Growing Lung Nodule Questions

Posted by Denise @azmn, Sep 4, 2022

Hello, my name is Denise and I am a recurrent metastatic ovarian cancer survivor. Before going on maintenance therapy, I had a chest CT and they found a nodule.

We decided it was best to wait and rescan in 3 months. Over the past 9 months, the nodule keeps growing.

I have had 2 biopsies and both were inconclusive. I have been told it's not cancerous and that's a load off my mind because I lost my dad to metastatic lung cancer.

I have had 90 days of fluconazole and it didn't make any difference at all. I am thinking the nodule is small in size (17mm x 12mm).

Long story short, because it's growing, they want to remove it. I am thinking a PET would be more appropriate to see if there's any uptake.

What do you think I should do?

Much gratitude
Denise

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@azmn

Hello, thank you everyone for your feedback.

I wanted to provide the outcome and next steps of my post for closure.

I had lung wedge resection surgery and they remove the wedge with the nodule (upper left lung). The surgeon followed suit with previous pathologies of it’s some type of infection that’s causing the growth to continue. Then I got the final pathology report and it’s totally different. This has made me believe it’s the only way to go from now on.
Pathology results: Mass forming pulmonary venous infarction described in the setting of chemotherapy treatment. Elastic trichrome staining highlights the area of pulmonary venous infarction as well as multiple pulmonary
veins with occlusive thromboemboli.

My medical oncologist had an e-consult with hematology oncologist and it was highly recommended to start on an anticoagulant for the rest of my life.
I have decided to give it a go.

I have ovarian cancer and have been on chemo for almost 3 years. However, due to the results, I’ve decided to stop all chemo.

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Denise-This must have been a very difficult decision to make. Essentially you are deciding to protect your heart but taking a chance on your cancer, I think. What led you to this decision?
Have you thought about a second opinion at a different hospital?

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@azmn

Hello, thank you everyone for your feedback.

I wanted to provide the outcome and next steps of my post for closure.

I had lung wedge resection surgery and they remove the wedge with the nodule (upper left lung). The surgeon followed suit with previous pathologies of it’s some type of infection that’s causing the growth to continue. Then I got the final pathology report and it’s totally different. This has made me believe it’s the only way to go from now on.
Pathology results: Mass forming pulmonary venous infarction described in the setting of chemotherapy treatment. Elastic trichrome staining highlights the area of pulmonary venous infarction as well as multiple pulmonary
veins with occlusive thromboemboli.

My medical oncologist had an e-consult with hematology oncologist and it was highly recommended to start on an anticoagulant for the rest of my life.
I have decided to give it a go.

I have ovarian cancer and have been on chemo for almost 3 years. However, due to the results, I’ve decided to stop all chemo.

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I'm wondering what led to the decision to stop chemotherapy? You must be so very overwhelmed with ovarian cancer, treatment, and now this.

It's good that your medical oncologist consulted with the hematology oncologist. Was it their recommendation that you stop the chemotherapy because there is a direct association with pulmonary embolism?

I'd like to provide support for whatever your decision is. When do you next see your medical oncologist?

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@colleenyoung

@azmn Denise, I’m tagging @merpreb and @naturegirl5 on this message too because I think they’ll appreciate getting the update as I did.

Am I understanding the report correctly that the chemo treatment may be causing the pulmonary infarction and that it was recommended to stop chemo at this time? Or forever?

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Hi. I've had "pneumonia " twice in summer. Collapsed at home in Aug. Sent home after 10 days (6 of those in ICU) and collapsed again 2 weeks later with sepsis as well as lung issue. Intubated, bronchoscopy, echocardiogram, lots of blood work, ct scans. No diagnosis. No symptoms leading up to collapsing. Drs guessing severe pneumonia or Interstitial lung disease. Healing well now, ground glass opacities are shrinking and swollen fibers shrinking. Ct done on Dec 9 saw "non specific lymph node" nearer to trachea. Is this how your condition began Denise? Has anyone had a non specific lymph node?
I'm waiting to see a pulmonologist and my doctor just doesnt know.
Anyone had this? Thank you 🙂

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@yvonne55

Hi. I've had "pneumonia " twice in summer. Collapsed at home in Aug. Sent home after 10 days (6 of those in ICU) and collapsed again 2 weeks later with sepsis as well as lung issue. Intubated, bronchoscopy, echocardiogram, lots of blood work, ct scans. No diagnosis. No symptoms leading up to collapsing. Drs guessing severe pneumonia or Interstitial lung disease. Healing well now, ground glass opacities are shrinking and swollen fibers shrinking. Ct done on Dec 9 saw "non specific lymph node" nearer to trachea. Is this how your condition began Denise? Has anyone had a non specific lymph node?
I'm waiting to see a pulmonologist and my doctor just doesnt know.
Anyone had this? Thank you 🙂

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@yvonne55- Hello! My goodness, have you been through a lot! I am very glad that you are doing better. Lung nodules are small clumps of cells in the lungs. They're very common. Most lung nodules are scar tissue from past lung infections. Lung nodules usually don't cause symptoms. They're often found by accident on a chest X-ray or CT scan done for some other reason.

I am hoping that your non-specific lymph node just turns out to be a part of healing. All medicine is double edge swords. If you have a symptom and you have a scan you can see something that you might not want to see. I can't tell you how many times my CT's have picked up scary things that turned out not to be a worry, except for me!

How is your breathing? Do you need oxygen at home?

