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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@stellerjohn

3 yrs in row CT scan , first time 9 mm solid ,18mm cloudy nodule.
Dr treatment is antibiotics for 1 week thinks infection..
3 more months CT to see if gone

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What are % of cancer in 9mm nodule

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@stellerjohn

What are % of cancer in 9mm nodule

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Hi John, thank for the additional information. I think you’ll find this information from Veterans Affairs to be really helpful in answering some of the questions you have:
- Small Lung Nodules: What You Need to Know https://www.prevention.va.gov/docs/NodulesWhatYouNeedtoKnow.pdf

The article states:
“A nodule is generally considered small if it is less than 9 mm.”
“ Should I worry that I have a small nodule?
Usually a small nodule (less than 9 mm) is not a cancer, but it still could be an early cancer. The best ways to tell if a small nodule is possibly cancer are by:
1. Seeing how it looks on the LDCT scan, and
2. Seeing whether it grows over time.”
“ Most small nodules are not early lung cancer. Fewer than 5 percent of small nodules, or 5 out of 100, turn out to be cancer.”

I can imagine that you’re concerned. But it is comforting to know that 9mm is still considered small and that 95% of small nodules are not cancer. It’s also good that this was discovered and that your doctor is monitoring the situation closely. I’d like to bring @merpreb and @sueinmn into this conversation as they have experience with lung nodules and can perhaps help with what questions you might want to ask your doctor.

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@colleenyoung

Hi John, thank for the additional information. I think you’ll find this information from Veterans Affairs to be really helpful in answering some of the questions you have:
- Small Lung Nodules: What You Need to Know https://www.prevention.va.gov/docs/NodulesWhatYouNeedtoKnow.pdf

The article states:
“A nodule is generally considered small if it is less than 9 mm.”
“ Should I worry that I have a small nodule?
Usually a small nodule (less than 9 mm) is not a cancer, but it still could be an early cancer. The best ways to tell if a small nodule is possibly cancer are by:
1. Seeing how it looks on the LDCT scan, and
2. Seeing whether it grows over time.”
“ Most small nodules are not early lung cancer. Fewer than 5 percent of small nodules, or 5 out of 100, turn out to be cancer.”

I can imagine that you’re concerned. But it is comforting to know that 9mm is still considered small and that 95% of small nodules are not cancer. It’s also good that this was discovered and that your doctor is monitoring the situation closely. I’d like to bring @merpreb and @sueinmn into this conversation as they have experience with lung nodules and can perhaps help with what questions you might want to ask your doctor.

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Thank you very much. If it is as a result of infection ( Amoxicillin treatment) will it disappear 3 months later in CT..
I am a former smoker,10 yrs ago, will that affect my percentages.?

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@colleenyoung

Hi John, thank for the additional information. I think you’ll find this information from Veterans Affairs to be really helpful in answering some of the questions you have:
- Small Lung Nodules: What You Need to Know https://www.prevention.va.gov/docs/NodulesWhatYouNeedtoKnow.pdf

The article states:
“A nodule is generally considered small if it is less than 9 mm.”
“ Should I worry that I have a small nodule?
Usually a small nodule (less than 9 mm) is not a cancer, but it still could be an early cancer. The best ways to tell if a small nodule is possibly cancer are by:
1. Seeing how it looks on the LDCT scan, and
2. Seeing whether it grows over time.”
“ Most small nodules are not early lung cancer. Fewer than 5 percent of small nodules, or 5 out of 100, turn out to be cancer.”

I can imagine that you’re concerned. But it is comforting to know that 9mm is still considered small and that 95% of small nodules are not cancer. It’s also good that this was discovered and that your doctor is monitoring the situation closely. I’d like to bring @merpreb and @sueinmn into this conversation as they have experience with lung nodules and can perhaps help with what questions you might want to ask your doctor.

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Despite having a ground glass nodule, the Dr told me it is not a cancer diagnosis yet. The whole thing is unnerving, so try not to ruminate too much and do the good things for yourself. I have another CT in March.

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@colleenyoung

Hi John, thank for the additional information. I think you’ll find this information from Veterans Affairs to be really helpful in answering some of the questions you have:
- Small Lung Nodules: What You Need to Know https://www.prevention.va.gov/docs/NodulesWhatYouNeedtoKnow.pdf

The article states:
“A nodule is generally considered small if it is less than 9 mm.”
“ Should I worry that I have a small nodule?
Usually a small nodule (less than 9 mm) is not a cancer, but it still could be an early cancer. The best ways to tell if a small nodule is possibly cancer are by:
1. Seeing how it looks on the LDCT scan, and
2. Seeing whether it grows over time.”
“ Most small nodules are not early lung cancer. Fewer than 5 percent of small nodules, or 5 out of 100, turn out to be cancer.”

I can imagine that you’re concerned. But it is comforting to know that 9mm is still considered small and that 95% of small nodules are not cancer. It’s also good that this was discovered and that your doctor is monitoring the situation closely. I’d like to bring @merpreb and @sueinmn into this conversation as they have experience with lung nodules and can perhaps help with what questions you might want to ask your doctor.

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Let me show everything; I'm 82, 10 yrs ago smoker, COPD now ,but doing well on sprays ..
Are my chances worse ?

