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

Posted by js @jstarkman, Jan 18, 2024

I had a CT scan and they found a nodule which has grown to 8 mm from 6 mm 12 months ago. The report says "slowly growing malignancy cannot be excluded". My doctor (GP) recommends another CT in 3 months but I am concerned that this approach is not aggressive enough. It has clearly changed from 6 mm to 8 mm.
What do I do?
Should I be seeing an oncologist now?
Should something more aggressive me done?

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Mentor
Lisa, Volunteer Mentor | @lls8000 | Apr 21 1:30pm

@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.?

REPLY
lhatfield96 | @lhatfield96 | Apr 19 8:50am
In reply to @lls8000 "Hi JS (@jstarkman). Remember that you posted this question on the Lung Cancer group, so you..." + (show)
@lls8000

Hi JS (@jstarkman). Remember that you posted this question on the Lung Cancer group, so you are seeing responses from people with cancerous nodules. Most nodules are not cancerous. The final pathology has come back for my latest nodule and it is fungal, not cancer.
Having a bronchoscopy does come with risks, and the pulmonologist will be able to help answer any specific questions that you may have. The location of the nodule can make it fairly easy or extremely difficult to biopsy via a bronchoscopy. My original nodules were deep in the lung, and were never biopsied via bronchoscopy, but this recent nodule was barely inside the lung so it was easily accessible. A rescan in three months doesn't seem unreasonable to me, but a pulmonology consult never hurts.

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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!

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caregiverwife | @caregiverwife | Feb 14 5:32pm

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.

REPLY
cmcguire10 | @cmcguire10 | Mar 7, 2024

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.

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mikewo | @mikewo | Mar 6, 2024

Do you have a mm scale to see the size you are talking about? How accurate is the person reading your CT scan?

REPLY
cmcguire10 | @cmcguire10 | Mar 5, 2024
In reply to @cmcguire10 "Hello skm101- After my Dr saw my CT scan he called me and said he wanted..." + (show)
@cmcguire10

Hello skm101-
After my Dr saw my CT scan he called me and said he wanted me to have a PET scan. He sent the order to our local hospital and when they called me to set up the appointment I called him and told him to send it to Mayo instead. I believe(not 100% sure) that you can go on the Mayoclinic.org website and request an appointment. They then contact you and go through what needs to be done as far as paperwork, etc. They’ll want your insurance information, your Primary doctor info, etc. It was pretty easy for me. I did have to get the release of information to my doctor so Mayo could get all of my records. I had my CT at SimonMed (local) so I had to get them a release as well. But it was still a fairly easy process. However, I work in an office so I had the email and fax capabilities, I know thats a different situation for others.
I hope this helps. Best of Luck! God Bless you and keep you near him! Cindy

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I had my CT scan here locally on January 5th, 2023. It took them 2 weeks to send the results to my doctor. I had my PET scan at Mayo around the end of February and had my segmentectomy March 24th, 2023. Whirlwind of appointments in between!

REPLY
cmcguire10 | @cmcguire10 | Mar 5, 2024
In reply to @skm101 "Did your Dr have to refer you to Mayos? How long did it take for you..." + (show)
@skm101

Did your Dr have to refer you to Mayos? How long did it take for you to get your second opinion there?

Jump to this post

Hello skm101-
After my Dr saw my CT scan he called me and said he wanted me to have a PET scan. He sent the order to our local hospital and when they called me to set up the appointment I called him and told him to send it to Mayo instead. I believe(not 100% sure) that you can go on the Mayoclinic.org website and request an appointment. They then contact you and go through what needs to be done as far as paperwork, etc. They’ll want your insurance information, your Primary doctor info, etc. It was pretty easy for me. I did have to get the release of information to my doctor so Mayo could get all of my records. I had my CT at SimonMed (local) so I had to get them a release as well. But it was still a fairly easy process. However, I work in an office so I had the email and fax capabilities, I know thats a different situation for others.
I hope this helps. Best of Luck! God Bless you and keep you near him! Cindy

REPLY
1 reply
skm101 | @skm101 | Mar 5, 2024
In reply to @cmcguire10 "Hi jstarkman- I totally understand the place that you are in right now. First, take a..." + (show)
@cmcguire10

Hi jstarkman- I totally understand the place that you are in right now. First, take a deep breath, Second, are you near a Mayo Clinic or a Specialty place like it? You can always ask for a second opinion. That is what I would do. I never had a biopsy until after my surgery I had a nodule in my left upper lung that took 9 years to grow from ground glass to Adenocarcinoma. I was lucky because it was so slow growing but I was unlucky because I never got told about it being there. Long story. Anyway my Dr sent me for a PET scan after he saw that it had changed and I went straight to Mayo. Then Mayo decided the order in which they would do things. Pulmonologist first. Compared CT scans, because of shape and size and his experience he knew it was cancer without a biopsy. Set me up to talk to Thoracic Surgeon. I asked about radiation they said best to cut it out. Had a Bronchoscopy done, no lymph nodes involved. Had a PET scan, nodule barely lit. Had not spread anywhere else. Had segmentectomy (partial lobe removed). Clear margins and none of the numerous lymph nodes removed were cancerous. They said they caught it early, and I am so Thankful I didn’t wait to do the lung screening. That’s what caught it. I tell you my story because I have read where others have waited and it had spread. Please get a Second or even Third opinion. Be comfortable with what and which doctor you choose. It has to make sense to you. Stay OFF of Dr. Google! It’s unnecessarily horrifying! Research your questions on Mayo clinic, Cleveland clinic, or any of the . Orgs. Shy away from anything that is a .Com.
Good Luck and God bless you!
Cindy

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Did your Dr have to refer you to Mayos? How long did it take for you to get your second opinion there?

REPLY
1 reply
kgbsawyr | @kgbsawyr | Feb 29, 2024
In reply to @pb50 "Depending on the corticosteroids used, you might have wild emotional swings. I had a course of..." + (show)
@pb50

Depending on the corticosteroids used, you might have wild emotional swings. I had a course of big dose steroids with a back injury in the mid 80’s and I was laughing out loud, crying like my puppy had died, and everything in between.

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Didn’t know my chemo drugs have steroids. I’ll have to ask.

REPLY
pb50 | @pb50 | Feb 29, 2024
In reply to @lls8000 "Hi JS (@jstarkman). Remember that you posted this question on the Lung Cancer group, so you..." + (show)
@lls8000

Hi JS (@jstarkman). Remember that you posted this question on the Lung Cancer group, so you are seeing responses from people with cancerous nodules. Most nodules are not cancerous. The final pathology has come back for my latest nodule and it is fungal, not cancer.
Having a bronchoscopy does come with risks, and the pulmonologist will be able to help answer any specific questions that you may have. The location of the nodule can make it fairly easy or extremely difficult to biopsy via a bronchoscopy. My original nodules were deep in the lung, and were never biopsied via bronchoscopy, but this recent nodule was barely inside the lung so it was easily accessible. A rescan in three months doesn't seem unreasonable to me, but a pulmonology consult never hurts.

Jump to this post

As much as I understand your urge to be aggressive in addressing the nodule, Becky is correct. My module increased from 9 to 14 mm in one year, but it was about as deep as it could be in the left lower lobe, and slam up against the outer wall. So the doc didn’t want to take that risky journey with a biopsy needle. We ended up deciding to just take it out.

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