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

Welcome, @aahlrichs. I can understand that you're concerned. Being told that you have a 13mm lung nodule is worrisome and you have a family experience with lung cancer. Most lung nodules (95%) aren't cancerous. Read more here: https://www.mayoclinic.org/diseases-conditions/lung-cancer/expert-answers/lung-nodules/faq-20058445

I moved your question to this existing discussion where @felix536 was asking similar questions as you are today:
- Multiple lung nodules: Might they be noncancerous? What next? https://connect.mayoclinic.org/discussion/multiple-lung-nodules/

I did this so you can read the previous helpful posts and connect easily with other members like @merpreb @sueinmn @vic83 @marye2 and others.

Often, active surveillance is the first step and a new CT scan ordered in 3 to 6 months to see if it is growing. Sometimes, with nodules over 12mm further testing such as a PET scan or biopsy will be ordered.

@aahlrichs, may I ask why the CT scan was ordered that found the nodule? Nodules rarely cause symptoms. Were you having symptoms or was the CT scan for something else?

Your concern is understandable. My mother died at age 58 from lung cancer and my cousin on my mother's side at 54 of the same. You mentioned "My family physician wants to take a watch and see approach". Is that a Family Medicine or Internal Medicine doctor? If so, and your insurance allows you, seek out a Specialist (Pulmonologist). Check their background and look for one that treats lung nodules and/or lung cancer because not all of them do. Have you read the radiologist's report? Those reports can contain recommendations on follow up. I had an abnormal chest x-ray at urgent care and the report recommended a CT scan. I made an appointment directly with Pulmonologist and skipped my primary care provider- the CT scan report recommended PET scan. I did have lung cancer. My only symptom was recent shortness of breath which could also be attributed to a heart issue. I always look for a specialist for specific health issues. Medicine is a large subject, and it is important to see the knowledgeable experienced doctor with the right training.

Thank you so much for the information. I truly appreciate it. I had CT for my heart..I had high cholesterol.
You stated a statistic of 95%, but that is not for nodules over 10mm. Unfortunately its much lower percentage. Everything I have read and as you stated, it should be biopsied or have a PET scan but for some reason my physicians want to wait. Even with my family history. 🤔 So if the national standard is to have the tests why are they so hesitant??

Thank you! It was my primary Dr. I’m going to ask her to refer me to a pulmonologist. But you know how mayo is..it will probably be months before I can get in. And the report stated wait 3 mos and do another ct scan..but that person doesn’t know my family history! So frustrating.

My mother also died from lung cancer at age 56, in 1973. Long time smoker, had a lot of pneumonia over the last years of her life. I have MCTD, so they keep watch and the first CT showed nodules and for about a year, it was a lot of testing, including a pet scan. But the followup CT showed no growth, so waiting until Jan of 2024 to return to the oncology pulmonologist. I am glad to have someone knowledgeable who has a sense of how serious this is. I have several nodules under 5mm and one ground glass at 1.5mm. I really was worried for awhile, after Covid, but breathing is pretty good. I hope that the greater technology these days will help you out on this.

I am at a teaching hospital, so the doctor who ordered the CT (rheumatologist) sent me to the pulmonologist in oncology quickly when some were found. They really "hooked" me up quickly with the people I needed to see. I had one biopsy in a lymph node, which showed nothing. They wanted to do a resection, but I declined since it was just one node. Drs concurred. They thought it was perhaps from getting a recent vaccination in that arm. I am also now taking D3, which is thought to affect nodules.

aahrichs
For me, I had a three month interval after my first CT to monitor a smaller nodule. At three months it was larger and a biopsy confirmed cancer, then a PET, and had surgery.
I'm not sure where you are located, but depending on their schedule/workload, Mayo can see people pretty quickly. For me, this all started a couple years ago, My doctor say some abnormal blood tests and referred me to a local oncology group and had to wait 3+ weeks for an appointment. On my own, I called Mayo on a Monday and received an appointment that Friday. Since then, I've had many appointments, and another surgery. In my opinion, making that first call to Mayo was the best thing I ever did. But there are many great doctors and facilities. Find what works for you and your family.

For me this has been stressful and expect it is for you and the family and am wishing you the best outcome possible, Colleen has provided a number of links to other connect conversations and encourage you to also look further at the connect website for other related podcasts and webinars. Let us know if you have questions and keep us updated. Good luck

It all depends on your insurance. If you cannot self-refer, I would certainly be insistent with your Primary Care doctor about seeing a Pulmonologist.
Regarding Mayo, they can move things along when they think it is the case. I sent my CT and PET scans (they want the actual scans not the report so be sure your doctor puts in the request to do that) and I was called the next morning by the Mayo Pulmonologist.
My x-ray said wait 6 weeks to do another x-ray and then CT scan, but I had local Pulmonologist order CT scan immediately. I read those reports and looked my local Pulmonologist in the eye and said I was going to Mayo. They were not happy, but I have original Medicare and pay mucho money for my Medigap insurance. I learned that it is very important to understand exactly what type of treatments are available and if your clinic/provider is capable of providing all options. My local clinic could not do VAT surgery for example. Also, the local Pulmonologist wanted to do a needle biopsy on the largest area, but their Radiologist refused to do it. He said that it was too risky, and he could not get enough sample tissue.
Mayo offered me surgery immediately and said 80% chance cancer. They did bronchial biopsy and VAT surgery together. Also, the first local CT scan only picked up two areas of concern. Mayo CT scan prep for surgery identified other nodules – they set their machines to do this. So, I was diagnosed with multifocal adenocarcinoma. They took out the largest area which was cancer and now I sit back and wait to see what the other nodules do. The area in the left lung which also lit up on the PET scan has not changed in 10 months and could still be scarring and not cancer. The other nodules in the right lung are part solid and ground glass. They don't want to do needle biopsy.

Thank you! It is stressful but my faith keeps me calm. ♥️ All I can do is keep looking for answers and praying.

PS - Mayo wants to see the actual scans and x-rays. I had to do an x-ray a few weeks after my VAT surgery, and Mayo gave me the order to do it locally. The local provider issued a written report, but Mayo evaluated and issued its' own report on that x-ray!