12 mm Spiculated Nodule upper right lobe

Posted by joannamountain24 @joannamountain24, Feb 19 8:38am

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?

Interested in more discussions like this? Go to the Lung Cancer Support Group.

@joaniepnw

Thank you, you eased my mind. Yes it is going to be a Vats surgery. What has concerned me are some comments I've read how some have seemed to have had such trouble with prolonged nerved pain after their surgery. I'm assuming that is pain in the chest/rib area. Is this so even with Vats surgery that you know of?
Thank you,
Joanie

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I’m only a week out from surgery, so I’m not sure if it gets worse. So far so good, feeling a little
nerve tweaking here and there but I guess that’s what to expected. No big deal yet. They did give me a nerve block before the surgery. Gabapentin is supposed to help with that too. That medication wasn’t for me though. I didn’t like it and only had it twice during my hospital stay.

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@joaniepnw

Thank you, you eased my mind. Yes it is going to be a Vats surgery. What has concerned me are some comments I've read how some have seemed to have had such trouble with prolonged nerved pain after their surgery. I'm assuming that is pain in the chest/rib area. Is this so even with Vats surgery that you know of?
Thank you,
Joanie

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@joaniepnw, you may appreciate these related discussions:
- Upper left robotic/VAT lobectomy
https://connect.mayoclinic.org/discussion/upper-left-roboticvat-lobectomy/
- My husband had lobectomy surgery: Mayo was wonderful!
https://connect.mayoclinic.org/discussion/mayo-was-wonderful/
- Lung cancer surgery: How much time until I heal?
https://connect.mayoclinic.org/discussion/lung-cancer-surgery/
- Lobectomy scheduled—What kind of home help will I need?
https://connect.mayoclinic.org/discussion/lobectomy-scheduled-what-kind-of-home-help-will-i-need/

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@joaniepnw

Thank you, you eased my mind. Yes it is going to be a Vats surgery. What has concerned me are some comments I've read how some have seemed to have had such trouble with prolonged nerved pain after their surgery. I'm assuming that is pain in the chest/rib area. Is this so even with Vats surgery that you know of?
Thank you,
Joanie

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Hello Joaniepnw,
Having a nerve block for your VAT lung surgery is the way to go in my opinion……..it numbs the pain on the side they will do the surgery on. Make sure to ask your surgeon about it. Your recovery from the surgery should go smooth…..just a couple of days in the hospital.

Good luck!

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@joannamountain24

Hello again all you wonderful people.
Just a little update from my end. I did the PET/CT at the end of February and there wasn't must uptake at all: FDG uptake with SUV max of 0.94 --One of you in here had mentioned that you didn't think there was going to be and that I needed to pay attention to the size (12 mm), the spiculated part and the fact that it grew twice in size over a year.

I paid attention, thanks to this group, and went ahead with the VATS Wedge Resection last Thursday--2 days in the hospital (nodule/mass was deep in my upper right lung). Yes, it was cancer 1a2, all margins clear and all 5 lymph nodes are negative for metastasis.

If it wasn't for this group, I don't believe that I would have gathered the courage to go forward with the surgery.
I was in denial thinking: I don't feel anything, I have no symptoms, I don't see it, so it must not be there.
Thank you for all your support! I'm so thankful that it was caught this early and removed.

This nodule was an accidental finding in May 22 when I had x-ray of my heart. I'm 57 years old, a former smoker, but haven't smoked for 35 years and therefor, probably would never have qualified for the screening either.

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Good for you!! As I think I told you, mine was at 6mm when we discovered it, and my doc and I watched it grow 1 mm a year - until 2023 when it grew 5mm. So out it came. S1N0.
I’m thrilled for you!!

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Glad I signed up for this group. I felt lost even though I have a lot of family support.
I will be having (RL) Robotic-assisted lobectomy in about 3 weeks to remove the lower left lung.
I have a 13.3 malignant nodule to be removed. I also face a angioplasty of the heart when strong enough
after the lung surgery. I am 78 yrs old and up to this point have always been very healthy so I was stunned to
say the least. Having never been a smoker or exposed to any cancer causing elements the doctors ask about, it is possibly hereditary.

