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

Hi Registrar. I am not sure what you mean by a "pleural based nodule". I have multifocal adenocarcinoma (lung cancer). I have multiple nodules at various "life stages" (size and solid, part solid). There are several of us on Connect with this type of lung cancer. They start out as "ground glass" opacity and eventually if they become solid, they are treated. Treatment options depend on where they are located in the lung and if they have gone to the lymph nodes. Since Dec 2021 I have had two VAT wedge resections (surgery) and one round of SBRT (radiation). Total of 3 nodules treated. Fortunately, my lymph nodes have been negative, so I have not needed any chemotherapy.
I had a case of pleurisy-fluid which fortunately resolved itself. It shrank on its' own, cause unknown. Had it not resolved itself, there would have been concern that cells from the previous surgery had fallen there.
I am under close observation now because I also had STAS (spread through air space) for one nodule, it shed cells in the lung.
Look for a Pulmonologist experienced with lung cancer in a center able to provide all types of treatment options including video assisted thoracic surgery.
How long have they been tracking your nodules? Has there been any growth? I would tell them if I were not comfortable with too long a period.

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I am starting tests (CT, PFT, etc) for my eighteen month checkup on lung nodules. I also had one ground glass one last time around; but nothing had grown within the first six months. I do not perceive any symptoms. I am now on D3, and there was an NIH article on low D3 being a possible cause of nodules. In any case, this whole process can be unnerving, but other comments have been reassuring on this journey.

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Can you PLEASE tell me your experience with SBRT? IM being told there are no side effects. Also, bcuz I have a blood disorder my non small cell was diagnosed by appearance...no biopsy. I was told I needed the SBRT because of how close the 1.8 cm is to my blood vessels and that I may begin to bleed in a year or two which is "rare but bad"

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@etb2 - Let's define "pleural-based nodule"- Nodules in the pleural cavity (the pleura includes two thin layers of tissue that protect and cushion the lungs. The inner layer (visceral pleura) wraps around the lungs and is stuck so tightly to the lungs that it cannot be peeled off. The outer layer (parietal pleura) lines the inside of the chest wall.

SBRT does not have side effects like a pill might. However, burning, such as sunburn, can take place where the rays are directed. Fatigue is a side effect and the amount of fatigue, the length of time, the number of days, and the dosage of the beams will determine how tired you will be, along with your physical stamina.

I remained fatigued for quite a while.

Your lungs will likely react with some swelling as these rays are meant to for setruction and are strong. You might have a cough bad lung irritation, or pneumonia. I did, and I had to take a strong antibiotic and prednisone for a few months.

This was my third use of SBRT. My lungs, after 25 years of treatments, are very sensitive. My reactions were rather extreme. But not having all the side effects of chemo was also a relief.

If I were you I would get a second opinion. By the way, a biopsy is seldom done with SBRT because whoever set up the regulations thought that if you are killing the cells what difference does it make if they are cancerous or not?

I haven't looked to see if you had a CT or PET. If your PET lit up then your tumors are most likely cancerous.

SBRT does have side effects.

Merry

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. INSTEAD, Thanks Merry, Finally, some answers! The nodule, which I'm told is located deep in the upper part of the left lung and close to blood vessels has doubled in size in the last 4 months. The CT Scan was combined with a pelvic CT ordered by my Nephrologist and read by the same radiologist, if that makes any difference. I'm just really freaked out because, since then, I haven't been able to contact ANY of my team, let alone my radiologist oncologist. What I got was several calls from scheduling telling me the CT Mapping scheduled for the 12th was off as was the SBRT. Instead I was to come in a week later, have a regular CT and a consultation with the radiation oncologist immediately after. he had told me this was the slowest growing lung cancer. He had told me I had 4 to 6 years to live if I didn't have the SBRT. I don't want to have it bcuz he said there was a rare chance that a year or two after the SBRT I could start to bleed which would be bad. Very bad for me bcuz I have polycethemia and, although my blood is thick, I usually require a trip to the ER or doctor for a few more stitches after I get home from even minor surgery. I don't know what to think. This doctor is my second opinion. But can you tell me about the bleeding a year or 2 after the SBRT? Have you heard of that.?

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@etb2- I'm sorry that you have had such a difficult time with your team. I've not heard of bleeding with SBRT and polycythemia vera, especially 2 years out from the radiation.

There are no incisions with this type of radiation. The radiation, the "rays" go through your skin. You feel nothing during the sessions. Nothing at all.

Did the doctor tell you the name of the cancer?

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Non small cell lung cancer (adenocarcinoma)

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Regarding my experience with SBRT, it is now three weeks and I have had zero side effects.
I have read that SBRT is typically between 3 to 5 sessions. In my case, they could do in three sessions in three consecutive days, maybe 20 minutes a session. My skin did not burn or even become red. I cannot tell where the radiation went. I did not notice any extra fatigue - I am still recovering from surgery in May so I deal with shortness of breath, nerve numbness.
Doctors did advise me that with radiation there is the risk of bone thinning and potential skin cancers. So, I will just be attentive for that in the future. Especially because I expect to do additional treatments for other nodules.

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I want to thank those who commented. I don't mean to sound angry but I guess I am in a way...I wasn't told SBRT could cause bleeding cuz of the polycethemia. I was told it could just cause it a year or two after the SBRT. The polycethemia and the way I bleed would just be a complicating factor.

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