8 mm lung nodule possible malignancy: What should I do?

I’ve been on targeted therapy twice, TEPMETKO. However had to discontinue treatment due to intolerable side effects. If you browse the drug I mentioned you’ll see how difficult it is to tolerate.
Diagnosed 2021 and ended second course of Tepmetko 4 weeks ago. PET SCAN scheduled for 9/4. Hoping despite side effect profile, it kept my cancer at bay🤞

Thanks for your responses….shall update after scan.

Hello @hatterasj10202 , welcome to Mayo Connect. I have the ALK mutation, stage IV, I've been on a targeted therapy since 2020. I've been fortunate in that it has continued to be effective for me, fingers crossed.
I'm sorry to hear that you're dealing with this. It's never easy. Are you taking one of the targeted therapies? How long ago were you diagnosed?

@trudyhs, did I see a post from you regarding MET exon14 deletion? What treatments have you had?

Hi @hatterasj10202—thanks for asking, and I’m really sorry the road has been so tough. Here’s my own path, in case it’s helpful:

I was diagnosed in 2018 with non–small cell lung cancer, adenocarcinoma, with an EGFR Exon 19 mutation. A small right-upper-lobe tumor led to a lobectomy. The margin stained positive, so I had 33 radiation treatments. Cancer was also found in a nearby lymph node, so I did 4 cycles of chemotherapy (Carboplatin + Alimta) alongside the radiation. Tagrisso was not recommended for Stage 2b at that time, though it is now.

In 2020, it metastasized to my brain. I had surgery to remove a 3.2 cm cyst and four radiation treatments to clean up the edges. I started Tagrisso (80 mg daily) then and I’m still on it.

About a year and a half ago I had a recurrence at the site of resection which was treated successfully with another round of radiation. Seven months later, my MRI showed treatment-related necrosis, which improved after six Avastin infusions.

Functionally, I’ve been dealing with right-side foot drop and limited ankle/toe control. A personal trainer/physical therapist has been a big help, and I’m steadily working back toward a more natural gait.

Through all of this I’ve kept working full-time in a job I love. Everyone’s journey is different, but I hope this snapshot gives you a clear picture and a little encouragement as you navigate your own path. I wish you all the best in your journey.

I am curious what your treatment journey has been over these years with your mutation Adenocarcinoma.
Currently I have stage 4 METX14 mutation ( less than 1% found as a mutation ) and have had a difficult medication/radiation journey. Thanks

Hi Deb—hearing about a new or growing nodule can be really unsettling, and it’s easy to spiral after reading worst-case scenarios online. For a little perspective: I’ve been living with stage 4 EGFR-mutated adenocarcinoma for five years. Because mine spread to the brain, I’ve had brain MRIs, CT scans, and bloodwork every three months. Three different times, my very thorough oncologist saw a nodule change—up to about 50% growth over three months—and sent me straight for a PET scan. Each time, the follow-up showed the nodule was benign, and the next scan showed it had shrunk.

What’s helped me is mindset of: “Until my oncologist tells me otherwise, I don’t have cancer.” It’s saved me a lot of unnecessary worry over the years.

Lastly, three-month imaging is a common follow-up interval, and your team can always adjust sooner if something needs a closer look. The fact that they don't believe they have to is encouraging. In other words, they are watching you carefully—and that’s a good thing. Hang in there, and try to give yourself some breathing room while the experts do what they do best.

Hello everyone,
I've had several lung nodules during the past 3 years with CT scans sometimes at 3, 6. or 12 month intervals.
One 3 mm nodule is now 4 mm.
A 5 mm nodule has resolved.
And since Aug. 2024 (1 yr.) I have a new 8 mm solid nodule in my right lung a little over halfway above the middle.
I have a family history of kidney cancer only, as far as I know.
I'm 67 and I do have a pulmonologist who has been with me during the past 3 yrs.
The current plan is a repeat Chest CT scan in 3 months.
What concerns me is I have had 2 different radiologists write their report of my CT scans and say "No nodules detected". Each time my pulmonologist looked at the scans and had the radiologists write an addendum at the top of their report correcting themselves due to her seeing what was actually there. Thank God she can read the scans, although even I can see where the 8 mm nodule is plain as day. The radiologists aren't building confidence.
At any rate, is the 3 month scan an acceptable approach since I have no idea how long it took the nodule to grow to 8 mm since it was a whole year vetween scans? And, what can I expect the next 6 months or so to look like? I have to admit since I went from "no nodules" to this situation I'm a little thrown by it.
Thanks for any input.
Deb

@lhatfield96, My fungal nodule was described as an "irregular pulmonary nodule". Which is not very descriptive, but the radiologist knew that I had been diagnosed with stage IV lung cancer over three years prior to this finding. I did have enlarged lymph nodes in the center of my chest with the fungal nodule and the lung cancer.
Of course this is a scary time for you, that's expected, and the waiting for the next scan can be the most difficult time. At least when you know what it is, you can breathe a sigh of relief or take action on next steps.
It seems that the radiologist and your doctors are being cautious in having you come back for another scan. This is very common. They don't want to put you through a procedure unnecessarily when nodules can come and go, or even stay the same for many years. Try to remember that most nodules aren't cancerous.
I try to focus on what's right in front of me. I have scans every 3-4 months. Overtime, I've learned that it's not helpful for me to focus on what might happen. I have to focus on what I know today, and not on what might happen three months from now. Can you focus on today? Have you found ways to take your mind off of this? Going for a walk, watching a movie meeting a friend for coffee, etc.?

Hi Lisa. Was your nodule sub solid ground glass or something else? I have an 8 mm sub solid GGO they have said is low suspicion but still wanted to see me in 3-6 month which doesn’t sound good. I’m so afraid!

I've read that any nodules 8mm should be looked at in an aggressive manner. But, for comparison, yours is slow growing compared to my husband's 6mm grew to 8mm in 3 months. Plus he has 7 nodules 6mm or larger and all have grown just in 90 days. Hope this helps.

I did actually use Google and it brings up a chart showing a peanut, a pea, etc. Lists the sizes in mm and cm. It gives you a pretty good idea. A radiologist reads your CT. If you are seeing a Pulmonologist they are looking at the results as well. The Dr tht read mine was quite accurate. Of course, make sure you ask questions if you’re not sure. They measure it again when they get it out.