Multiple lung nodules: Might they be noncancerous? What next?

Posted by felix536 @felix536, Aug 17, 2021

I have 3 lung nodules measuring 4mm, 6mm and 14 mm in three different lobes. Have had ct scans showing no change in 6 months and have another scan scheduled in three months per my pulmonologist. Should I get a second opinion from an Oncologist or wait it out? What are the chances of this being noncancerous?

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@etb2

Can you PLEASE tell me your experience with SBRT? IM being told there are no side effects. Also, bcuz I have a blood disorder my non small cell was diagnosed by appearance...no biopsy. I was told I needed the SBRT because of how close the 1.8 cm is to my blood vessels and that I may begin to bleed in a year or two which is "rare but bad"

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Regarding my experience with SBRT, it is now three weeks and I have had zero side effects.
I have read that SBRT is typically between 3 to 5 sessions. In my case, they could do in three sessions in three consecutive days, maybe 20 minutes a session. My skin did not burn or even become red. I cannot tell where the radiation went. I did not notice any extra fatigue - I am still recovering from surgery in May so I deal with shortness of breath, nerve numbness.
Doctors did advise me that with radiation there is the risk of bone thinning and potential skin cancers. So, I will just be attentive for that in the future. Especially because I expect to do additional treatments for other nodules.

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@marye2

I am starting tests (CT, PFT, etc) for my eighteen month checkup on lung nodules. I also had one ground glass one last time around; but nothing had grown within the first six months. I do not perceive any symptoms. I am now on D3, and there was an NIH article on low D3 being a possible cause of nodules. In any case, this whole process can be unnerving, but other comments have been reassuring on this journey.

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@marye2, The repeated testing process is anxiety provoking for many of us. Deep breaths! Good luck with your scans!

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@etb2 - Let's define "pleural-based nodule"- Nodules in the pleural cavity (the pleura includes two thin layers of tissue that protect and cushion the lungs. The inner layer (visceral pleura) wraps around the lungs and is stuck so tightly to the lungs that it cannot be peeled off. The outer layer (parietal pleura) lines the inside of the chest wall.

SBRT does not have side effects like a pill might. However, burning, such as sunburn, can take place where the rays are directed. Fatigue is a side effect and the amount of fatigue, the length of time, the number of days, and the dosage of the beams will determine how tired you will be, along with your physical stamina.

I remained fatigued for quite a while.

Your lungs will likely react with some swelling as these rays are meant to for setruction and are strong. You might have a cough bad lung irritation, or pneumonia. I did, and I had to take a strong antibiotic and prednisone for a few months.

This was my third use of SBRT. My lungs, after 25 years of treatments, are very sensitive. My reactions were rather extreme. But not having all the side effects of chemo was also a relief.

If I were you I would get a second opinion. By the way, a biopsy is seldom done with SBRT because whoever set up the regulations thought that if you are killing the cells what difference does it make if they are cancerous or not?

I haven't looked to see if you had a CT or PET. If your PET lit up then your tumors are most likely cancerous.

SBRT does have side effects.

Merry

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@vic83

Hi Registrar. I am not sure what you mean by a "pleural based nodule". I have multifocal adenocarcinoma (lung cancer). I have multiple nodules at various "life stages" (size and solid, part solid). There are several of us on Connect with this type of lung cancer. They start out as "ground glass" opacity and eventually if they become solid, they are treated. Treatment options depend on where they are located in the lung and if they have gone to the lymph nodes. Since Dec 2021 I have had two VAT wedge resections (surgery) and one round of SBRT (radiation). Total of 3 nodules treated. Fortunately, my lymph nodes have been negative, so I have not needed any chemotherapy.
I had a case of pleurisy-fluid which fortunately resolved itself. It shrank on its' own, cause unknown. Had it not resolved itself, there would have been concern that cells from the previous surgery had fallen there.
I am under close observation now because I also had STAS (spread through air space) for one nodule, it shed cells in the lung.
Look for a Pulmonologist experienced with lung cancer in a center able to provide all types of treatment options including video assisted thoracic surgery.
How long have they been tracking your nodules? Has there been any growth? I would tell them if I were not comfortable with too long a period.

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Can you PLEASE tell me your experience with SBRT? IM being told there are no side effects. Also, bcuz I have a blood disorder my non small cell was diagnosed by appearance...no biopsy. I was told I needed the SBRT because of how close the 1.8 cm is to my blood vessels and that I may begin to bleed in a year or two which is "rare but bad"

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I am starting tests (CT, PFT, etc) for my eighteen month checkup on lung nodules. I also had one ground glass one last time around; but nothing had grown within the first six months. I do not perceive any symptoms. I am now on D3, and there was an NIH article on low D3 being a possible cause of nodules. In any case, this whole process can be unnerving, but other comments have been reassuring on this journey.

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@registrar

I asked because you stated this in an earlier post:. "Now I too must watch and wait as I still have a 7mm pleural based nodule and ground glass.".

