Is a Spiculated lung nodule always malignant?

I am glad you have a plan. I had five treatments 20 minutes each. But a friend of mine had ten treatments ten minutes each. I had no stomach issues..just some fatigue which would just hit me so I took a nap. I arrived about 15 minutes early and they took me right on time. I was in and out in 30 minutes. At the first appointment they do marking… you lie on something that moulds to your body and they mark your body with a marker pen and cover it with special tape so that they can put you in the correct same position each time. Then the following visit is your first treatment visit. it is absolutely painless and I had to remain very still. I was able to choose music to listen to which made the time go quickly. You can drive yourself or have someone else drive you but if you bring someone they cannot be in the room with you. The radiologist doctor met me a couple of times after a treatment. He then has rescheduled me for a PET scan 2 and 1/2 months after I finished treatment to see if the tumor has broken up and how my lungs look. They have had very good success with SBRT and I think this is the “to go” procedure for elderly people who cannot have a biopsy or surgery.. I have had no side effects from the treatments except for some fatigue. They have had time will go by quickly once you start treatment. I will be thinking of you.

Hello @democrite, every case is different, so we aren't able to say if this biopsy is warranted or not. You didn't mention how large the nodule/mass is believed to be. A biopsy can be performed for more than a yes/no decision on if this is cancer. A biopsy has the potential to determine what type of cells are contained in the nodule or mass, and based on that, the doctors can determine if further treatment is necessary, and the best course of treatment.
The opinion of another pulmonologist will help you to make a decision on the biopsy.
The PET didn't show uptake/light at all? That's good news! You may want to ask the pulmonologist about the potential for infection, and wouldn't an infection light up on the PET too, just at a lower rate? You are questioning the need for the biopsy. Some people would need to know what the nodule is right away, while others would be comfortable waiting and re-scanning. We all get to make decisions about our comfort levels; comfort with waiting, comfort with procedures, etc. Doctors make recommendations, but ultimately, we get to make the final decisions. Wishing you well!

My neuroendocrine tumor was coincidentally discovered when an x-ray looking for something else showed a mass in my right lung with spiculation. Biopsy and PET scan confirmed it was an NET in the middle lobe and also a cancerous lymph node in the upper lobe. The middle lobe and bottom part of the top lobe were removed with robot-assisted surgery. It’s three and a half months later, and I am feeling close to fully recovered and hoping the six month scan will find nothing but good news.

Hello. Yes. I have had same experience.
I had CT scan... 15 months later another scan. It shows a 7mm spiculated nodule that was not there before and radiology seemed concerned. I have been diagnosed 17 months ago by have a test. I got in glass box and panted haha. I'm 54 and surprisingly had no clue as to what I was doing or why. 2 months after test the finally admitted mind you I worked 2 months with me saying to doctors I AM SICK. I assumed it was bronchitis. They say I have COPD with unspecified emphasema. ( My latest CT say no emphasema no bronchitis) I use 2 puffers 4 times a day. My lung "specialists" sent me a note in my portal saying..." I believe this 7mm spiculated nodule is due to infection. I will do another CT scan and see you Sept 19. I'm not sure what infection I have and wouldn't that need rest and antibiotics? I've been working a very strenuous job that requires approximately 15 trips up and down stairs. So maybe yours is a infection that will just heal itself. I also take ibuprofen. 800 mg 2 times daily. Generic OTC I'm hoping for healing.

I would insist on surgery!I am having a biopsy and my nodule
Has some spikes on the top?

Hello @milana, I'm sorry to hear that you are facing this issue, it's never an easy thing to go through. Nodules are rightfully concerning, but they are usually not cancerous.
I'm not a clinician, just a lung cancer patient.
For reference, my first PET showed an SUV over 10. We knew it was cancerous, and that was confirmed by a biopsy. A later PET of a different nodule showed a much lower SUV, and it was not cancer, it was a fungus in my lung, also confirmed through biopsy.
Did you see a pulmonologist? Did they discuss doing a biopsy prior to surgery?

Hello @milana, I'm sorry to hear that you are facing this issue, it's never an easy thing to go through. Nodules are rightfully concerning, but they are usually not cancerous.
I'm not a clinician, just a lung cancer patient.
For reference, my first PET showed an SUV over 10. We knew it was cancerous, and that was confirmed by a biopsy. A later PET of a different nodule showed a much lower SUV, and it was not cancer, it was a fungus in my lung, also confirmed through biopsy.
Did you see a pulmonologist? Did they discuss doing a biopsy prior to surgery?