Is a Spiculated lung nodule always malignant?

@lls8000 See my posting dated January 13, 2026 here. The CyberKnife was successful according to the latest scan!

@astaingegerdm I am glad to see your report that radiation worked for you, as it also did for me. It was good that we avoided surgery. Very encouraging that your regular CTs just show scarring and nothing new. How often do you have the CTs?

@junerose42
I had CTs every 4 months for 2 years, now it’s going to be 6 months since the last one.
I decided on radiation since surgery was not superior in my case. Recovery from surgery would be tougher in my mind. I only noticed fatigue after radiation.
And brittle ribs!
Broke ribs on both sides separately from minor injury.

Hi everyone, My ex-husband had a CT scan today which revealed a new spiculated 2.5 cm masslike density in the left upper lobe. He has stage 4 COPD and has had bilateral lung reduction surgeries. This lesion was not observed in his CT scan 6 months ago. He will be seeing his local pulmonologist tomorrow for a consultation, scheduling of PET scan, and advice regarding whether biopsy is possible. We would like any biopsy and follow up surgery done in Boston. My question is about follow up treatment if the lesion is malignant. If it is operable, and the lymph nodes are clear, is chemotherapy or radiation still indicated? Does anyone have thoughts to share about targeted therapy or immunotherapy? Many thanks in advance. Sending love and light to this community!

@brixisnonni, A new mass of that size is concerning. It sounds like you are both very on top of the situation and are taking good next steps. A next-day appointment is great!
There are many questions to be answered before treatments are discussed. Each patient's situation is different, and they go into this with differing levels of overall health too. There are no hard and fast rules for what is aways done. It's not easy to wait through the diagnosis process, but each step needs to occur to make sure we're getting the treatment that is right for us.
IF he needs it, in Boston he will have access to some of the best lung cancer doctors and researchers.
How did the appointment with pulmonology go? What are they recommending as a next step?

Thank you for your kind words, Lisa! As it turns out, the old guy (OG as I fondly refer to him) had an appointment with his primary care doc, not his pulmonologist. Fortunately, an immediate referral for a PET scan was placed. The OG plans to wait until he receives a call back. I suggested that he call on Monday afternoon if he hasn't heard from the scheduling department by then. I'd also like him to call his surgeon at Brigham & Women's, but I can only push him so far. The surgeon also consults with Dana Farber. I have been known to give this surgeon a heads up when the OG procrastinates. I know that he is scared, so for the moment I'm just listening to the thoughts he wants to share, and doing research.
I hope you are doing well. Thank you for the support you provide to everyone in this group. You are truly an inspiration!
XO,
Carolyn (Brixi's Nonni and the OG's ex)

@brixisnonni
My PET scan 2 years ago showed a 1 cm spiculated upper lung nodule too. My pulmonologist did a bronchoscopy which was painless & came back negative for cancer. I go yearly now for a PET scan & so far so good.

@junerose42 Hello, I was reading about your cyber knife treatment in sept of last year and you mentioned you would have follow up in Jan of this year to see if the nodule is gone. I wanted to check in with you to see if you would share the results of your follow up from treatment. I hope that the procedure you had took care of the nodule and this message finds you in excellent health. Thanks, Hercules

@363 Good news! I had the follow up scan in January after having the CyberKnife radiation on my lung nodule. The scan showed that the nodule had been reduced to scar tissue. I have another follow up scan to be done in July. I'll report the results here. The fact that mine was "spiculated" and had also grown some since first discovered in 2017 resulted in my decision to have the CyberKnife radiation treatment. Since deciding on radiation over surgery at age 83, I've attended a seminar with a lung surgeon at my local hospital whom I found very kind and impressive. He said that he did lung nodule surgeries on many patients in their 80s, and that they were up off the operating table and walking down the hall soon after their surgeries. He did the surgery with the Da Vinci Robot. Thus, I wouldn't rule out a surgical procedure if you choose that over radiation. But I hope you won't need either.

@sallik74 That is wonderful news! I'm so happy for you. Here's hoping your PET scans continue to bring you good news. XO