Nodule & VATS

[Steph1235]

Hi everyone, I have an indeterminate nodule in my lower right lobe.  The nodule was found after a series of events.  I was in a car accident on December 26th looked over at hospital and released.  The following day I was doubled over in pain on my lower left side.  After visiting the ER, I was admitted to the hospital with a micro-perforation and diverticulitis.  I ended up getting sepsis and was treated for a week in the hospital.  During my stay they performed 2 CT scans with the first one showing a indeterminant nodule in lower right lobe that was 4mm x 5mm then a few days later the lung nodule showed it was 6mm x 8mm nodule.   Upon release from the hospital they instructed me to see my primary care and to follow up on Nodule.   So, in February my primary care said have it checked in 3 months.  I went in May for a follow up CT and now the nodule was 9mm x 11mm measuring a total of 10mm.  The doctor called and said follow up with another CT in 3 months.  At this point I started to get really worried as I was now researching nodules and noticed that it was growing.  She said to wait the 3 months.  Well, this month I had my follow up and the nodule grew slightly to 9mm x 12mm and total of 10.5mm and results noted a spiculated margin.   So, my PCP called and referred me to a pulmonologist.   I saw the Pulmonologist this past week and she said I can either do a biopsy or wedge surgery but first I need a PET SCAN.  Her recommendation was that I skip the biopsy as it is still considered small and the results will be inconclusive.  She thought that removing the nodule was the best course of treatment and that I was a 46yo women with a long life to live.  When I asked about the probability if it was malignant she indicated that it was very high based on growth and characteristics.  I have my PET this Wednesday and made appointments with 2 thoracic surgeons as I would like two opinions.  Needless to say, I am so scared.  My thoughts keep going in so many directions.  

[Tom Galli]

Steph,

Welcome here and I was scared during my diagnosis experience also. It is indeed par for the course. To the point, I like the idea of a PET scan first before considering surgery or other invasive biopsy.  It is always good to know what you are facing before surgery. But, I agree with your doctor, if your case involves just a single potentially malignant nodule, surgery offers the best probability for a no evidence of disease (NED) outcome.  Yours is still a relatively small nodule and hopefully it is the only thing revealed on the PET scan.

Take some time and read about us.  You might also spend some time learning about lung cancer and this is a very good resource.

Stay the course.

Tom

[BridgetO]

Hi Steph and welcome.  I also had a nodule that was discovered "by accident". I was having regular CT scans to watch for possible metastasis from a prior non-lung cancer. An nodule was found, and retested after 3 months. It had grown slightly. It didn't ook likena metastasis to any of the doctors but it did look like it might be a primary lung cancer-- spiculated and ground glass. It didn't light up on the PET, which it seems some small, slow growing cancers don't. Because of its location, it couldn't be biopsied except by surgery. I  had a lobectomy by VATS. It was an adenocarcinoma (non small cell lung cancer) stage 1. The surgery was easier than I expected. I didn't need further treatment. This was almost 3 years ago and I remain NED (no evidence of disease). 

The prospect of having cancer is indeed scary!  But if you do have it, it seems like it's pretty small and not very fast growing, which makes it easier to treat. We on this site have been through lung cancer or suspected lung cancer either as patients or as caregivers, so we have a pretty good idea of what you're going through. Let us know what questions you may have and how we can support you.

Bridget O

[Curt]

Hi Steph.  I also had a small (8 mm) nodule discovered by accident.  I am 43.  We watched it for a year.  I’ve never smoked and it didn’t grow but it was spiculted and I have a family history of lung cancer.   I did have a PET but it did not “light up”.  Small and slow growing cancers often don’t.  After a year of watching I opted to have a wedge resection.   I was told the same thing that it was too small for biopsy.  During the resection they found it was Stage 1 Adenocarcinoma.  They proceeded with a full upper right lobe lobectomy.  The surgery was not as bad as I expected and I’ve made a full recovery.  I go for scans every six months to check on things.   The watching and diagnosis phases are terrifying.  The uncertainty is difficult.  Take it one step at a time.  Avoid Dr. Google.  If you have questions or concerns ask them here.  We will do what we can to help get you through this.  

