Lung nodule... Reassuring results but still anxious

Welcome - and I’m sure one of our awesome mentors will find their way to this post soon with an official welcome.

I had a nodule discovered when I was having a chest X-ray in response to a positive Tb Test (which turned out to be a False Positive). No TB but a 6mm nodule way down in the
Bottom outside corner of my left
Lower lobe. Mmm. Assumption was that since I have RA it was an RA nodule. Let’s Watch it. Next year it was 7 mm. Get a PET scan since it grew a bit - all Good. Then it was 8 the next year then 9 and then last spring it was… Ruh roh - it was 14!
All hands on deck. Had surgery and tho no one predicted it, in fact it
was malignant - so out it comes along with the lobe it was resident in. That was last May. I’m good.

If I channel our awesome mentors, they would point out That you are on a board dedicated to Lung cancer. So anyone you ask will answer from our experienced perspective - that is also biased. You know the old adage that when you have a hammer in your hand everything looks like a nail. So you have the hammer and we are all nails 🙂

I will Put my bias aside and tell you as an honest to goodness statistician to remember that statistics mean nothing to an individual. They are great for forecasting outcomes of a population - but not for a population of one.

Trust your doc or get a second opinion from an oncologist to give you peace of mind - and then live large for six months. It’s a small thing, so take a breath. Eat in great restaurants, take a cruise -
Not because you won’t be able to later but because you chose to let it go for six months.

There are a lot of great people On this board so I will hush and yield the floor 🙂

Thank you, your response is greatly appreciated. I see your grew, my mom's nodule have not changed in size in 3 years, but the spiculation is what scares me. I do not want it to spread so waiting 6 months is so difficult.

I do not know if oncologist will do much if pulmonologist says it's fine to wait. They already did the liquid biopsy, pulmonology mostly deals with cancer treatments on confirmed or highly suspicious findings, and her is neither.

So now we can just wait, which is very anxiety provoking, get a second pulmonologist opinion or maybe consult a thoracic surgeon to see what removal options are available.

Given yours was not PET reactive, how many years total did it take for it to grow to 14mm? Also, did they have to remove the whole lobe? I thought they now were doing minimally invasive VAT surgeries where only a small part of the lobe comes out??

Four years. It grew 1mm per yr from 6 to 9mm and then went from 9 to 14 in one year. It is less about size than growth rate. Yes spiculation can be consistent with malignancy, but again that’s not a consistent correlation.

Fwiw, my pulmonologist handed me over to a thoracic surgeon and then backed away. I would get a surgeon and tell him you would like him or her to recommend an oncologist should it be needed. You might want both surgical and Non surgical intervention options after you get the pathology result and know what you’re dealing with. and yes I had VAT surgery but removing the lobe it resides in is the gold standard. But what I would do differently is to ask them to do the wedge resection they send to pathology with the tumor and nodes and then give oncology a chance to follow up with radiology or chemo - to prevent losing an entire lobe. But that’s just me.

BUT FOR NOW - take a breath and have the good scotch ! 🙂

Thanks for more info.

I also think that removing the whole lobe is pretty invasive and surprised they did that. Like if your nodule was only stage 1 with no spread to lymph nodes, why remove the whole thing?

How bag was the VAT recovery? Also, how did they know it was malignant? Did they find out during the procedure and decided on the spot to remove the whole lung? Did you need any chemo? Sorry for so many questions.

To be fair, he told Me in advance that if path showed malignancy he would Go immediately to lobectomy. He also Told Me there was only a 25% chance it would be malignant. I was a bit panicked and just wanted it all over with.

He did a wedge resection with the tumor and sent it to pathologist who knew it was Coming. He said it’s malignant and surgeon went back to work. The staging came afterwards. No chemo. I deferred to the collective wisdom. Not a terrible idea but neither is exploring less traumatic options.

I am reading studies that suggest if it is early stage and margins and nodes are clean the wedge resection is as reliable for preventing recurrence. . So discuss it with your Mom’s surgeon Up front.

thank you.

You haven't mentioned, was your nodule spiculated at all? And were you offered a conventional or even liquid biopsy prior to surgery?

Yes.. spiculated opacity in the left lower lobe - and no wasn’t offered that. It was not in a position that lent itself to needle biopsy. So it was biopsied intraoperatively.

oh, got it. That's why they decided to remove the lobe. See, based on all the findings, it should not have been malignant (minus spiculation) and even with that they thought it was still benign due to small growth and negative PET....

Did you have to go through chemo/radiation? And what was the grade after biopsy?

sorry, just read your message again, you said no chemo... So recession was curative for you? Do you have to do any follow ups now?

I’m having CT scan every six months and the presumption is it was curative.