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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@marye2

Well, it turned out to be a needle biopsy! I was so thankful after learning it was going to be a 3-4 hour experience. However, it was recovery time for the sedation. I saw the Dr come in and later woke up done. Fentanyl. You certainly helped me along...results in a week or so. RELIEF

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Yes, so scary going in for the needle biopsy. The sedation medication worked amazing.
They did not sedate for same procedure type prior to wedge resection. They needed to insert some kind of tracer in to the nodules so they could find the nodules during the surgery. Placing the tracers was a procedure similar to the needle biopsy performed immediately ahead of the wedge resection surgery. As they carted me off to that procedure, I was thinking “they must be going to give me something in there” Nope, they did not. I laid there the whole time (felt like eternity) as they inserted the needle into both nodules and put the tracers in, thinking “is this on purpose or did someone forget to give me sedation?” I resolved that they must not want to give something right before anesthesia and tried hard to bring my grand babies into my mind. If I have to do again, I will ask them if they can give me something first.
Best wishes for your medical progress. If you come across this same type of procedure recommendation, you can ask more questions about how it all lays out prior to the actual surgery.

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@jamineibs

Yes, so scary going in for the needle biopsy. The sedation medication worked amazing.
They did not sedate for same procedure type prior to wedge resection. They needed to insert some kind of tracer in to the nodules so they could find the nodules during the surgery. Placing the tracers was a procedure similar to the needle biopsy performed immediately ahead of the wedge resection surgery. As they carted me off to that procedure, I was thinking “they must be going to give me something in there” Nope, they did not. I laid there the whole time (felt like eternity) as they inserted the needle into both nodules and put the tracers in, thinking “is this on purpose or did someone forget to give me sedation?” I resolved that they must not want to give something right before anesthesia and tried hard to bring my grand babies into my mind. If I have to do again, I will ask them if they can give me something first.
Best wishes for your medical progress. If you come across this same type of procedure recommendation, you can ask more questions about how it all lays out prior to the actual surgery.

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I have to thank you for all of the "backing" on my journey this week. We had kind of a journey as they were unclear as to which building we were going to, so we were somewhat stressed about that, but they were fine with lateness. ;o). Interesting was that they gave me oxygen after the procedure to help me wake. Take care.

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When you go to Mayo or MD Anderson for the 2nd opinion, do you just randomly pick an oncologist? or do you specifically find the doctor with best review or something like that?

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@jamineibs

I truly beg you and everyone to get a second opinion. Different doctors and surgeons treat differently. You need to be armed with as much information as possible to understand all options and possibilities so you can make a good decision about what is best for you!
Long story alert!
I turned 50 this year and lead a very active lifestyle, I had no symptoms. I have a family history of heart disease so had undergone a CT for calcium score and they saw one of the my ground glass nodules (upper left lobe about 11mm) which was called out on the CT report to follow up with Pulmologist. After follow up CT 12/2020 finding 4 nodules, largest 11 mm - the Pulmonologist and primary, “most of the time these are nothing, but could be a slow growing cancer - need to follow).
Another CT 6 months, upper left lobe nodule change to 13 mm (1.3cm) and another small one popped up in that lobe too. Do you want to do a lung needle biopsy on that tumor or wait and see what happens in another 6 months. I opted for the needle biopsy - performed by my pulmonologist. Super scary going in, but it wasn’t a terrible procedure and we got the biopsy and identified the cancer. I understand this was a very small tumor to do a needle biopsy they stated the others are just too small to do needle biopsy or in location that is not good for that either.
Definately get second and/or third opinions. You need to be comfortable throughout the entire process, you will not have regrets if you are well informed and feel that you have the best care. My first oncologist was great and because of that I would have his recommendation/opinion, but luckily I met with each specialty department also to learn about my options. The thoracic surgeon said lobectomy did not present other options and really wanted to do it that week ahead of their team meeting to discuss my case and present findings. I am not a super religious person, but I have. I doubt there was a higher power involved in lighting and guiding the path to second opinion. I got in to Mayo and am so grateful I did.
After meeting with everyone except the thoracic surgeon I had decided I’ll do proton beam radiation. My goal was to preserve as much lung capacity as possible because I have these other nodules to think about too. I am not ready to slow down any time soon. Then I met with Dr. Shen, Mayo Thoracic surgeon and all but told him, I don’t need you I’ve made up my mind. We talked anyway, he declared he wouldn’t consider taking the whole lobe at this point, he would do a wedge resection to preserve as much lung as possible - recognizing I am an active person and have other nodules to consider may need treatment someday. Hold the phone, you mean there is another option and not just take a lobe? About-face! Gave it a few days to marinate and moved forward with the surgery. I was so scared going in, I mean it’s a vital organ! The recovery was quick. With the approval from my medical team, i started lower body workouts about 4 weeks after surgery and at 6 weeks returned to High Intensity Interval training and jogging. I do notice a slight change in my breathing when exerted, but it has been getting better all the time. While I don’t want to go through the surgery again, knowing there is a strong likelihood, I want to be as healthy as possible.
I am blessed for now and try not to think about what these other nodules will do to me someday. I get a little anxiety now coming up to my scan in December, but truly trying to leave it alone and wait patiently.