[Steff]

Hi Steph,

Many on the site understand the watch and wait game, the stress it brings, along with the scariness of a possible cancer diagnosis.  My mom was on the watch and wait game for about a year.  She was able to have a biopsy which showed lung cancer.  She opted for a lobectomy and follow-up treatment.  My mom was 60 years old at the time and is not the epitome of health.  She also had an "old-school" surgery that resulted in a large incision and has more recovery time than the VATS surgeries.  She was in the hospital for a bit, but recovered fine.  I've met 2 folks (Bridget being one of them) who had surgery via VATS and their quality of life does not seem to be effected.  My mom's quality of life has not been effected by the surgery either (the after treatment yes, but the surgery, no).  My point being, if you decide to have a lobectomy or wedge resection (whichever is recommended), you will likely be fine too.  

We all understand your roller coaster of emotions.  Everyone here has experienced it.  Rest assured, it sounds like you are moving in a good direction.  Know that we are here for you...

Take care,

Steff

[ColleenRae]

Hello Steph - I am also a member of this "club"...  I had a lung CT done in Nov 2016 and several nodules were located but all very small, so I was put on a "watch 'n wait" regime.  By July 2018, after another lung CT, Dr's were particularly concerned about one upper right lobe nodule. It was still fairly small (8mm) but it was becoming more dense.  A biopsy was discussed but ruled out - the nodule was too small and in a difficult place to biopsy. I had a PET Scan and that one nodule lit up - and I had been told it might not due to the small size, but it was like a flashlight! This was still not guarantee of cancer, but odds were high. I ended up having VATS, upper right lobe lobectomy October 2018. The pathology report showed the tumor was indeed malignant (adenocarcinoma), Stage Ia, no lymph node involvement or metastasis. I required no further treatment other than surgery.  My recovery  went well with a couple of hiccups (needed fluid drained from lung about 2 weeks following surgery; allergic reaction to pain med gabapentin - I just used Tylenol after that). I am able to do just about everything I did before but I have noticed a decrease in my lung capacity and find myself a little shorter on breath.

I am actually heading to Seattle today in about 30 minutes for my 2nd post-op cat scan and wanted to read a bit on this site for inspiration - the people here help so much in this journey! My first CT following surgery showed a couple of nodules in the upper left lobe. The radiologist suspected it's a slow growing cancer again but my surgeon did not agree. So I am back in the watch 'n wait mode again.  I'll be honest, sick to my stomach with anxiety... but what can you do other than march forward and hope for the best?!  

I know / we all know how frightening this is... But hopefully sharing our stories with you helps. Go for the PET scan.  I had my lobectomy not knowing for sure if I had cancer or not, but it was worth the gamble imo.  I am glad it was caught early, that the tumor was small and had not spread.  I hope the same outcome for you.  We are here for you! Good luck!

[Lisa L]

I’m in the same boat, been dealing with this since Dec. 14, 9mm spiculated nodule.  I had a pet scan 3 weeks later, no uptake at all, had another scan in April and it was the same and so today I’m going for 3rd Scan and praying it’s the same because I’m just so freaked out about having the Vats surgery.  I’m hoping it’s just indolent and doesn’t do anything.  This forum and the people are amazing.

[Laurel]

I had the VATS surgery February 2018.  I started out stage 1, but 3 months later after surgery removing upper right lung and several lympth nodes, it was stage 3.  I was blessed it was not known to be stage 3 as surgery is not usually a choice.   I had a wonderful surgeon at MD Anderson in Houston, excellent hospital and follow up care. Everyone has different experience with pain....I don't tolerate pain.  It was well controlled with meds.  Although I had chemo and radiation to follow, I believe the surgery is the reason for no evidence of disease....one year and 3 scans later.

[Steph1235]

Thank you, everyone, I appreciate all the feedback, encouragement and support.  So thankful to have found this group.  I’ll keep you all posted on the PET.  Colleen hope all goes well today with the scan.