8 mm lung nodule possible malignancy: What should I do?

I watched a nodule increase over 4 years from 6mm to 14mm and only then had surgery to remove it - Losing a lobe of my lung in the process. So based only on my experience, I would suggest you ask for an oncologist consult now. It may be that the insurance company has guidelines re how big it has to be before they will pay for intervention. It’s too small to biopsy now in all likelihood. But I would be asking whether it can be eradicated now - perhaps via radiation ablation - and if not why not.
I have RA and watched mine grow for 4 years thinking it was nothing to worry about - an RA nodule everyone thought. It moved at a snail’s pace of 1mm a year until the last year when it jumped 5mm. I suggest you don’t do that. Now I’m looking over my shoulder to see if it spread without detection - yet.

Good luck!!

Finding you have lung nodules is frightening but are common and most likely are benign. At this point your GP has you on the right track with a follow up CT-Scan in 3 months. It’s premature to have an oncologist involved at this point but you may wish to set an appt thru your GP with a pulmonologist for after your next CT. I had 3 nodules found in 10/22, CT’s every 3 months and No problem until 9/23. So try to relax and know all will be well. Go about your life. Prayers for you
P.S. they cannot confirm or rule out malignancy without a biopsy which most likely not be done on your sized nodule Mine grew to 24mm before things got serious

That is certainly conventional wisdom. In my opinion that’s a statistical rationalization that insurers use to withhold funding for intervention until you reach the statistical threshold for it, That seems to be overall size and/or speed of growth. And I agree you will probably be fine to wait. But probably isn’t that reassuring to me. If I had it to do again I would say the very minute the risk could be sold to the insurer, I want to pull the trigger. And I would still talk early to the oncologist for their input.

I would talk to a Specialist in lung cancer and not rely only on a GP who lacks depth of knowledge.
If your insurance allows it.
There are Pulmonologists specialized in lung cancer, Radiation Oncologists and Medical Oncologists. Treatment of lung cancer depends on various factors including size and location and can be surgery, radiation, chemotherapy, etc. One wants to be sure that all options are offered.

Hi jstarkman- I totally understand the place that you are in right now. First, take a deep breath, Second, are you near a Mayo Clinic or a Specialty place like it? You can always ask for a second opinion. That is what I would do. I never had a biopsy until after my surgery I had a nodule in my left upper lung that took 9 years to grow from ground glass to Adenocarcinoma. I was lucky because it was so slow growing but I was unlucky because I never got told about it being there. Long story. Anyway my Dr sent me for a PET scan after he saw that it had changed and I went straight to Mayo. Then Mayo decided the order in which they would do things. Pulmonologist first. Compared CT scans, because of shape and size and his experience he knew it was cancer without a biopsy. Set me up to talk to Thoracic Surgeon. I asked about radiation they said best to cut it out. Had a Bronchoscopy done, no lymph nodes involved. Had a PET scan, nodule barely lit. Had not spread anywhere else. Had segmentectomy (partial lobe removed). Clear margins and none of the numerous lymph nodes removed were cancerous. They said they caught it early, and I am so Thankful I didn’t wait to do the lung screening. That’s what caught it. I tell you my story because I have read where others have waited and it had spread. Please get a Second or even Third opinion. Be comfortable with what and which doctor you choose. It has to make sense to you. Stay OFF of Dr. Google! It’s unnecessarily horrifying! Research your questions on Mayo clinic, Cleveland clinic, or any of the . Orgs. Shy away from anything that is a .Com.
Good Luck and God bless you!
Cindy

Hi JS (@jstarkman), I'm assuming that your CT was completed for a lung screening exam? I'm glad to see that the screening program is working; nodules are being identified early, and it is saving lives! It also puts patients like you into a state of worry. Most nodules are non-cancerous. You need to be comfortable with the plan presented to you by your doctor. Some people are comfortable with a 3 month wait. Your nodule hasn't grown much, but no one can really tell you at this point what it will do in the next three months. A second opinion from an expert can be very helpful, and a pulmonologist would be able to provide additional input on what they believe the next steps should be.
From my experience, oncologists want to see patients that have a pathology confirmed case of cancer. I would certainly recommend seeing an oncologist prior to having surgery for cancer. We all have different experiences to contribute, there is no one right answer. The right answer for you is what puts your mind at ease.
I have a type of lung cancer that will come back and spread someday. I just had a second biopsy completed on a 9mm nodule and two enlarged lymph nodes which were first identified in November. It's not cancer. So, even stage IV lung cancer patients can have non-cancerous nodules. My oncology team is surprised too!
Take a deep breath and determine what works best for you.

My experience was finding a similar size nodule in 2020. It was in left lung close to my heart. Opted a wait & watch approach. In 2021 & 2022 stayed about same size. In 2023 it almost doubled to 13 mm. It is considered as a very very slow growing carcinoid. Had biopsy in Oct 23. Confirmed as a typical neuroendocrine carcinoid. There are typical & atypical neurendocrine carcinoids ( called lung NETS),
I am 77 yrs old. Had robotic surgery 10 days ago. Did so well I was sent home the following day. No chemo, no radiation. I’m very glad I had surgery. Four lymph nodes were negative. There was a cluster of tiny carcinoids, largest 4mm, in same area. They were not noticeable in CTScans but suspicious areas with a PET. I’m very glad I didn’t continue to wait. On YouTube there are several recent presentations on neuroendoctine tumors, known as NETS. I think the only way to know for sure is by biopsy. Please keep us posted.

Thank you for your comments. Do you see any benefit in having a bronchoscopy done at this point?

Please get an appointment with a pulmonologist as he/she will recommend a bronchoscopy or not. I think 8mm may be too small for biopsies, bronchoscopies so like many of us you are in the 3 month CT scan let's wait program. The nodule is currently being monitored, thank heavens and likely those tests will need to be done when it increases.

@jstarkman, I agree with Lisa, Take a deep breath. 8mm = .8cm is very small. My younger brother had larger nodules monitored every year for 8 years before they finally stopped checking. Nodules are not uncommon, and you don't say

Before you have any physical testing, it would have to grow, which may not happen. I have stage 4 lung cancer, and my doctor saw 3 lymph nodes increase in size by 50% in 3 months. That got me a PET scan and a blood test. Both came back negative. After another three months, they were smaller. I know lymph nodes are not the same as lung nodules, but the point is you're way before a cancer diagnosis at this point. And my attitude is that if I don't have a positive diagnosis for lung cancer, then I DON'T have lung cancer! Life's too short to literally worry ourselves sick.

Let us know what you learn in 3 months.