REPLY
@colleenyoung

Hi John, thank for the additional information. I think you’ll find this information from Veterans Affairs to be really helpful in answering some of the questions you have:
- Small Lung Nodules: What You Need to Know https://www.prevention.va.gov/docs/NodulesWhatYouNeedtoKnow.pdf

The article states:
“A nodule is generally considered small if it is less than 9 mm.”
“ Should I worry that I have a small nodule?
Usually a small nodule (less than 9 mm) is not a cancer, but it still could be an early cancer. The best ways to tell if a small nodule is possibly cancer are by:
1. Seeing how it looks on the LDCT scan, and
2. Seeing whether it grows over time.”
“ Most small nodules are not early lung cancer. Fewer than 5 percent of small nodules, or 5 out of 100, turn out to be cancer.”

I can imagine that you’re concerned. But it is comforting to know that 9mm is still considered small and that 95% of small nodules are not cancer. It’s also good that this was discovered and that your doctor is monitoring the situation closely. I’d like to bring @merpreb and @sueinmn into this conversation as they have experience with lung nodules and can perhaps help with what questions you might want to ask your doctor.

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Have Sue & Merp commented?

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@stellerjohn

Have Sue & Merp commented?

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Hello - Sorry for the delay - I ran out of battery last night and never saw all the posts.
I don't have any experience with lung cancer, but I have had small nodules, in my case related to a mycobacteria infection. If the amoxycillin doesn't resolve the "ground glass" please ask them to culture your sputum, and see if you have an infection that requires a different antibiotic. People with COPD are susceptible to many different types of lung infection which can be treated.
Do you have a return appointment scheduled?
Sue

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@sueinmn

Hello - Sorry for the delay - I ran out of battery last night and never saw all the posts.
I don't have any experience with lung cancer, but I have had small nodules, in my case related to a mycobacteria infection. If the amoxycillin doesn't resolve the "ground glass" please ask them to culture your sputum, and see if you have an infection that requires a different antibiotic. People with COPD are susceptible to many different types of lung infection which can be treated.
Do you have a return appointment scheduled?
Sue

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Yes. Dr treated me with Amoxicillin for infection, she thinks the cloudy look of nodule is prior infection, then 3 months a CT again.
As a COPD patient and former smoker,10 yrs ago , she says % is still low, not 5% .

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@marye2

You have been so helpful! This is all new to me, although I have been through it with an autoimmune disease. I have another CT in March, and feeling good about the team. I am a little Dr fatigued, but keeping on with appointments. I'm going to PCP next week to arrange for axillary lymph node excision (it showed on petscan, where the ground glass did not!) I have I found several articles, not peer reviewed, linking thyroid nodules to low Vit D. hmmm.

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Good morning Mary- I'm sorry to be a bit late in responding. I'm struggling with a migraine that won't leave me alone. I'm so glad that you are so quick on your feet to deal with each step that needs to be dealt with. It's difficult to be organized when there are things coming at you like a scud missile. I love my team too. One thing that makes me feel good about them is that they listen to me and include me in decisions and the reasons. They are also open-minded to ideas "outside" the box.

I have learned that the internet can be a scary place for information. I think that basing our judgments on peer-reviewed tests is the best way to go. I think that discussing a link between thyroid nodules and vitamin D with your new PCP is a smart decision since there have been lots of studies that show a link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618598/

Have you seen these peer-reviewed studies?

I know what you mean about doctor fatigued. What I do, when I can get away with it and when there is nothing "urgent" going on is to schedule appointments further apart or try to get more than one appointment on the same day.

Have a wonderful New Year and I really do look forward to talking to you soon.

Merry

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@colleenyoung

Hi John, thank for the additional information. I think you’ll find this information from Veterans Affairs to be really helpful in answering some of the questions you have:
- Small Lung Nodules: What You Need to Know https://www.prevention.va.gov/docs/NodulesWhatYouNeedtoKnow.pdf

The article states:
“A nodule is generally considered small if it is less than 9 mm.”
“ Should I worry that I have a small nodule?
Usually a small nodule (less than 9 mm) is not a cancer, but it still could be an early cancer. The best ways to tell if a small nodule is possibly cancer are by:
1. Seeing how it looks on the LDCT scan, and
2. Seeing whether it grows over time.”
“ Most small nodules are not early lung cancer. Fewer than 5 percent of small nodules, or 5 out of 100, turn out to be cancer.”

I can imagine that you’re concerned. But it is comforting to know that 9mm is still considered small and that 95% of small nodules are not cancer. It’s also good that this was discovered and that your doctor is monitoring the situation closely. I’d like to bring @merpreb and @sueinmn into this conversation as they have experience with lung nodules and can perhaps help with what questions you might want to ask your doctor.

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Welcome, John, to Mayo Clinic Connect. I'm sorry that it has taken me so long to respond. It is indeed harrowing to learn that something unexpected is growing in your body. The only thing that I can tell you is that to take one thing at a time. I don't know much about your medical history so I have a couple of questions to help me know what is going on.

First, I am a 24-year lung cancer survivor with a history of many treatments. I have had 2 types of lung cancer. I am treated at a major teaching hospital in Boston.

What brought you to getting care for a doctor's visit? Many lung lesions under 9mm are not considered cancerous. There are different types of cancer and having a CT scan is the first scan that will help determine what is going on in your chest. I glimpsed a hint that you are on an antibiotic and already have a CT planned?

What is the date of your CT? If you have an infection then it should pretty much show up an improvement. If there is something else going on that is not based on a bacteria then further testing is needed, hence the CT scan.

I agree with Sue that having your sputum tested is a good idea. Have you had this done?

I smoked for 35 years. Smoking is the leading cause of lung cancer but if you have lungs you can get lung cancer.

WHat kind of doctor is ordering the tests? DO you know him/her and do you like him/her?

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