreaded disease?? 50 years is far too long in this progressive day and age to not eradicate this dreaded disease, does anyone feel the same way?? maybe it’s just me??

[Robert Macaulay]

Pattymac

This excellent book will give you a answer to your question and then some.

https://www.amazon.ca/Emperor-All-Maladies-Biography-Cancer/dp/1439170916

[Pattymac]

Thank you Robert for recommending this book, i will definitely read it! I have 2 pharmacists in my family and they both think......it’s a $$$ thing to not cure it! It’s such a sad disease, and I have lost so many loved ones due to it! Thanks for your comment!

[Tom Galli]

Patty,

I think you'll find universal agreement here with your point that 50 years is too long for discovering an effective lung cancer cure -- way too long!

Immunotherapy has emerged as a treatment that is helping many. Targeted Therapy helps a small portion of adenocarcinoma diagnosed folks but compared to many cancers, we are in the dark ages of treatment. The progressive era passed us by without even a mention. Here are the sobering statistics.

So it is not just you, but we are expert hopers!

Welcome here.

Stay the course.

Tom

[Pattymac]

Thanks for your reply Tom, yes I have been an expert hoper for many years, I also believe in miracles.......they happen everyday! Those stats surely are sobering, I thought decades ago that cancer of all kinds should have been dealt with as a number one priority in the medical field, most were and lung cancer was not!! Truly very sad, as it not only effects people who smoke or former smokers, but people who have never smoked at all! My interventional Pulmonologist told me about the strides in immunotherapy and the “lock and keys” they use to determine which therapy to use in relation to our very own DNA! I pray this will be the breakthrough needed to cure and prevent lung cancer from ever starting in the first place! I can only keep hoping, thank goodness for this forum, I’m so glad my daughter found it!!

Take care,

Pattymac