Is a Spiculated lung nodule always malignant?

@363
I recently had my first follow-up scan after 6 months, and all nodules were stable. So my next scan will be in another 6 months.
I always took comfort that if nodules are stable for some years we can most definitely assume that they are benign but unfortunately I've come across a lot of cases where people's nodules were monitored for several years and declared benign, but years later they grew and turned out to be cancerous.
That realization lefts me very concerned.
Given that I have a spiculated nodule, I think it's just a waiting game for it to grow and confirm to be malignant. The uncertainty is just the worst.

I had a nodule in my left upper lobe..it was 9mm and had some worrisome characteristics but they didn’t want to do a biopsy due to the size..I had regular ct scans for 3 years and it started growing in 2020, a 2nd nodule popped up beside the first one so they decided to think out the lobe.. I had numerous lymph nodes removed and they didn’t find any cancer so no chemo. I had a second nodule removed about a year and a half later but this time they just removed the nodule.. I have another nodule that has all the signs of cancer but it hasn’t changed since 2019 and they referred to it as a “indolent nodule”and my research said that these type of nodule can stay with you forever and not develop into anything harmful..I would rather have it removed…I think some people have nodules that never became cancer and they just keep a watch for any changes..it’s much better today with all the new technology that can allow for early detection and we will hopefully benefit from them until they find a better way for us to survive

@tracy76, I'm so sorry to hear what a rough time you've had and continue to have. I hope you are able to find some peace. It's so hard to see past all the pain and fatigue. Do you have the support of family, or friends? Are you under the care of a doctor, do they have treatment suggestions for you, or are they continuing to monitor the nodules and other health issues?

I have had a nodule followed for 2-3 years. This spring it had grown a little and looked like adenocarcinoma. Had biopsy that confirmed that diagnosis. Stage 1. Just finished radiation. Supposed to be curable. Another scan in 3 months.

@tracy76
You must feel very weak with all your separate illnesses. I know the feeling.
Do you have a gastroenterologist that follows you for your abdominal problems including the hernia?
I was born in Sweden so I know what National Health Insurance is like. My daughter lives there now and is fighting the system.
I hope you don’t have to wait to hear from the cancer clinic. Call and remind them.
Can anything be done about your sliding hernia so you can eat again? You need to add some pounds to help fight everything.

@tracy76, I'm so glad that you have family around you. Your husband must feel so helpless, when he likely just wants to make things better. It sounds like you have had a hard but full life! You've accomplished so much in your 47 years! I have to agree with Ingegerd. You need to get your strength up and put some weight back on. I'm not sure if you have access to a dietician, but they may be helpful with suggestions on how to ingest some nourishment, or other methods that may help. Have your doctors had suggestions for getting some nutrients into your body?

@tracy76, I'm sorry that they didn't have more ideas for you. If you continue to feel this way while waiting for the appointments, don't hesitate to reach back out. The weight loss is concerning.
Mayo Connect is a public forum. Others can view the posts. If you have specific concerns, you can send me a private message (using the envelope icon in the upper right of your screen), and I can see if the IT experts can help.

I’ve had a 5mm nodule on my right middle lobe for well over 12 years. In January I had a CT and it was 7mm so my doctor ordered a follow up ct for in July. I didn’t have it done till Thursday. I have a brand new spiculated nodule in lower lobe right. And it’s already 13x11mm. I got for a PET tomorrow and I am scared to death. My husband keeps saying I’m overreacting and it could be nothing. I’m a registered nurse and I know this is bad. Am I wrong?

@valerie131
Welcome to Mayo Connect!
I understand how scared you must be. I just went through similar myself.
Spiculated nodules don’t necessarily mean cancer- there are benign conditions that also appear spiculated.
The PET CT obviously will tell you what it is.
Don’t get yourself too panicky- if it is cancerous it is caught early. If you didn’t have to have another CT you wouldn’t have known.
I have had a pulmonary nodule followed for 3 years. It was only detected because I had a chest X-ray after treatment of pneumonia. It had been stable until this year. I had a CT in October last year- stable. This May I had CT angiogram prior to a TAVR procedure to get a new aortic valve. The nodule had grown and now had the appearance of an adenocarcinoma. After recovering from the heart surgery I had a biopsy early August, confirming adenocarcinoma. I had radiation in September, supposedly curative. I’ll have a follow up CT 3 months later.
I’m very lucky that it was found early. Try to think the same way. You will be able to handle anything coming your way. Being an RN means that sometimes you’ll know too much but you also understand the treatment if you need any.
I’m in the same position- retired Peds. I also had breast cancer 31 years ago- chemo and all.
Do you have a Pulmonologist?

No. I’ve never needed one before. Guess it’s time to find one. Thank you. I’m sorry you’re going through all of that. You’re one tough cookie. I hope I can be as well.