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Hi again. Sorry for confusion. What post was that? I will rephrase it.
I had liquid buildup in the pleural space which caused me pain. My nodules are in a variety of locations in my lungs, mostly right upper lobe. As you stated, it is a waiting game.....

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@vic83

Hi Registrar. I am not sure what you mean by a "pleural based nodule". I have multifocal adenocarcinoma (lung cancer). I have multiple nodules at various "life stages" (size and solid, part solid). There are several of us on Connect with this type of lung cancer. They start out as "ground glass" opacity and eventually if they become solid, they are treated. Treatment options depend on where they are located in the lung and if they have gone to the lymph nodes. Since Dec 2021 I have had two VAT wedge resections (surgery) and one round of SBRT (radiation). Total of 3 nodules treated. Fortunately, my lymph nodes have been negative, so I have not needed any chemotherapy.
I had a case of pleurisy-fluid which fortunately resolved itself. It shrank on its' own, cause unknown. Had it not resolved itself, there would have been concern that cells from the previous surgery had fallen there.
I am under close observation now because I also had STAS (spread through air space) for one nodule, it shed cells in the lung.
Look for a Pulmonologist experienced with lung cancer in a center able to provide all types of treatment options including video assisted thoracic surgery.
How long have they been tracking your nodules? Has there been any growth? I would tell them if I were not comfortable with too long a period.

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I asked because you stated this in an earlier post:. "Now I too must watch and wait as I still have a 7mm pleural based nodule and ground glass.".

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@registrar

Hi, Vic. You are the FIRST person who I've found has a pleural based nodule. I have somewhere around 8 of them, both lungs, ranging in size from 6mm, 5mm, a couple 3mm, and some smaller. What are you being told can be done about your pleural based nodule and if it is cancerous, how do they treat it? I have two LDCT, one in May and one last month. So far all I can tell that is new is that they found pleural thickening in both lungs, but they don't plan to rescan until NEXT AUGUST!!!!! Based on your experience, what would you do? Request another one sooner, request PET, go to another pulmonologist? LOL

Jump to this post

Hi Registrar. I am not sure what you mean by a "pleural based nodule". I have multifocal adenocarcinoma (lung cancer). I have multiple nodules at various "life stages" (size and solid, part solid). There are several of us on Connect with this type of lung cancer. They start out as "ground glass" opacity and eventually if they become solid, they are treated. Treatment options depend on where they are located in the lung and if they have gone to the lymph nodes. Since Dec 2021 I have had two VAT wedge resections (surgery) and one round of SBRT (radiation). Total of 3 nodules treated. Fortunately, my lymph nodes have been negative, so I have not needed any chemotherapy.
I had a case of pleurisy-fluid which fortunately resolved itself. It shrank on its' own, cause unknown. Had it not resolved itself, there would have been concern that cells from the previous surgery had fallen there.
I am under close observation now because I also had STAS (spread through air space) for one nodule, it shed cells in the lung.
Look for a Pulmonologist experienced with lung cancer in a center able to provide all types of treatment options including video assisted thoracic surgery.
How long have they been tracking your nodules? Has there been any growth? I would tell them if I were not comfortable with too long a period.

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@vic83

In November a chest x-ray showed "ground glass" and indeterminate. I went to a Pulmonologist to order CT and PET scan and I had those scans sent to Mayo. They called immediately, and I decided to do bronchoscopy + VATs with wedge resection surgery at same time. It was a 3.1cm cancer stage 1b. That means negative lymph nodes. I had the option to wait, but I am not getting any younger, and there was a very high probability that it was cancer. Better to do the surgery when I will tolerate it well...which I did. Now I too must watch and wait as I still have a 7mm pleural based nodule and ground glass.

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Hi, Vic. You are the FIRST person who I've found has a pleural based nodule. I have somewhere around 8 of them, both lungs, ranging in size from 6mm, 5mm, a couple 3mm, and some smaller. What are you being told can be done about your pleural based nodule and if it is cancerous, how do they treat it? I have two LDCT, one in May and one last month. So far all I can tell that is new is that they found pleural thickening in both lungs, but they don't plan to rescan until NEXT AUGUST!!!!! Based on your experience, what would you do? Request another one sooner, request PET, go to another pulmonologist? LOL

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@aahlrichs

Omgosh. You have a lot going on. I just said a prayer for you. I will know more on Monday and what kind of kickback my dr wants to give me on how to proceed. Sounds like a PET scan is the first step on what I’m reading..less invasive. Wonder how long that wait is. My family physician is with mayo and all my tests and records are at mayo. I do everything there.

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aahlrichs, It's nice to hear you are in the Mayo system, If you can share, I'm curious if your family physician is located in Rochester, Jacksonville, or Scottsdale? Or practicing in one of the many outlying Mayo owned hospitals or clinics. Anyway there are many locations in the Minnesota, Wisconsin area. I'm not sure about Florida and Arizona. Thanks

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