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First visit to nodule specialist


Scruboak

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The doc informed my husband and I today that he is fairly certain that my little 17x 10 mm nodule is malignant because of it’s shape, margins (spiculated), and growth since scan 3 months ago.  His plan is to do PET scan to “ stage” and then surgery a soon as possible. He said that even if the PET is negative he wants the growth removed.  I am shook up but amazingly I’m more relieved to get a plan! He was very encouraging in that the nodule is in the lower left lung and “ easy” to treat.  WillI I need chemo or radiation? Can anyone shed some light on this aspect of treatment. I’ve just always assumed that chemo or radiation happens with cancer. 

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Welcome. You have found the right place to get accurate and helpful information. There are many people here who have experienced exactly what you just went thru.

I had the surgery your doctor is referring to 5 weeks ago and I am feeling awesome. Surgery is by far the best option if possible. If you are staged at IA then I am guessing they will reccomend no follow up Chemo. I am rooting hard that your PET scan comes back with just the one mass.

FWIW.....even if the PET scan results look like the mass is benign, I agree with your doc. I would have the thing removed. I wish that is what I had done 15 years ago when my nodule was found but that is a different story.

Keep posting as you get more info. Others will be around and respond to you shortly. There are a lot of very special people on this board. Again.. welcome. You are one of us.

Peace

Tom

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Thank you, TJM.  I had a conversation with a fellow lung nodule patient in the waiting room. She has been having a nodule followed for a year and every time she comes to the clinic, she shakes all over. I replied that for the past several weeks every time I go to the dr’s office or to the hospital for scans, I get diarrhea! She crossed herself.

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Hi Scruboak,

My situation was similar to yours. My nodule was a bit smaller than yours and was in my lower right lobe. It grew slowly during 3 months observation. It did not register on the PET scan at all. Seems like some slow growing small tumors don't have enough metabolic activity for the scan to detect. Because of its location (near the center of the lobe, it wasn't susceptible to biopsy by needle or by bronchoscope.  Because of its growth and appearance, the pumonologist and the surgeon as well as the tumor board, recommended it be removed, which required removal of the lobe. It turned out to be adenocarcinoma stage 1a, and no chemo was needed. The surgery was tolerable and I recovered well. 

If you plan to have the surgery, I and others can give you some (or maybe a lot of!) suggestions. Let us know what questions you have and how we can support you.

Bridget O

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Hollow @Scruboak   I had an 8mm spiculated nodule in my upper right lobe that we watched for a year.  PET scan was negative but I have a pretty significant family history of lung cancer.  That and the doctor didn’t like the way it looked.  I went in for what was called a wedge resection to just remove the nodule and tissue around it for testing.  They tested it while I was in surgery and it turned out to be NSCLC.  They proceeded with removing the entire lobe (lobectomy).  I have not require any follow up treatment.  I was pretty shook when I was told I should do the surgery, and relieved I was finally doing something about the nodule.  Waiting and watching was stressful.  Surgery was not as bad as I imagined.  I’m a little of a year out from it and doing great. 

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Thank you, Bridget and Curt.  So it seems that if the nodule turns out to have cancer, an entire lobectomy is preferable, right?  

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Hi!  Here is a little information about surgery that might answer some of your questions.

https://lungevity.org/for-patients-caregivers/lung-cancer-101/treatment-options/surgery

There are also lists of questions to ask your doctors and checklists as well.  Hope that helps, please keep us updated on your PET scan!

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Yes that is the preferred treatment for early stage lung cancer.  There are some other variables.  It’s location, is it localized to just one lobe, etc. They will want to make sure you have sufficient lung function and can handle the surgery but it is the most affective treatment for early stage.  

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17 hours ago, Scruboak said:

The doc informed my husband and I today that he is fairly certain that my little 17x 10 mm nodule is malignant because of it’s shape, margins (spiculated), and growth since scan 3 months ago.  His plan is to do PET scan to “ stage” and then surgery a soon as possible. He said that even if the PET is negative he wants the growth removed.  I am shook up but amazingly I’m more relieved to get a plan! He was very encouraging in that the nodule is in the lower left lung and “ easy” to treat.  WillI I need chemo or radiation? Can anyone shed some light on this aspect of treatment. I’ve just always assumed that chemo or radiation happens with cancer. 

Hi Scruboak:

I had the same surgery, lower left lobe, done by VATS on December 16, 2019.  My nodule was also spiculated.  I was staged at NSCLC 1a...the lobe was removed and I have had no further treatment.   After 8 weeks, I felt pretty much back to "normal".  Best wishes for your PET scan.

Terry

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Scruboak,

Welcome here. To digress before answering your question on post surgical chemo and or radiation, I still "cross myself" before every visit to my oncologist! Let's review your bidding.

You have a relatively small pulmonary nodule with spiculation. Your doctor is suggesting a PET to stage and if PET results point only to your suspicious nodule, surgery is the next suggested treatment. If PET results show SUV uptake is limited to your suspicious nodule and surgery is performed, will you need post surgery chemo and or radiation?

First, be mindful that PET scans may be unreliable for small nodules. Some small nodules may be malignant but display low standard uptake values (SUV). Here is a primer on PET scans that may explain SUV.  Assuming the nodule displays as metastatic, and no other areas of concern are shown, you might stage at IA or IB, an early find and surgery could be considered as curative treatment. Post surgical chemotherapy becomes a judgement call depending on the type of lung cancer reported by the pathologist's examination of the resected nodule. Here is some information about lung cancer surgery.

If your medical oncologist or surgeon suggest post surgical chemotherapy, I'd be inclined to undergo the treatment. Why? This post surgical chemotherapy is designed to sweep the blood stream and lymphatic system of loose cancer cells to lessen the chance of a recurrence.  Here is some information about the probability of recurrence. Post surgical complications stopped me from having post surgical chemotherapy, and this resulted in three recurrences after surgery. Reducing the probability of recurrence in lung cancer is a wise course of action.

I do hope the PET shows malignancy only in your identified nodule. More questions, this is the place for answers.

Stay the course.

Tom

 

 

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Scruboak,

Like Bridget and Curt, my tumor was small and in my lower lobe (right side).  I had a lobectomy and since there were no mets or lymph node involvement I was staged at 1a and the surgery is considered a "cure".  I'm now ten months from my surgery and have been NED (No Evidence of Disease) and I fully recovered from the surgery over the course of about 2 1/2 months.  So there is a lot to be hopeful for.  Stay focused, ask questions and don't let your mind run ahead on you.  It appears your nodule was found early and that provides the greatest chance for cure.  Let us know any questions you have.

Lou

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Thanks, guys. It’s weird that I feel closer to you all in a sense than to most anyone else right now.  I am grateful

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Scrub,

Best of luck. Just a heads up to talk with the surgeon about what pathology they will plan to do for the tumor. I wish I had. Though the odds are very small, it is possible that you have a different type of cancer than they think. That is what happened to me. I wish I had known it was even a small chance. For one, if I had known, the news wouldn't have been as shocking as it was and two I would have made sure that they (the pathologist) had my permission to send a sample of live tumor for a trial that is going on for large cell. I contacted them and the sample must be live for their trial. You would think all of this would be well known....but I guess it isnt.

Again.... very unlikely to happen. I am scouring the older posts here trying to find other Large Cell cases. So far only have found two and neither went into any detail. But it is possible.

Right now I think you are in as good a place as a lung cancer patient can be...other than NED...and that is coming.

Peace

Tom

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