Accidentally discovered 17 x 10 nodule

[Troy2]

I had a calcium test done to check on potential buildup in my arteries with a CT test. Good news is that my arteries proved to be perfectly clear. Bad news is that they noticed a 17 x 10 nodule in a lung. I had a PET performed a few days later but won't have the results until next week. This seems to be a fairly large one from what I have read. Anyone else have a similar experience? 

I haven't spoken to my general doc yet, only his nurse. The doc's online system shows it marked as malignant. I am hoping that they just treat it that way until they know otherwise.

Given the size, is it likely that they will just remove it? 

[Tom Galli]

Troy,

I'm assuming your nodule size is in millimeters.  If so, the nodule size would translate to about 3/4" by 1/2". The PET scan result should provide the important information -- is the nodule malignant. Here is some information about a PET scan that may help you understand the results when your receive them.  The results should tell is two things: is the reported nodule malignant and is it the only one.

A single malignant nodule, depending on its location, can be addressed with surgery. Here is some information about lung cancer surgery that might be helpful. So I hope you get a favorable PET report.  More questions? This is the place.

Stay the course.

Tom

[Troy2]

Thanks Tom. I will read the info in the links.

[Curt]

Hi Troy.  Tom has provided good answered to your specific questions.  I’ll just add that the majority of nodules are benign so let’s hope your is.  If it does prove to be malignant there are lots of treatment options, including surgery.  Stay away from Dr. Google.  Much of that info is outdated and misleading.  There are treatment options.  If you are looking for answers read through the posts on this site and ask your questions here.   

[Troy2]

The nurse just called and said that it came back all clear! They want me to have a PET in a year. I have not seen the detailed results yet.

Does that sound about right? Would I be better off asking for one in six months? Or am I safe waiting for the year before getting another PET in your opinions?

[Tom Galli]

Troy,

Diagnostic timing is variable.  If one has metastatic disease and is under treatment, a common interval is a scan midway through treatment, then if no evidence of disease, a rescan after 6 months. 

When small suspicious nodules are discovered, a common interval is a rescan after six months. Most often performed is a CT scan, not a PET. I don't have any concrete data to back up this timing, just recollection of reading a lot of posts on this forum. So, I think a 6 month re-scan is prudent.

How fast do tumors grow? Here is an interesting article by an oncologist that gives some insight.

Stay the course.

Tom

[Curt]

My follow ups after my negative PET were CT Scans every six months.

[Troy2]

I finally spoke directly with my general doc. He is having me get another CT scan now as well as setting up an appointment with a pulmonologist. I also learned that the nodule is spiculated. The negative PET is good, but the fact that it is spiky is a bit scary. At least it is in a good location to remove if needed. It's at the very top of the left lung. Not embedded somewhere.

[BridgetO]

Hi Troy,,  Th referral to a pulmonologist is a good idea. I had a small spiculated nodule that was slow growing (I had a 3 month follow-up CT scan that showed slow growth) . It didn't ligtht up at all on the PET scan. I understand that small slow-growing cancers sometimes don't. It couldn't be biopsied by needle or by bronchoscope because of its location. I had  a lobectomy and the nodule turned out to be adenocarcinoma stage 1a. The surgery turned out to be easier than expected and I'm well now.

If your nodule does turn out to be malignant, it's very early stage cancer and surgery would probably be curative..

Best of luck and keep us up to date.

[Troy2]

Thanks Bridget. That's helpful. 

[Curt]

@Troy2 spiculated does increase the concern a bit but is still not definitive.  A negative PET is also not definitive that it is NOT cancer.  I had an 8mm spiculated nodule in my upper right lobe.  I watched it for a year with no changes and a negative PET.  The doctor felt I should take it out but gave me the option of continuing to watch it.  I have a pretty significant family history of lung cancer, the fact of where it was and that it was spiculated increased the concern.  The surgeon said right before I went under that he didn’t think it was anything and that it would only be a wedge resection.  I woke up a few hours later and found out I had NSCLC Adenocarcinoma.  They did a full upper right lobe lobecty while I was under.  The surgery and recovery was not nearly as bad as I imagined it would be.  I had visions of being debilitated and walking around on oxygen.  None of that was the case.  I’ve made a full recovery from the surgery in late February.  Some minor numbness and pulling when I cough.  Normal breathing and my lung capacity is back to where it was pre surgery.  

[Troy2]

Thanks Curt. I'll find out what the pulmonologist thinks in a few weeks. I am leaning towards taking it out just to be sure.

[BridgetO]

Hi Troy, depending on the location, you may be able to have a biopsy by needle or by bronchoscope, which could  give you a diagnosis without  surgery.. 

[Troy2]

It's on the very upper part of the left lung. If it's not that difficult to take it out it seems that it would be wise to remove it. Are there downsides to taking that route? 

[Curt]

It’s better to do a biopsy if possible.    Mine was too small to be able to biopsy.  No point in removing any healthy lung if it’s not cancer.  

