Multiple lung nodules: Might they be noncancerous? What next?

Posted by felix536 @felix536, Aug 17, 2021

I have 3 lung nodules measuring 4mm, 6mm and 14 mm in three different lobes. Have had ct scans showing no change in 6 months and have another scan scheduled in three months per my pulmonologist. Should I get a second opinion from an Oncologist or wait it out? What are the chances of this being noncancerous?

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@felix536

Thank you for checking in. Have not gone for a second opinion, decided to wait it out until early November (next ct scan). KInd of curious how long one waits. Maybe I'll find that out next visit. I hope all is going well with you!

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Good morning- It seems that between every 3 months and 6 months are the norms for following lesions depending on how new they are or if they have grown, and of course their size.

With my first cancer, I started keeping all of my tests, scans, and lab work. I began looking up all of the terms that I wasn't familiar with and wrote them down on the results so that when I ran into them again I knew what they meant. I wrote lists of questions. I asked every single question at my appointments and made sure that I understood the answers as best as I could and then googled them when I got home. There's just so much to learn and understand, it can be pretty overwhelming. Are you keeping track of your findings?

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Yes I am. I have read that nodules over 10mm have a very high rate of being cancer, however my pulmonologist is comfortable with the watch and wait for my 14mm nodule (& 2 other smaller ones). I thought I remembered the Thoratic Surgeon saying to me that it would have to be removed via wedge section whether it grows or not, so that has caused confusion. They are both monitoring the situation so I will be patient until November. I do appreciate you input. Thank you!

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@felix536

Yes I am. I have read that nodules over 10mm have a very high rate of being cancer, however my pulmonologist is comfortable with the watch and wait for my 14mm nodule (& 2 other smaller ones). I thought I remembered the Thoratic Surgeon saying to me that it would have to be removed via wedge section whether it grows or not, so that has caused confusion. They are both monitoring the situation so I will be patient until November. I do appreciate you input. Thank you!

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When you have your 3-month scan you could also ask for an explanation of the differing opinions. I'll look forward to hearing the results!

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@felix536

Nodules were detected on a check ct scan in January by my Cardiologist. I was referred to a Pulmonologist and subsequent scans were taken in February, May and August (this month). A PET scan was done in May but the area where the 14mm nodule was not clear enough (due to breathing) to detect if there was any PET activated activity there. Also, on the May scan there were only a 4mm and 14mm nodules but on the August scan there was a 6mm nodule listed as "unchanged", that makes three. My Pulmonologist and I had a meeting with a Thoratic Surgeon are ok with waiting another 3 months but I am wondering if there are other more sophisticated tests for this condition that possibly they don't offer in this area that they might at UCLA or somewhere. Any ideas?

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Hello. I don’t know about other cancers, but I can share my story.
Same for me, radiologist reported seeing a small ground glass opacity in right upper lobe on heart CT ordered by Cardiologist. Referred to pulmonologist.
Pulmonologist recommended full chest CT for base line. Saw 3 or 4 similar GGOs in various lobes. Recommend watch for change.
3 months Dec 2020 CT nodules unchanged
6 months June 2021 CT nodule in upper left lobe grown 2-3mm and now another in upper left. Recommend continue to watch or lung needle biopsy. I opted for biopsy - found malignant.
August 2021 meet with one of the Mayo Lung Cancer Teams - Oncology, Thoracic, Radiation Oncology, Pulmonology. They call mine Multifocal Adenocarcinoma Insitu said: slow growing and that even when removed it can just pop back up in other glands in the lungs. They mentioned it is not like a cancer that has spread but more like each is an individual cancer. Of course those that have not been biopsied are only suspect at this point.
September 2021, have wedge resection surgery to remove the two nodules in upper left lobe.
December 2021 follow up CT to see if the other GGO nodules have changed.
Of course you do not have knowledge of type yet, but for the Adenocarcinoma, Oncologist told me to think of it as a marathon not a sprint.
Best wishes to you, praying for your nodules to turn out to be nothing.

