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?

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@lls8000

@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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My cancer was found when a CT scan was done to check the heart. This was followed up with a second CT and then a PET scan was ordered. I did have a biopsy and Robotic-assisted lobectomy surgery is now set to remove the lower left lobe. I will then heal for 3 to 4 weeks and hopefully be strong enough for the angioplasty. I have meet some wonderful doctors at Mayo whom I have complete confidence in.

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@vic83

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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Yes, I meant the lower left lobe. Your situation sounds a lot like mine. No one has suggested putting me on any medication for the heart during the time I am waiting for the lobectomy. I am glad that everything has turned out so well for you. I hope mine turns out as well. Thank you for your notes.

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@char09

Yes, I meant the lower left lobe. Your situation sounds a lot like mine. No one has suggested putting me on any medication for the heart during the time I am waiting for the lobectomy. I am glad that everything has turned out so well for you. I hope mine turns out as well. Thank you for your notes.

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My angioplasty (done at local hospital) revealed a 70 percent blockage in the left anterior descending artery (and other significantly lesser blockages). 70% is the threshold for putting in a cardiac stent. That threshold was set because they were putting in too many stents for lesser blockages before. The medication was to keep arteries open until after lung surgery. In fact, there is a study that indicates that people on medication can do as well as people who have stent. After my VAT lung surgery at Mayo, I had Mayo consult to see if I might continue on the medication and not do a stent (I was thinking about the possibility of additional lung surgeries). If you haven't had an angioplasty, I assume they have yet to identify blockages.
Best wishes for your surgery. They have lots of experience at Mayo for lung surgery.

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I was to have the angioplasty the day they saw the cancer on the CT. The angioplasty was canceled because the cancer surgery must be done first due to the blood thinners that must be used after the angioplasty. I am identified with 70% blockage in the left artery.

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@char09

My cancer was found when a CT scan was done to check the heart. This was followed up with a second CT and then a PET scan was ordered. I did have a biopsy and Robotic-assisted lobectomy surgery is now set to remove the lower left lobe. I will then heal for 3 to 4 weeks and hopefully be strong enough for the angioplasty. I have meet some wonderful doctors at Mayo whom I have complete confidence in.

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@char09, having confidence in your team is so important. I’m glad that you’ve found that kind of comfort and trust, especially knowing you are headed toward future procedures.
Being a never smoker, a mutation may be driving your cancer. Do you know if they sent your initial biopsy for biomarker testing? If not, they’ll likely test the lobectomy tissue for any known mutations.

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@char09

I was to have the angioplasty the day they saw the cancer on the CT. The angioplasty was canceled because the cancer surgery must be done first due to the blood thinners that must be used after the angioplasty. I am identified with 70% blockage in the left artery.

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Amazing, that is just like me! Locally I had gone to pulmonologist about shortness of breath. CT scans showed issue with lungs. I was returning the overnight oximeter to hospital when my lower legs/feet became numb. The ER was right there so I went in. I had elevated troponin, so they recommended angiogram. When the doctor cried out "blockage" I reminded them about my lung issue and my scheduled appointment at Mayo and they said they could medicate. I wondered if I was doing the right thing, some would say the heart was more important. But after another cardiologist told me about the study that some people stay on medication and do not do stent....and confirmed that with the blood thinner therapy required after a stent no one would do surgery on me. I appreciated that and felt better after. Three weeks later my surgery at Mayo confirmed lung cancer. The local cardiologist was pleased they made the call to put me on medication at the time and I did not have to delay such a surgery.

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@vic83

Amazing, that is just like me! Locally I had gone to pulmonologist about shortness of breath. CT scans showed issue with lungs. I was returning the overnight oximeter to hospital when my lower legs/feet became numb. The ER was right there so I went in. I had elevated troponin, so they recommended angiogram. When the doctor cried out "blockage" I reminded them about my lung issue and my scheduled appointment at Mayo and they said they could medicate. I wondered if I was doing the right thing, some would say the heart was more important. But after another cardiologist told me about the study that some people stay on medication and do not do stent....and confirmed that with the blood thinner therapy required after a stent no one would do surgery on me. I appreciated that and felt better after. Three weeks later my surgery at Mayo confirmed lung cancer. The local cardiologist was pleased they made the call to put me on medication at the time and I did not have to delay such a surgery.

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Good luck with your surgery. My Pulmonary doctor said most lung cancers are discovered when doing a CT for heart issues. We are lucky.

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@char09

Good luck with your surgery. My Pulmonary doctor said most lung cancers are discovered when doing a CT for heart issues. We are lucky.

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Thanks, but I already had my surgery...actually now two surgeries. Many people have commented that I must have someone looking out for me because I discovered my lung cancer and my heart problem early on and in the right order!

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