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

Posted by js @jstarkman, Jan 18, 2024

I had a CT scan and they found a nodule which has grown to 8 mm from 6 mm 12 months ago. The report says "slowly growing malignancy cannot be excluded". My doctor (GP) recommends another CT in 3 months but I am concerned that this approach is not aggressive enough. It has clearly changed from 6 mm to 8 mm.
What do I do?
Should I be seeing an oncologist now?
Should something more aggressive me done?

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Profile picture for Lisa, Volunteer Mentor @lls8000

Hello Deb @ready2talk2000, Welcome to Mayo Connect. I'm glad you have consistent care through a pulmonologist, and one that thoroughly reviews your images. I have found that doctors often review the images themselves. They are usually very good at noticing areas of concern. I've had some that don't even seem to read the radiologist report, but they do pull up the images and show them to me. I appreciate that approach, even though I rarely understand what I'm looking at.
A 3-month waiting period between CT scans is generally the shortest time frame that we see, unless there is a change in how you are feeling: cough, pressure in your chest, swollen lymph nodes, etc. The waiting can be difficult. There are many things that can cause nodules in our lungs, most are not cancerous. For now, you know that there is something that needs further monitoring but try not to get ahead of that. Were the nodules first identified through lung screening, or were they found incidentally when you were treated for something else?

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The first 5 mm nodule was discovered when I had a chest CT in 2022 as a follow-up to a chest x-ray a month earlier that showed an opacity in an area of the chest.
The follow-up chest CT said I had a 5 mm ground-glass nodule in the right lung.
Since that time I have had 3 mo, 6 mo, and this last time I waited 12 months since things appeared to be improving. However, the 12 mo chest ct I just had Aug. 14 of this month showed two 3 mm nodules and a new 8 mm nodule.
My mom died of kidney cancer at age 53. She only lived 9 months after diagnosis.
I have a big family history of heart attacks, stroke, and cancer.
I've already been diagnosed with Stage 1 heart failure, but doing pretty well. I turn 67 this month.
I promised myself that I would never ignore anything just hoping it got better and these issues are not something I want to play around with.
Thank you so much for your reply. It does help not feeling alone in this.
Take care,
Deb

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CT found 1.5 cm nodule and I immediately scheduled a pulmonologist specializing in lung nodules and biopsies. It was NSCLC stage 1A adenocarcinoma malignant. It was removed by robotic Segmentectomy. Best wishes with your journey.

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Profile picture for Lisa, Volunteer Mentor @lls8000

Hello @hatterasj10202 , welcome to Mayo Connect. I have the ALK mutation, stage IV, I've been on a targeted therapy since 2020. I've been fortunate in that it has continued to be effective for me, fingers crossed.
I'm sorry to hear that you're dealing with this. It's never easy. Are you taking one of the targeted therapies? How long ago were you diagnosed?

@trudyhs, did I see a post from you regarding MET exon14 deletion? What treatments have you had?

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Hello,
I have multifocal LC with MET exon 14. I have had upper left lobectomy (2020) followed by chemotherapy, upper and lower right resections (2024) and radiation to lower left (2025). Doing well. Also seeing a naturopathic oncologist (FABNO) for complimentary therapies, high dose vitamin C and mistletoe IV infusions twice monthly.

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Profile picture for pb50 @pb50

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!!

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I see an oncologist at Dana Farber quarterly. I get a CT with contrast during each visit. The surveillance is comforting. After each visit he compares the growth of nodules with prior CTs. He occasionally consults with the radiation oncologist and we discuss options if there is continued growth. My metastatic disease remains a major concern and I am on hormonal therapy. In my opinion, getting care from a specialized oncologist is getting the best possible care.

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Profile picture for hatterasj10202 @hatterasj10202

I’ve been on targeted therapy twice, TEPMETKO. However had to discontinue treatment due to intolerable side effects. If you browse the drug I mentioned you’ll see how difficult it is to tolerate.
Diagnosed 2021 and ended second course of Tepmetko 4 weeks ago. PET SCAN scheduled for 9/4. Hoping despite side effect profile, it kept my cancer at bay🤞

Thanks for your responses….shall update after scan.

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Hi @hatterasj10202 , These drugs can be powerful, and sometimes they are too much for the other systems in our bodies to handle. I'm sorry that you had to discontinue the targeted therapies. Are you on any treatment at this time? Would you like to share the results of your recent PET scan?

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Profile picture for Lisa, Volunteer Mentor @lls8000

Hi @hatterasj10202 , These drugs can be powerful, and sometimes they are too much for the other systems in our bodies to handle. I'm sorry that you had to discontinue the targeted therapies. Are you on any treatment at this time? Would you like to share the results of your recent PET scan?

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Will try to send PET SCAN
results.
No therapy for now, but may restart target drug in 6 weeks accepting side effect profile once again, since target drug is still being productive, by keeping cancer in check with no progression.

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Profile picture for hatterasj10202 @hatterasj10202

Will try to send PET SCAN
results.
No therapy for now, but may restart target drug in 6 weeks accepting side effect profile once again, since target drug is still being productive, by keeping cancer in check with no progression.

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@hatterasj10202, Oh, you don't need to send the actual report, it's probably best if you don't (for privacy reasons). I was just curious how things are going. It sounds like you have come to a plan along with your oncologist. Enjoy your medication vacation. I hope some of the side effects resolve for you over the next six weeks.

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Profile picture for ready2talk2000 @ready2talk2000

The first 5 mm nodule was discovered when I had a chest CT in 2022 as a follow-up to a chest x-ray a month earlier that showed an opacity in an area of the chest.
The follow-up chest CT said I had a 5 mm ground-glass nodule in the right lung.
Since that time I have had 3 mo, 6 mo, and this last time I waited 12 months since things appeared to be improving. However, the 12 mo chest ct I just had Aug. 14 of this month showed two 3 mm nodules and a new 8 mm nodule.
My mom died of kidney cancer at age 53. She only lived 9 months after diagnosis.
I have a big family history of heart attacks, stroke, and cancer.
I've already been diagnosed with Stage 1 heart failure, but doing pretty well. I turn 67 this month.
I promised myself that I would never ignore anything just hoping it got better and these issues are not something I want to play around with.
Thank you so much for your reply. It does help not feeling alone in this.
Take care,
Deb

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Hi @ready2talk2000, Have you learned any more about the nodules seen on the last CT scan? Has your doctor outlined the next steps?

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Profile picture for dwcar @dwcar

CT found 1.5 cm nodule and I immediately scheduled a pulmonologist specializing in lung nodules and biopsies. It was NSCLC stage 1A adenocarcinoma malignant. It was removed by robotic Segmentectomy. Best wishes with your journey.

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Welcome @dwcar. I saw in another post that you were 12 weeks from surgery at that time. Are you having any other treatments, beside surgery?

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Profile picture for Lisa, Volunteer Mentor @lls8000

Hi @ready2talk2000, Have you learned any more about the nodules seen on the last CT scan? Has your doctor outlined the next steps?

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No new information yet. I am having another Chest CT at 3 months that is scheduled for mid-November. It's on my mind all the time, but I'm trying to focus on other things. I did read about the possible tests of a PET scan or possibly a biopsy. Some sources say they would do those things after finding the 11 mm nodule, but others say to do the Chest CT first. Does anyone on this thread have any information about the order of what happens?
Thanks for the inquiry, sorry I don't have anything new to tell yet. I will have more info in November.
Take care everybody.

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