Not diagnosed but future looks ominous

[Karen W]

I had a pneumonia last October and was sent for a CT in December.  A spiculated semi-solid nodule was noted at that time that was about 1.5 cm and my pulmonologist sent me back in March for a repeat.  The nodule was unchanged at that time so I just went back for a 6 mos CT and the nodule is now 2.5 cm, still semi-solid with irregular borders.  I have an appointment with my pulmonologist next week and I am pretty frightened.  From all that I have read this is more than likely a malignancy.  I also have some enlarged mediastinal nodes that are enlarged but unchanged.  He had told me last time that if there was growth, he would send me to a thoracic surgeon to have it removed, which is a Yippee on one have, let's get that nasty stuff out, but a boo hoo on the other hand because of Covid and being in a hospital.  Just thought I would begin to share my story.

[Tom Galli]

Welcome Karen,

I’d press your pulmonologist for a PET/CT scan. Here is more information about diagnostic imaging and you can read about PET scans. This scan will report on malignancy of your nodule and mediastinal nodes.

Lung Cancer diagnosis is a winding trail. The only way our disease can be confirmed is with a tissue biopsy and if the PET/CT returns a suspected malignancy, then a biopsy is next up. There are several ways these are performed. Here is more information on biopsies. 

Of course, all this discussion about lung cancer could be premature. Pulmonary nodules form for many reasons and most are not cancer. Lymph nodes also enlarge for reasons other than cancer. Here is a discussion about the various pulmonary nodules that form in the lung. Note, most are not cancer.

Questions? This is the place.

Stay the course.

Tom

[LexieCat]

Hi, Karen, and welcome! Your imaging sounds a lot like mine (spiculated nodule that enlarged) when I was diagnosed three years ago. The surgery isn't really that big a deal--I was in the hospital overnight (I had an unusual complication and had to go back in for a few days but for most people it's 1-2 nights in the hospital, max). Have they ordered a PET-CT yet? That should help determine whether the lymph nodes are likely to be involved. When you have surgery, they will sample the lymph nodes too, and check those out.

This is a terrific group--glad you found us. 

[Sabacat]

Welcome, Karen!  Have to agree with Tom and Lexi - you really need a PET-CT scan.  My nodule/mass was found on a CT Angiogram along with a bunch of mediastinal lymph nodes, and we went straight to PET-CT after that which told a much clearer story.   And it's early going -- as Tom said, there are MANY reasons for nodules and enlarged lymph nodes. 

Keep us posted as you proceed down the diagnostic path, and ask any questions you might have.  Folks here a VERY knowledgeable and VERY helpful and supportive.  After my diagnosis, this forum was what saved me from terror and deep depression.  It's a very positive and hopeful place!

Susan  

[jack14]

I agree with everyone here, a PET scan first and then a general surgeon (unless your thorascic surgeon one can do it; mine was axillary and outside the chest), to take a biopsy of one of the lymph nodes. And back to the thorascic surgeon according to the results from the biopsy. And then maybe an Oncologist.I suggest getting a second opinion on the biopsy too. I got one from the masters at Johns Hopkins and my Medicare paid for it because my General surgeon requested it for me. So glad I did that too. Also a Foundation One panel of genes and PDL-1 tests. I was advised that in my case, it was best to wait till the test results were all in before beginning any treatment.

 

[BridgetO]

Hi Karen and welcome here. I also agree with the others. You've gotten some really good advice. The PET CT is essential. I had a VATS (laparoscopic) lobectomy almost 4 years ago and, like LexieCat, found it fairly easy (as surgeries go). If you wind up having to go that route, we can give you advice and suggestions (maybe more than you want!) But  you're not there yet. As Tom G said, there are lots of reasons for nodules. But, spiculated is suspicious.

If you have questions, we'll be happy to tackle them. Let us know how we can support you.

Bridget O

[RH1970]

Karen,

I’m struggling with that ominous possibility too, so I know where you’re coming from.  Like the others have suggested, I think a PET scan would be the next step in figuring out what you’re dealing with, then on to a biopsy.  
 

I may be simplifying It, but the way I understand it is that if a PET scan shows little or no uptake, the nodule is more likely benign.  However if it does show an uptake, malignancy is still a possibility, and so a biopsy is then needed.
 

I’ve also come to understand that an PET scan uptake still doesn’t necessarily mean malignancy.  It could also still mean some kind of infection.

In the end only way to confirm what you’re dealing with is a biopsy.
 

I’ve moving on to a biopsy next Friday, but until then, I’m trying not to draw any dire conclusions.  It’s definitely hard, but I’m trying.

The people in this forum are a BIG help.

Good luck and keep us posted.

-Rick

 

[Karen W]

Thank you everyone for your encouragement.  I am 68 years old and smoke for 30 years, quit the year I turned 50.  The doc said that he would send me for a PET scan if the nodule grew but he also said that he didn't like the idea of just a bronchoscopy for a biopsy since it is only semi-solid but would rather just have it removed.  Have already had PFT's and my lungs function is good enough that my body would function after a lobectomy.  So I guess my next step is seeing him next week and then going for a PET scan.

Thanks everyone,

Karen

[GaryG]

Hi Karen: Glad you joined the forum. I smoked for 10 years on and off and quit 35 years ago and still ended up with lung cancer. I am glad you quit. I don't mean to scare you but some studies concluded that it takes 15 years for the lungs to recover from smoking. That's the bad news.

The good news is that thanks to new drugs and more capable and experienced doctors lung cancer is now beatable. Hang in there, be optimistic and don't hesitate to  visit and ask questions.  We will be here to help.

Good luck with your PT and please post the results.

[LouT]

Karen,

You've already gotten so much good counsel on diagnosis and how to proceed that I'll focus on the other part of you.  While all this is going on, don't let yourself become a slave to Dr. Google...the data is out of date and doesn't reflect the most current treatments and protocols...stick with your team and ask any questions here.  Also, this may be a bit tougher, focus on living each day.  Find something that can bring you joy and/or peace and use it.  If you find yourself too emotionally overwhelmed then speak with your doctor.  You need to be in the best physical and mental shape you can be for this journey and you can do it.  
Also...Lexie is correct the surgery is not as bad as you may believe it is.  If you do need it we have some tips what to do pre-surgery, in the hospital and when you get home.  If you want to see it you can find it at the link below:

We'll be here to help you and remember the surgery will not be as bad as you expect.

Lou