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

Posted by js @jstarkman, Jan 18 9:47am

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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@dedehans

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.

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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!

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@reneew

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!

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

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@jstarkman

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

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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,

Has your doctor suggested a biopsy?

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@aprilradek

Hi,

Has your doctor suggested a biopsy?

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It was surgically removed in a lobectomy and Biopsy was done then.

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Age, location and insurance will probably determine where you can go for your care. No matter, I would get a pulmonologist soon. The next step might be biopsy. Depending on the location of the nodules will determine what type of biopsy. Mine were in a difficult place so I had the biopsies done robotically. I'm fortunate to be on Medicare with good supplemental insurance. If you are in a location where you could go to Mayo Clinic or City of Hope, I would try to get in to either of those. I hope your nodules are benign!

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@kdelbert

Age, location and insurance will probably determine where you can go for your care. No matter, I would get a pulmonologist soon. The next step might be biopsy. Depending on the location of the nodules will determine what type of biopsy. Mine were in a difficult place so I had the biopsies done robotically. I'm fortunate to be on Medicare with good supplemental insurance. If you are in a location where you could go to Mayo Clinic or City of Hope, I would try to get in to either of those. I hope your nodules are benign!

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Welcome @kdelbert, were your nodules benign?

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No. I had a part of my lung removed and am doing chemo now.

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@dedehans

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

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I’m curious how yours was biopsied? I ask because my pulmonologist and surgeon said mine was too small to biopsy when it was 9mm. It was in the bottom outside edge of my left lung and they both said it would be difficult to grab and hope to drag it Up and out and it was too small to section. Then they said if they were going do a wedge resection to biopsy it, they might as well do the gold standard of lobectomy. I’m still not sure that wasn’t overkill but it’s done and I’m focused on recovery.

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@pb50

I’m curious how yours was biopsied? I ask because my pulmonologist and surgeon said mine was too small to biopsy when it was 9mm. It was in the bottom outside edge of my left lung and they both said it would be difficult to grab and hope to drag it Up and out and it was too small to section. Then they said if they were going do a wedge resection to biopsy it, they might as well do the gold standard of lobectomy. I’m still not sure that wasn’t overkill but it’s done and I’m focused on recovery.

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Mine were done by bronchoscopy and needle biopsy. I had one on each lung and the one done by needle was very hard to get to. Remember to insist that they send the tissue samples to a pathology place like Foundation Medicine for genetically identifying the tumor(s). You may be eligible (as I am) for a targeted therapy treatment.

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