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@merpreb

@yvonne55- Hello! My goodness, have you been through a lot! I am very glad that you are doing better. Lung nodules are small clumps of cells in the lungs. They're very common. Most lung nodules are scar tissue from past lung infections. Lung nodules usually don't cause symptoms. They're often found by accident on a chest X-ray or CT scan done for some other reason.

I am hoping that your non-specific lymph node just turns out to be a part of healing. All medicine is double edge swords. If you have a symptom and you have a scan you can see something that you might not want to see. I can't tell you how many times my CT's have picked up scary things that turned out not to be a worry, except for me!

How is your breathing? Do you need oxygen at home?

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Well hello! My breathing is very good. I didn't realize how badly a body can decondition! I was mostly on rest from aug 25 to about nov 22. That's when a temp doctor replaced mine briefly and said get up girl!! My pulse used to be 125-140 just going to the washroom 02 would fall down to 88. So I was scared to move! One day I just had enough and started doing small things....
Now I'm doing housework, I vacuumed today, scrubbed the toilet, laundry etc. I've been building up to this, didnt go nuts in one day. Been grocery shopping and carrying the bags in the house. Last night brushing snow off my car. I am driving again! They determined in hospital I didn't need home 02 but I swore I did. I couldnt take a full breath and felt only half my lungs were expanding. For awhile my 02 said 96 but I had dyspnea. It felt awful. It just kinda went away.
I'm still terrified of a repeat illness because I was doing all these things even in the minutes before my lungs quit on me. When I use that little machine with the ball in it? I can get it to the middle section where the happy face is and get it up to the 3000 point.
I pray this nightmare is over. I feel very lucky!

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@yvonne55

Well hello! My breathing is very good. I didn't realize how badly a body can decondition! I was mostly on rest from aug 25 to about nov 22. That's when a temp doctor replaced mine briefly and said get up girl!! My pulse used to be 125-140 just going to the washroom 02 would fall down to 88. So I was scared to move! One day I just had enough and started doing small things....
Now I'm doing housework, I vacuumed today, scrubbed the toilet, laundry etc. I've been building up to this, didnt go nuts in one day. Been grocery shopping and carrying the bags in the house. Last night brushing snow off my car. I am driving again! They determined in hospital I didn't need home 02 but I swore I did. I couldnt take a full breath and felt only half my lungs were expanding. For awhile my 02 said 96 but I had dyspnea. It felt awful. It just kinda went away.
I'm still terrified of a repeat illness because I was doing all these things even in the minutes before my lungs quit on me. When I use that little machine with the ball in it? I can get it to the middle section where the happy face is and get it up to the 3000 point.
I pray this nightmare is over. I feel very lucky!

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Oh @merpreb one side note...I do notice that first thing in the morning and at bedtime I can hear (but barely audible) pops and high crackles when I breathe in. When I cough, they stop for a few breaths. Dr said " just mucus". But in hospital they were concerned about these crackles. Mucus is lessening but cough was dry and non productive from the beginning. Thank you Merry!

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@yvonne55

Oh @merpreb one side note...I do notice that first thing in the morning and at bedtime I can hear (but barely audible) pops and high crackles when I breathe in. When I cough, they stop for a few breaths. Dr said " just mucus". But in hospital they were concerned about these crackles. Mucus is lessening but cough was dry and non productive from the beginning. Thank you Merry!

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@yvonne55- Let me answer both of your replies to me in this post. After all of your hospital visits due to what most likely was pneumonia, I do not think that doctors would have released you to bed rest unless they told you this.

After all the hospitalizations that I have had, not one nurse or doctor suggested bed rest for me. They made me get up and walk around the hospital floor. Weren't you made to do this? They said get up and move! You can make yourself ill just by staying still. Lungs take a while to heal. From your report, it looks as if you were pretty ill so your lungs were quite inflamed.

I also suggest that you get a referral to a pulmonologist who can trace your recovery, prescribe inhalers if needed and refer you to pulmonary rehab. It is truly a lifesaver. Exercising will also take your mind off of every little muscle twitch and lung cackle. Having your lungs injured by a "bug" and having strange machines breathe for you is very scary. I hear you. I went through something similar. But your job now is to live. Do everything possible to live your life to the fullest so that you don't have to be in ICU ever again. What do you think?

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@merpreb

Denise-This must have been a very difficult decision to make. Essentially you are deciding to protect your heart but taking a chance on your cancer, I think. What led you to this decision?
Have you thought about a second opinion at a different hospital?

Jump to this post

I'm just checking in to see how you are.

Merry

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Hi Merry! I say let's do this! After being in a strange city and hospital on life support for my bronchoscopy and tests and sent back to my local hospital for more recovery, I was told to sit up as much as possible, toilet myself and rest rest rest.
I had a hard time breathing as it felt with each inhale, my lungs only got half full. I got a puffer but only needed it twice. I have a cpap and a bed wedge so sleep almost sitting up! I'm quite active now. This morning finished Christmas shopping, carrying 2 cases of soda through the snow into the house. Not even breathless. Yes I worry when I hear a crackle or see my 02 sats are 93 but yesterday were 99. I had no fever, no flu, no chills, no fatigue prior to collapsing and there being no air. No phlegm and a normal white blood cell count. It just didnt spell pneumonia to me.
I thought aspiration pneumonia because I have GERD and every night woke choking on acid. But drs said aspiration happens to stroke victims or people who cant swallow well. But yes no more ICU!!!!!

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Hi Colleen, it is true that the chemo caused the pulmonary infarction. They removed it and now I am taking Lovenox two times a day for 3 months and then another drug for the same prevention.

On the upside, I had medical reason to stop chemo and that helped those who didn't want to support me in my decision.

Happy Holidays!

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