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@char09

Glad I signed up for this group. I felt lost even though I have a lot of family support.
I will be having (RL) Robotic-assisted lobectomy in about 3 weeks to remove the lower left lung.
I have a 13.3 malignant nodule to be removed. I also face a angioplasty of the heart when strong enough
after the lung surgery. I am 78 yrs old and up to this point have always been very healthy so I was stunned to
say the least. Having never been a smoker or exposed to any cancer causing elements the doctors ask about, it is possibly hereditary.

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@char09, Welcome to Mayo Connect. I'm glad you found us, it helps to have others around us, albeit virtually, that have experienced the same diagnosis, thoughts and feelings. It sounds like you have a lot coming up.
Being a never-smoker, you likely didn't qualify for screening, how was your cancer found? Have you had a biopsy?

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@char09

Glad I signed up for this group. I felt lost even though I have a lot of family support.
I will be having (RL) Robotic-assisted lobectomy in about 3 weeks to remove the lower left lung.
I have a 13.3 malignant nodule to be removed. I also face a angioplasty of the heart when strong enough
after the lung surgery. I am 78 yrs old and up to this point have always been very healthy so I was stunned to
say the least. Having never been a smoker or exposed to any cancer causing elements the doctors ask about, it is possibly hereditary.

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I assume you mean lower left lobe not lung. I too had a similar nodule removed by wedge resection from right upper lobe. Four months later I did an angioplasty and they put in a stent. I discovered I had lung cancer and cardiac blockage at same time....so I could postpone the angioplasty - they put me on medication instead- and I did the lung surgery first because with Plavix dual anti-platelet medication for at least 6 months, one has to postpone any surgery. I certainly did not want to postpone lung cancer surgery! All went well, I was driving my car one week after surgery, and putting in a cardiac stent is painless. I was 80 years old at the time. Very best wishes, and remember to exercise after surgery!

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@joannamountain24

So sorry to hear that you had to go through this. I appreciate you sharing your experience in here to help others. I'm so glad that I found this group. If you don't mind me asking, how long did it take you after the surgery to feel like yourself again?

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I had a right upper lobe lobectomy for a 3.2 cm nodule in early March 2024. The breathing tube during surgery damaged my vocal cords. It’s now 3.5 months later and my voice has not returned completely. The surgeon and oncologist say wait six months and if not much better see a specialist. So something to look out for there for sure. I could walk a little after a few days and do light household chores. After a few weeks I was walking a few miles easily. After six weeks I was playing tennis albeit not at full strength. Now 3.5 months later I’m on Tagrisso to keep the cancer from returning for the next three years. It’s got some side effects that do hinder a return to pre surgery “Normal “. My voice seems to be getting better but still a ways to go. My stamina is good and I can do most anything now. I have had to accept that this is my new normal. But very happily I’m cancer free but get a blood test and oncologist visit every month while on Tagrisso. I haven’t had a follow up CT yet but I’m sure the oncologist will want one fairly soon. I have stage 1b. Good luck to you and try and go easy with your situation. You’re alive and should ultimately be fine !

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There is one known heritable lung cancer gene. That is the EGFR T790 biomarker.

If you are interested in contributing more to cancer research, the Go2 Foundation is sponsoring a study called Inherit which will look for possible germ line mutations. With the fastest growing population of lung cancer patients being never smokers with no known risk factors this is important research.

https://inheritstudy.org/
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Hi I had 17 mm nodule RUL removed 5 weeks ago, they tried a broncosopy to get a BIOPSY sample, inconclusive. I also had a 7MM LRL removed thru Vats wedge resection.
I felt , and currently feel great but mine were non small cell cancer. My larger tumor grew adjacent to a lymph node, which did show cancer cells.
It is unclear if the lymphbwas involved or its incidental because of thetumors location.
I've just seen an oncologist to undergo 4 rounds of chemo. Which they hope will decrease my chance of reoccurance.
I'm not a wait and see person, the anxiety was overwhelming.
A VATS wedge resection is easier to recover from than a lobectomy, I'd recommend that if possible.
I'm 62, in pretty good shape, not elitevathlete, but I'm back walking 6 to 8 km a day!!
Good luck

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