[Troy2]

The pulmonologist doesn't agree about the nodule being spiculated after the second CT scan (high res this time). The nodule has not changed in appearance or size. He is certain that it is benign. He thinks it is a granuloma that is probably related to a common infection in the area I grew up. I am scheduled for another CT in 9 months just to be certain. That will be followed with one in 12 months. 

That is better news than I was expecting to hear.

[Curt]

Good stuff Troy.  

[BridgetO]

Yay! is it a Valley Fever nodule?  I have scarring apparently from Valley Fever , and I was never aware I had it. I did grow up where it was common,

[Troy2]

1 hour ago, BridgetO said:

is it a Valley Fever nodule? 

It was something from the Ohio River Valley/Mississippi. I can't remember what he called it. A quick internet search shows up Histoplasmosis. It sounds like what he was talking about. Very similar to your Valley Fever!

Apparently it is sometimes referred to as "Cave Fever". lol

[BridgetO]

Yep, I think they are both fungal. 

[Troy2]

I just want to take a moment and thank this wonderful group! While I have most likely dodged a bullet, I have found your help and support invaluable while getting it figured out. I hope you all fully realize what a great thing it is you do here. 

[TJM]

Troy

That is the exact diagnosis I received for a similar sized nodule in the bottom lobe of my right lung in 2004. Watched for two years and declared indolent (basically something foreign in my lung like a fungus).

Fast forward 15 years and the indolent b*stard is 4.9 cm and almost circular with involvement of lymph nodes. I hope you log back on and read this. I am confident I will be "cured" with surgery but it is pure luck I found this and I already KNEW it was there and so did my docs. If this turns into "more" (what's happening is plenty) I will be pretty pissed. Especially because they only gave me the CT scan because I asked for it. Other wise that bad boy would be slowly growing and unobserved.

If I could do it over I would have had her take it out then (she offered but recommended PET scan instead)

Bottom line.....dont forget about that little sucker. Mine would have grown till it invaded some other part of my body and made surgery not an option. Hell..it may alreadt have. I will find out Tuesday Jan 28 2020.

Good luck and,

Peace

Tom

 

[Terry S]

On 11/21/2019 at 12:29 PM, BridgetO said:

Hi Troy,,  Th referral to a pulmonologist is a good idea. I had a small spiculated nodule that was slow growing (I had a 3 month follow-up CT scan that showed slow growth) . It didn't ligtht up at all on the PET scan. I understand that small slow-growing cancers sometimes don't. It couldn't be biopsied by needle or by bronchoscope because of its location. I had  a lobectomy and the nodule turned out to be adenocarcinoma stage 1a. The surgery turned out to be easier than expected and I'm well now.

If your nodule does turn out to be malignant, it's very early stage cancer and surgery would probably be curative..

Best of luck and keep us up to date.

BridgetO:  has it been a while since your surgery?  I also had a Stage 1a spiculated nodule and had a lobectomy on 12/16/19, so I'm almost 8 weeks post-op.  Did it take a while before you felt really good?   I'm still a bit sore and feel a bit swollen....plus have a dry cough.  I'm waiting until 8 weeks before going back to exercising as well.

Thank you,  Terry 

[BridgetO]

My surgery was in November 2016, so over 3 years ago. I think I recovered fairly quickly , but I had a nasty bout of bronchitis about 6 weeks after my surgery, which slowed things down some. I did sleep elevated on a wedge pillow for a couple of months after the surgery because it was more comfortable and easier to breathe that way. In February of 2017, I took a trip that involved about a 2-1/2 hour flight, which was fine -- I understand some people have pain on flying after lung surgery, but I didn't. I recall feeling fine on that trip, but I didn't have all of my energy back by then, so I took it easy. I haven't had  any residual pain from incisions. My breathing does sound a little funny to me at times and I occasionally cough but no pain.  

I suggest exercising as you feel comfotrable. and increasing gradually.  Walking is a good idea and then increasing from there. Recently Lou  T  posted about getting back to exercise pretty fast. Maybe you can find that post.

I hope this is helpful.

[Terry S]

5 hours ago, BridgetO said:

My surgery was in November 2016, so over 3 years ago. I think I recovered fairly quickly , but I had a nasty bout of bronchitis about 6 weeks after my surgery, which slowed things down some. I did sleep elevated on a wedge pillow for a couple of months after the surgery because it was more comfortable and easier to breathe that way. In February of 2017, I took a trip that involved about a 2-1/2 hour flight, which was fine -- I understand some people have pain on flying after lung surgery, but I didn't. I recall feeling fine on that trip, but I didn't have all of my energy back by then, so I took it easy. I haven't had  any residual pain from incisions. My breathing does sound a little funny to me at times and I occasionally cough but no pain.  

I suggest exercising as you feel comfotrable. and increasing gradually.  Walking is a good idea and then increasing from there. Recently Lou  T  posted about getting back to exercise pretty fast. Maybe you can find that post.

I hope this is helpful.

Thanks so much for your response.  It helps to hear how you fared after a similar diagnosis and surgery.  Good to know about flying....I hadn't even thought of that yet.

Good health to you,

Terry