12 mm Spiculated Nodule upper right lobe

I didn’t know that likelihood was different for different lobes. BUT definitely get a PET scan. And if it indicates malignancy, see an oncologist as well. That doc will be the one that helps with ongoing monitoring, advising whether there are reliable options other than surgery, etc.
In my experience, the idea of partial lobectomy is abandoned if it is malignant. But that is just my experience. My surgeon did a wedge resection of the area with the 1.5cm tumor, kept me sedated while the pathologist confirmed malignancy, and then took the left lower lobe out.

You need to trust that your surgeon has your Good outcome at heart. If you don’t, find another one.

I was also told that anything larger than 1.0 is malignant. Both my 1.0 tumors in each lung were malignant. 🙏🏻

When a ground glass nodule (opacity) is suspicious for malignancy a wedge resection is usually the preferred method of biopsy. GGO/GGNs are subsolid and cannot be easily biopsied otherwise. A needle biopsy is most likely to yield a false negative.

Currently, I am dealing with GGOs that are becoming part solid. Like spiculations, this often indicates that it is becoming malignant. (95% of GGOs are benign). My oncologist and my second opinion oncologist both took my case to their respective Tumor Boards, both suggested wedge resection but also said it might get be risky due to damage from previous treatment. I opted to wait for this to become solid enough to perform a needle biopsy or an EBUS.

Surgery is the gold standard in lung cancer treatment. If caught early enough it gives the patient the best chance for complete cure.

Thank you so much for all the information. I have been in denial about the whole thing for awhile, thinking that it was just going to disappear again. The doctor did say that if anything it would probably be stage 1 and he didn't think that I would be needing chemo/radiation afterwards. He also mentioned that he didn't think my PET/CT would show much more than the CT did. Regardless, having the PET/CT done next week. I know that many of you are going through far worse and I should consider myself very lucky that it's caught early, but I'm still very scared.

@joannamountain24, Welcome to Mayo Connect, I'm glad that you found us. I can appreciate you taking time to access the situation and to process what this all means and what the surgery might entail. It sounds like it's now time for action, and a PET is a great next step. The PET will show a level of 'uptake' in nodules and any other areas that may be metabolically active. Cancer, infections, and inflammation can all be active, but cancer is usually most active and will generally have a higher uptake number than other causes. (Here is some additional info: https://www.mayoclinic.org/tests-procedures/pet-scan/about/pac-20385078)
Surgery is always a big step, but if this is cancer and it hasn't spread, surgery is likely your best option for long term survival. If you are able to get input from more than a surgeon, a pulmonologist or an oncologist, it may help you to access the options. Let us know how the PET scan goes, and if you have other questions.

@joannamountain24, It's ok to be scared, this is scary stuff! I liked to live in denial too, it's a comfortable place to be, but sometimes our bodies have other plans for us. None of this is easy, but we get through it with the support of others.

Hi @jannam, Welcome to Connect. I saw your profile (thanks for adding that). I was also diagnosed in 2020 with metastases to the liver and lymph nodes. I'm glad that you are doing well and are treatment free. Wishing you many more years in that same mode!

Lung cancer is a gut punch whether you are stage one or stage four. When we were younger this was an automatic death sentence. It's hard to imagine otherwise it's so ingrained.

The reason your doctor thinks the PET scan won't reveal much is because it images metabolic activity. GGOs are not terribly metabolically active. And they are slow to experience apoptosis (cell death) so they don't shed pieces of the dead cell into the bloodstream so liquid biopsies are not useful either. I tried,

Please know that I am grateful that this was caught so early. Patient advocates have been pushing hard to find a way to detect these early. Your early diagnosis, no matter how incidentally it was found, represents a kind of victory.

Yea but that 1” threshold just doesn’t hold true. It was true for you - but it’s not a universal Truth. Bigger Is frequently more indicative of malignancy. But not always.

So sorry to hear that you had to go through this. I appreciate you sharing your experience in here to help others. I'm so glad that I found this group. If you don't mind me asking, how long did it take you after the surgery to feel like yourself again?