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jamineibs Was really nice to hear your concerns and explanations. Am actually scheduled for wedge resection surgery tomorrow with the same surgeon. The testing and biopsies and were not fun, but felt the knowledge they provided was worth the discomfort. I've been following the Multiple lung nodule postings because this is the second nodule to be removed. This all started for me in 2019. Routine blood tests resulted in an Oncology referral and was a few weeks wait for the appointment locally. I called Rochester Mayo on a Monday, and was seen by a hematologist that Friday afternoon and completed a bone marrow biopsy and blood tests the same afternoon. The following Wednesday had an early morning CT and afternoon appointment with another Hematologist and was informed of my lymphoma diagnosis. The CT also found a lung nodule which resulted in a followup and biopsy showed adenocarcinoma Also started seeing an Oncologist, which resulted in a lobectomy procedure in Oct 2019.
But through all this, I sure have been very pleased with all the staff and Doctors at Mayo.

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@stanleykent

jamineibs Was really nice to hear your concerns and explanations. Am actually scheduled for wedge resection surgery tomorrow with the same surgeon. The testing and biopsies and were not fun, but felt the knowledge they provided was worth the discomfort. I've been following the Multiple lung nodule postings because this is the second nodule to be removed. This all started for me in 2019. Routine blood tests resulted in an Oncology referral and was a few weeks wait for the appointment locally. I called Rochester Mayo on a Monday, and was seen by a hematologist that Friday afternoon and completed a bone marrow biopsy and blood tests the same afternoon. The following Wednesday had an early morning CT and afternoon appointment with another Hematologist and was informed of my lymphoma diagnosis. The CT also found a lung nodule which resulted in a followup and biopsy showed adenocarcinoma Also started seeing an Oncologist, which resulted in a lobectomy procedure in Oct 2019.
But through all this, I sure have been very pleased with all the staff and Doctors at Mayo.

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Wow! It sounds like it was destiny that settled you in with some very amazing medical professionals. Being in there expert care can allow us to relax a little.
Prayers for the best possible outcome tomorrow and a speedy recovery.

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@dongshiming

When you go to Mayo or MD Anderson for the 2nd opinion, do you just randomly pick an oncologist? or do you specifically find the doctor with best review or something like that?

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For my situation, as part of the initial request to be seen by Mayo Doctors they collected my medical records. After a review they placed me with a team that met my specific health care needs. The team consisted of Oncologist, Thoracic Surgeon, and Radiation Oncology. While at Mayo I also found a pulmonologist that I wanted to be part of my care, since my other pulmonologist was at the previous medical office. I made a request to his unit to be his patient and was accepted by him.

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@dongshiming

When you go to Mayo or MD Anderson for the 2nd opinion, do you just randomly pick an oncologist? or do you specifically find the doctor with best review or something like that?

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@dongshiming, you ask "Can I request a particular provider?" I can answer how it works at Mayo Clinic.
Appointment specialists are specially trained to match you with the provider or group that's the best fit for your diagnosis and medical history. But you may wonder if you can request a specialist that you've read about or who's been recommended by a friend or colleague. Mayo Clinic can't honor all requests, but we try to when possible.

You can read more on this page of Frequently Asked Questions https://www.mayoclinic.org/appointments/faq

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@merpreb

@felix536- You are getting very sophisticated testing already. Multiple lung lesions are all primary nodules that seem to begin as ground glass. What I would love is a test that would tell if the nodules are cancerous and should be treated, so others can be left alone! I have had a slew of nodules that have come and gone, and many little thingies hanging around, just taking up space.

Will you please join us in the Multifocal group?
https://connect.mayoclinic.org/discussion/multifocal-adenocarcinoma-of-the-lung-continual-recurrences/

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I have a ground glass lesion, and the Oncology Dr (specializes in Nodules!!) said biopsy is impossible as they are lacey along the edges and hard to get tissue from. They are watching it; I return in June. The followup PET scan showed an axillary lymph node issue, though, and not the lesion. I had the lymph node "punch" biopsied a couple months ago but now the Dr wants an excision biopsy where they remove it. I have to arrange with the GP. Having another followup thyroid CT.

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@marye2

I have a ground glass lesion, and the Oncology Dr (specializes in Nodules!!) said biopsy is impossible as they are lacey along the edges and hard to get tissue from. They are watching it; I return in June. The followup PET scan showed an axillary lymph node issue, though, and not the lesion. I had the lymph node "punch" biopsied a couple months ago but now the Dr wants an excision biopsy where they remove it. I have to arrange with the GP. Having another followup thyroid CT.

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Please let us know what you learn, Mary.

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I will; it is a journey. They said it looks extremely slow growing.

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