Lung Nodules: Anyone monitoring these in regular scans?

Posted by stevm @stevm, Mar 26 8:25am

I was diagnosed at stage 3 in May 2023 at 69 y.o.. I had a distal pancreatectomy and splenectomy followed by 12 rounds of Folfirinox and 6 weeks of chemo radiation. My CA-19-9 has been 7 for two years and my scans have been NED. I have had no issues since completing treatment and lead a full active life. Feeling very fortunate. My initial chest scan prior to surgery in May 2023 indicated innumerable small (3mm) nodules. These have been noted in all of my scans over the past three years as unchanged. My most recent scan (March 17) indicated 3 new small (also 3mm) indeterminate nodules. My oncologist is not overly concerned. The radiologists recommendation is to have a follow up CT scan in 3-4 months to see if there's any change. The nodules are too small for a PET scan to be meaningful. Has anyone had similar experiences with nodules? I have agreed to get the scan in 3 months to be on the safe side.

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anne7573217 | @anne7573217 | Mar 27 10:30am

Yes, I just had a scan today and the perpetual 3mm nodules today were "scattered". I haven't seen the oncologist yet. I know that there were lung nodules present though for years and have been told repeatedly they are not concerning, but after the PC diagnosis they have now switched to watching those.

pcand52 | @pcand52 | Mar 28 10:32am

Hi Stevm
had similar condition in 2024 and treatment in 2025 but no chemoradio
what is that and why?
Regards

stevm | @stevm | Mar 28 1:04pm

In reply to @pcand52 "Hi Stevm had similar condition in 2024 and treatment in 2025 but no chemoradio what is..." + (show)

@pcand52
I hope that your treatment was successful and that all is going well.

Chemo/radiation was offered as adjuvant therapy following surgery and 12 rounds of Folfirinox. My diagnosis was not made until after the tumor was surgically removed (distal pancreatectomy & splenectomy) as they could not get a good biopsy. The surgeon was confident that he could successfully remove the tumor. Most oncologists prefer chemo followed by surgery. However, in my case not knowing if it fact it was cancer, the decision was made to go forward with surgery. Unfortunately it was stage 3 adenocarcinoma so I then did the 6 months of chemo. Upon completing chemo I was offered the option to do chemo/radiation which involved taking capecitabine (oral form of 5-FU) and daily radiation for 4 weeks. The theory is the radiation targets the area where the tumor was removed with the aim of destroying any remaining microscopic cells that may remain. The capecitabine acts a a radiosensitizer making the cells more vulnerable to the radiation damage. I figured that having gone through 9 months of treatment I might as well go for it. One will never really know whether it added benefit. Although my margins were clear I had lymph node involvement so thought it best to do all I could. Hopefully this explains it for you. Best to you and good health

stevm | @stevm | Mar 29 8:57am

In reply to @anne7573217 "Yes, I just had a scan today and the perpetual 3mm nodules today were "scattered". I..." + (show)

@anne7573217
Thanks Anne. Curious to learn how you are doing overall. When were you diagnosed and how is the battle going?

pcand52 | @pcand52 | Mar 29 10:09am

In reply to @stevm "@pcand52 I hope that your treatment was successful and that all is going well. Chemo/radiation was..." + (show)

@stevm
Hi
thanks for the elaborate response;
I wish I had been offered that additional treatment in Montreal,
where did you get yous?
maybe it was not offered because I was 2a , no positive margins ,no nodes.
Still ,this add on treatment makes so much sense especially in light of the recurrences %
Personally my markers were normal before and after surgery, same before and after chemo which ended 1 year ago.
As my CA-19-9 (350) and CEA (30) had been going up since november 2025 I had a December 2025 scan and a january 2026 MRI , both showing no signs of cancer .
I suggested to my reluctant oncologist to resume Folfirinox which I just started
(they say that they would prefer seing what they treat in order to monitor chemo response)
Chemo radiation sounds so logical as additional adjuvant
Regards

stevm | @stevm | Mar 29 12:39pm

I was treated at Mass General Boston. The comparative clinical data for adding the chemo/radiation is not particularly telling. My radiation oncologist at the time felt that it potentially added some protection against recurrence at the site of the tumor. I had gotten through chemo without issues other than neuropathy in my feet so he felt that physically I was a good candidate. That has to be very unnerving seeing an increase in cancer markers but no evidence of recurrence in scans and MRI. Hopefully getting back on the chemo regimen will do it for you. How many rounds are you planning to do? I wish you the best. Keep me informed please.

anne7573217 | @anne7573217 | Mar 29 1:13pm

In reply to @stevm "@anne7573217 Thanks Anne. Curious to learn how you are doing overall. When were you diagnosed and..." + (show)

@stevm it's been pronounced I am doing "great" and "all the boxes have been checked" as far as everything that can be done medically for now. The anxiety has been the worst. I was diagnosed IIB in February 2025. Thanks for asking!

pcand52 | @pcand52 | Mar 29 1:15pm

Thanks
1st time 10 rounds
7 normal
then 3 at 80% and at 3 weeks instead of 2

now just trying 2 rounds to see if it reduces markers

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zora0121 | @zora0121 | Apr 5 6:48am

In reply to @pcand52 "@stevm Hi thanks for the elaborate response; I wish I had been offered that additional treatment..." + (show)

@pcand52
Hi im from Canada also and salute you for advocating for yourself. I too have had to push to receive additional adjuvant treatment after surgery and chemo. Thats why I appreciate this group so much. So much knowledge here!!
All the very best in your future.