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Erin62


Erin62

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Hello.  I am looking for some insight.  I had a CT scan today in preparation for un upcoming surgery for uterine cancer that was diagnosed just two weeks ago.  On the scan, it showed a 1.3cm spiculated nodule in the right lower lobe.  The reader of the scan said it was "suspicious for metastasis" but my Gynecological Oncologist (who I love!) said that would be "rare because there are no other signs that the cancer has spread into the belly".  She is consulting with a Pulmonary specialist.  Has anyone ever had this scenario before?  If so, was the nodule cancer?  Thank you for any insight you may have for me.  I'm a tad bit worried, especially with my recent and very unexpected cancer diagnosis two weeks ago.

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Hello Erin,

Welcome to our forums.  First of all most nodules (spiculated or not) are not malignant (up to two thirds of benign nodules are spiculated).  The definitive test for malignancy is a biopsy.  But with a lower probability of the nodule being malignant the doctors may decide to observe it over time to see what, if any, changes it goes through.  If at that point they believe the probability grows for malignancy they would surely perform the biopsy. 

Lou 

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Erin,

I agree with Lou. Spiculated nodules can be suspicious for lung cancer but so can non-spiculated nodules. My go-to resource for understanding pulmonary nodules is the Cleveland Clinic.

You will note that most of the causes of lung nodules are not cancer. I do however think you should be followed by your pulmonary specialist with routine scans to follow the nodule.

Stay the course.

Tom

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Hi, the risk evaluation for lung nodules depends on many factors including size, spiculation, growth, and factors related to the patient like smoking status, age, etc. Having said that calculating risk is not getting an answer so hopefully your doctors will either biopsy it to get a definitive answer, or at least monitor it very closely until they are certain that it is benign. The biopsy is an easy procedure if the location is not in a dangerous or complicated place. I’m sorry you have to deal with this worry in addition to your other worry, but hopefully both issues will be resolved soon. Just make sure that they do not ignore that nodule because nodules that are spiculated and of decent size are risky and you better catch anything very early before it spreads. Good luck. 

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Erin good luck on your surgery.  Once you get the pathology back from surgery and a treatment plan in place, I trust things will settle down for you. It's not usual that uterine cancer would spread to your lungs, but it can. It would most likely show up somewhere else first.   It's also unusual that there is only 1 nodule. So, I trust what your GYN-O has told you.  It would also be very unusual to have 2 primary cancers at the same time (uterine + lung) highly unlikely. Hope that helps ease your mind a bit.  

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Hi Erin, In 2011 I had a sudden and unexpected diagnosis of cervical or endometrial cancer,Stage 3. The "Or" is because it was in both places and customarily it would be "named" after the place where it started and two pathologists differed on that. That cancer was treated with a radical hysterectomy, radiation and chemo. I had regular CTs to surveille for possible spread or metastasis. In 2016, a   single small, slow growing nodule was found in my right lung. There was a concern that it might be a metastasis from the gyn cancer, but doctors felt that it  wasn't  because it was NOT spiculated  and metastases tend to be smooth edged (and often multiple). Because of its location, It couldn't be biopsied except by surgery. I had a a lobectomy and it was diagnosed as non-small-cell lung cancer, adenocarcinoma, stage 1a. I didn't need further treatment other than CT scans to watch for recurrence. So far no recurrence. I was actually relieved to find out that it was a new primary cancer rather than metastasis. So that's my story.

Most nodules, spiculated or not, are not cancer of any kind. But I think you'll need to follow up on this little nodule after your gyn surgery. Have you had a PET scan? That would be a likely step. BTW, my nodule didn't light up on the PET and I was told that small, slow growing lung cancers don't. Another step would be a followup CT to see if it's growing. Nodules that do are suspicious for being malignant. 1.3cm is probably big enough to biopsy, which is usually done by needle or sometimes by endoscope (down the trachea) if the nodule location allows.

So, I think it's hard to know what might happen next for you, other than your gyn surgery. But whatever it is, hang in there.  Lung cancer, if found early while small, are easier to treat with curative intent.  And multiple primary cancers are not unheard of. You'll probably find on this site that I'm not the only one. I've had breast cancer as well as the other two and at 77, I'm still working part time and have a good quality of life. 

I hope for the best for you. Maybe that little nodule will just cease to trouble you and disappear by itself.

 

 

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Erin, 

Your head must be spinning.

As I recall, 4 mm is typically the action point for lung nodules, i.e., biopsy. Smaller than that, they tend to come and go, at least in my lungs. A biopsy is the only surefire way to know if a nodule is trouble. Sounds like your oncology doc is doing the right stuff by reaching out to a lung person.

Just try to take some slow, deep breaths. This waiting period is killer. 

Karen

 

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