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12 mm Spiculated Nodule upper right lobe
May 2022- they found an incidental nodule in my right upper lobe. The CT impression said 8 mm ground-glass could be a low-grade malignancy. A month later, I had another CT which said that there was no significant interval change 6 mm upper lobe pulmonary nodule.
July 2023-I had a follow up CT scan. Impression 12x7 mm slightly spiculated. Malignancy cannot be excluded. I was referred to a thoracic surgeon who also couldn’t rule out cancer and said that it would be very difficult to get a biopsy because of the location. The test could come back negative, but they wouldn’t be sure that they really got it from the right area. He recommended removing it and biopsy it. Probably a partial lobectomy but he wouldn’t know for sure till he got in there. He could end up removing the entire upper lobe. Does anyone have experience with this? I decided to wait.
February 2024--I just had another CT scan about 2 weeks ago. 1.2 x 0.7 x 0.8 cm spiculated nodule in the right upper lobe not significantly changed since July 2023 but has increased in size since May 2022. This nodule remains suspicious, and PET/CT may be considered for further evaluation.
I’m having a PET/CT scan done next week. I’m so scared about everything. Most people say, just have it removed. Is this really the best option? What will the PET/CT scan show. How long does it take to get back to “normal” after having a surgery like this? It would be a minimally invasive procedure.
Also, I’m reading that there is a much higher chance of it being malignant when it’s found in the upper lobe?
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Thank you so much for all the information. I have been in denial about the whole thing for awhile, thinking that it was just going to disappear again. The doctor did say that if anything it would probably be stage 1 and he didn't think that I would be needing chemo/radiation afterwards. He also mentioned that he didn't think my PET/CT would show much more than the CT did. Regardless, having the PET/CT done next week. I know that many of you are going through far worse and I should consider myself very lucky that it's caught early, but I'm still very scared.
When a ground glass nodule (opacity) is suspicious for malignancy a wedge resection is usually the preferred method of biopsy. GGO/GGNs are subsolid and cannot be easily biopsied otherwise. A needle biopsy is most likely to yield a false negative.
Currently, I am dealing with GGOs that are becoming part solid. Like spiculations, this often indicates that it is becoming malignant. (95% of GGOs are benign). My oncologist and my second opinion oncologist both took my case to their respective Tumor Boards, both suggested wedge resection but also said it might get be risky due to damage from previous treatment. I opted to wait for this to become solid enough to perform a needle biopsy or an EBUS.
Surgery is the gold standard in lung cancer treatment. If caught early enough it gives the patient the best chance for complete cure.
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1 ReactionI was also told that anything larger than 1.0 is malignant. Both my 1.0 tumors in each lung were malignant. 🙏🏻
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1 ReactionI didn’t know that likelihood was different for different lobes. BUT definitely get a PET scan. And if it indicates malignancy, see an oncologist as well. That doc will be the one that helps with ongoing monitoring, advising whether there are reliable options other than surgery, etc.
In my experience, the idea of partial lobectomy is abandoned if it is malignant. But that is just my experience. My surgeon did a wedge resection of the area with the 1.5cm tumor, kept me sedated while the pathologist confirmed malignancy, and then took the left lower lobe out.
You need to trust that your surgeon has your Good outcome at heart. If you don’t, find another one.
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