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@merpreb

@felix536- Welcome to Mayo Clinic Connect. Good morning, it's nice to meet you. I am the Mentor for the Lung Cancer group for Mayo Connect. As members, we can only share our own health experiences, and are we not able to provide a medical diagnosis.

I'm wondering what brought you to the doctor. Were you coughing, spitting up blood, trouble breathing?

I have what is called multifocal adenocarcinoma of the lung. Simply put, this is when several ground glass lesions show up in one or both lungs. Mine started out with 3 lesions in my left upper lung. Then 3 years later a single one along the surgical line of that surgery. I also have a lower left lesion that is being watched with very little change in over 5 years.

I want to state that I do not know enough about all lung cancers to say that only multi-focal adenocarcinomas present this way.

What kind of doctor are you seeing for this? Has anyone considered doing a biopsy?

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I have a ground glass 1 cm nodule in my lung; they would remove it with laparoscopy as they cannot biopsy it. This and other benign nodules are being followed due to slow growth and they say, no rush. Okay..

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@marye2

I have a ground glass 1 cm nodule in my lung; they would remove it with laparoscopy as they cannot biopsy it. This and other benign nodules are being followed due to slow growth and they say, no rush. Okay..

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Good morning Mary, it's nice to meet you. I have what is called Multifocal Adenocarcinoma of the lung. It's indolent (slow-growing) and I have had several removed or zapped with radiation.

When was this discovered? Are you considering having it removed?

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@merpreb

Good morning Mary, it's nice to meet you. I have what is called Multifocal Adenocarcinoma of the lung. It's indolent (slow-growing) and I have had several removed or zapped with radiation.

When was this discovered? Are you considering having it removed?

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First of all, thank you for your reply. I had never heard of this and I was wondering what the deal was. Both parents had lung cancer, so it has been unnerving. Mine was discovered with a baseline CT in January; a followup in May and a petscan in October. Hadn't grown at all, so they will look at it in June. I still have to get in for a lymphnode biopsy (axillary under arm, same side as glass nodule. They told me they could remove it and certainly is my preference, but they want to evaluate. Nodules in thyroid are benign.

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@marye2

First of all, thank you for your reply. I had never heard of this and I was wondering what the deal was. Both parents had lung cancer, so it has been unnerving. Mine was discovered with a baseline CT in January; a followup in May and a petscan in October. Hadn't grown at all, so they will look at it in June. I still have to get in for a lymphnode biopsy (axillary under arm, same side as glass nodule. They told me they could remove it and certainly is my preference, but they want to evaluate. Nodules in thyroid are benign.

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Mary- This is a lot of good news! One of the reasons for a needle biopsy is that it is less invasive than a surgical one. And if there is are no cancer cells then you will be saved from a surgical procedure. I know that it's hard to wait. It seems as if cancer is either all action or all waiting.

It's great news that your Thyroid nodules are benign!

WHen is the biopsy scheduled?

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@merpreb

Mary- This is a lot of good news! One of the reasons for a needle biopsy is that it is less invasive than a surgical one. And if there is are no cancer cells then you will be saved from a surgical procedure. I know that it's hard to wait. It seems as if cancer is either all action or all waiting.

It's great news that your Thyroid nodules are benign!

WHen is the biopsy scheduled?

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I am having the biopsy for axillary lymph node on Friday. A little concerned about post op, but time will tell. The nurse has to call me; but they said it is 3-4 hour procedure so I presume it will use tracking stuff and a cut.

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@marye2

I am having the biopsy for axillary lymph node on Friday. A little concerned about post op, but time will tell. The nurse has to call me; but they said it is 3-4 hour procedure so I presume it will use tracking stuff and a cut.

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Hi. Is this a needle biopsy? What are your concerns about postoperative? I was also scared to death before mine. Postoperative was a breeze.

Maybe look on YouTube for a video to show the procedure? I'm on my phone. And don't know how to paste a link

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