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

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.

I had my nodule biopsied to determine the type of cancer and what stage it was. Also it's genetic composition. Surgery came afterwards.

I had a nodule that also was 8mm and it was cancerous. It is not too small for it to be biopsied. I decided to skip a pulmonologist and go to a thoracic surgeon. I ended up having a lobectomy, Its now 4 years later, no reoccurrence, and I feel great!

@jstarkman, I agree with Lisa, Take a deep breath. 8mm = .8cm is very small. My younger brother had larger nodules monitored every year for 8 years before they finally stopped checking. Nodules are not uncommon, and you don't say

Before you have any physical testing, it would have to grow, which may not happen. I have stage 4 lung cancer, and my doctor saw 3 lymph nodes increase in size by 50% in 3 months. That got me a PET scan and a blood test. Both came back negative. After another three months, they were smaller. I know lymph nodes are not the same as lung nodules, but the point is you're way before a cancer diagnosis at this point. And my attitude is that if I don't have a positive diagnosis for lung cancer, then I DON'T have lung cancer! Life's too short to literally worry ourselves sick.

Let us know what you learn in 3 months.

Please get an appointment with a pulmonologist as he/she will recommend a bronchoscopy or not. I think 8mm may be too small for biopsies, bronchoscopies so like many of us you are in the 3 month CT scan let's wait program. The nodule is currently being monitored, thank heavens and likely those tests will need to be done when it increases.

Thank you for your comments. Do you see any benefit in having a bronchoscopy done at this point?

My experience was finding a similar size nodule in 2020. It was in left lung close to my heart. Opted a wait & watch approach. In 2021 & 2022 stayed about same size. In 2023 it almost doubled to 13 mm. It is considered as a very very slow growing carcinoid. Had biopsy in Oct 23. Confirmed as a typical neuroendocrine carcinoid. There are typical & atypical neurendocrine carcinoids ( called lung NETS),
I am 77 yrs old. Had robotic surgery 10 days ago. Did so well I was sent home the following day. No chemo, no radiation. I’m very glad I had surgery. Four lymph nodes were negative. There was a cluster of tiny carcinoids, largest 4mm, in same area. They were not noticeable in CTScans but suspicious areas with a PET. I’m very glad I didn’t continue to wait. On YouTube there are several recent presentations on neuroendoctine tumors, known as NETS. I think the only way to know for sure is by biopsy. Please keep us posted.

Hi JS (@jstarkman), I'm assuming that your CT was completed for a lung screening exam? I'm glad to see that the screening program is working; nodules are being identified early, and it is saving lives! It also puts patients like you into a state of worry. Most nodules are non-cancerous. You need to be comfortable with the plan presented to you by your doctor. Some people are comfortable with a 3 month wait. Your nodule hasn't grown much, but no one can really tell you at this point what it will do in the next three months. A second opinion from an expert can be very helpful, and a pulmonologist would be able to provide additional input on what they believe the next steps should be.
From my experience, oncologists want to see patients that have a pathology confirmed case of cancer. I would certainly recommend seeing an oncologist prior to having surgery for cancer. We all have different experiences to contribute, there is no one right answer. The right answer for you is what puts your mind at ease.
I have a type of lung cancer that will come back and spread someday. I just had a second biopsy completed on a 9mm nodule and two enlarged lymph nodes which were first identified in November. It's not cancer. So, even stage IV lung cancer patients can have non-cancerous nodules. My oncology team is surprised too!
Take a deep breath and determine what works best for you.

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

I would talk to a Specialist in lung cancer and not rely only on a GP who lacks depth of knowledge.
If your insurance allows it.
There are Pulmonologists specialized in lung cancer, Radiation Oncologists and Medical Oncologists. Treatment of lung cancer depends on various factors including size and location and can be surgery, radiation, chemotherapy, etc. One wants to be sure that all options are offered.