Noticed 3 nodules on my right lung (scared to death)

hi @joe88 - welcome to mayo connect! let me preface my message by saying we are a community of patients (with lung cancer in this group) and caregivers, not doctors. I can empathize with the stress of receiving and trying to understand a radiology report before you've had a chance to talk about what the results mean with your doctor.

I think bc of your smoking history, your doctor is screening you for lung cancer. that's why the radiologist included a LUNG RADS score. in this case, category 2 means smaller nodules were found that don't have other concerning characteristics for cancer. that said, the only way to know if a nodule is malignant or not is through a biopsy. did you schedule a follow up appointment at City of Hope? it definitely would be best to meet with a doctor soon who can answer your questions and address your concerns.

It seems that the radiologist thinks the nodules are benign (non-cancerous), and early emphysema. I am NOT a doctor, but I've had several CT & PET scans. I think it's a wake-up call to look into smoking cessation patches or other support to help. I smoked for 16 years, quitting at age 31. I'm 68 and was diagnosed with non-small cell lung cancer stage 4 right before Xmas 2025. Found out I had a genetic mutation. I had a negative biopsy last September, so I thought I was okay. Until I had a follow up scan in early December. Then my world came crashing down. I certainly understand your fear. Will you be seeing the doctor that ordered the scan again soon? They can certainly help you through the next steps.

Hi@mamajite. I composed a note to my doctor (pulmonologist) that I see on the 18th. Hello Dr. Farhad. Thank you so much for taking me as a patient. I am truly blessed to have you as my pulmonologist. I am composing this note to assist you and give you a background of why we are here. Doctor, I truly hope, pray, and wish to hear you say that what you're looking at is not a case of present or future cancer but unfortunately, after researching and taking risk assessments for lung cancer, I feel that my hope of not wanting cancer is going to end up the complete opposite and be a case of malignancy. Doctor, when I was about 10 years old, I was exposed to asbestos, and the exposure was a sheet of insulation that was lined with asbestos, and I thought it was something harmless, I played with it. I smoked cigarettes for approximately 19 years, half a pack a day (10 cigarettes a day), and a habit. Like everyone, I have been exposed to radon and other pollutants from gas exhaust. Going back to the abestos, I read several articles that smoking cigarettes and being exposed to abestos raises the risk of lung cancer astronomically. I am truly paralyzed with fear doctor and afraid to die. I know there are individuals who get lung cancer in the 40s, but I read that it is uncommon and that the majority of people who get diagnosed with lung cancer happen when they are in their mid 60's to early 70s. That's why I am certain that my exposure to abestos and cigarettes has sped that process much faster to now. What else caught my attention was that two of the nodules were in the upper right lobe, and that location in the upper lobe is a strong indication for malignancy. I have been crying, hitting my head, praying for this to be non-cancerous. Thank you so much, doctor, for reading. I just wanted to give you some important information.

@joe88 it's really good you've got an appointment this week. until then, try to take your mind off of worrying (it won't change anything.) the unknown time is the hardest for many of us, where nodules are found on imaging, but we don't know what they are yet. until you have a biopsy - you won't know if it's cancer or not. one thing that keeps me hopeful is that there are many new treatment options for lung cancer. if you're still smoking, looking into programs that can help you stop would also be helpful. you can also make a list of questions you would like to ask your doctor this week. let us know how your appointment goes.

Hi@medtech4
Thank you for your response. Yes, it seems from the radiology report, suggests benign at this time, wait to follow up in 12 months to do another low dose CT chest. Then the mild case of emphysema, correct. Oh, I quit the cancer sticks, no longer taking those horrible things. You had that many CT and PET scans? Wow, im sorry buddy. Im glad you quit. Im sorry about your diagnosis of non small cell, especially before Christmas. Damn, thats horrible. I heard with non small it is no longer a death sentence that it once was, is that true? I heard many more drugs on the horizon. So you have a genetic predisposition to lung cancer with your mutation? What is the name of the mutation? I go to city of hope on Friday the 18th to see what the specialist says. I am pretty sure he is going to say it does not look right and that it is a good chance of malignancy. Im pretty sure of it. Did you ever have several nodules? Thank you for your email. Look forward to hearing from you.

Hi@mamajite. Yes, I go to the city of hope on Friday to talk to the pulmonologist. I am certain he is going to say from the report and what I tell him that it does not look good and more than likely I have a malignancy. Im almost certain he will say that. Did you ever have several nodules on your imaging? I dont think they will do a biopsy yet as they are still small. Your right, there is novel drugs out for non small cell but you do still have those where the cancer rejects the treatment and such or if you have small cell which is very aggressive and mutates and evades treatment. Lung cancer is still very dangerous, why it is still number 2 death worldwide. Would you have any questions that you can recommend to me, so I can ask the provider? Thank you so much for your response.

@joe88 It's good that the radiologist seems to think the nodules are benign. That's good news. I think I would believe your radiologist. He does this for a living. You'll probably be told they're benign and they'll just keep an eye on them.
Yes, it's true that non small cell lung cancer is no longer a death sentence. I have the EGFR mutation. (No cancer history in my family-mom had breast cancer and had mastectomies in her late 50's but had a heart attack at age 76 due to smoking 44 years although she quit at age 60. The damage was done. I take a targeted treatment drug that seems to be working for me with minimal side effects called Tagrisso at 80 mg. daily. I had six chemo treatments with cisplatin & alimpta, and 3 with just Alimpta that ended nearly a mont ago. Yes, I had that many CT scans & PET scans! The tumor has shrunk a little and the metasteses have gone away! I had one on my skull, in my brain and lymph node. I was devastated at the diagnosis, needless to say. I saw here that people have used the targeted treatment (just for stage 4 lung cancer -non small cell) for years. There are many drugs on the horizon. My oncologist has a patient who has been on Tagrisso for 16 years! Very encouraging. One day at a time. I was lucky that my side effects for the chemo were minimal. Mostly fatigue and a little nausea. Some loss of appetite on Cisplatin, but lately I have been gaining weight and eating well and not feeling that bad. I'm a little anemic. I look forward to hearing about your doctor visit on the 18th. I really think it'll be good news.

@medtech4 I think it is good as well at the moment but I know things change and thats what im concerned about. Especially having one at 5mm and then having two nodules in the upper lobes. That is a good sign of cancer from what I researched.
Thank you for telling me that non small cell is no longer a death sentence. I remember 20 years ago, once you had lung cancer, plan your goodbyes. Scary to say the least. Doesn't the EGFR mutation happen because of smoking? I thought i recall reading about that. Wow. Your mom was a good old lady, smoked 44 years and she passed away from the heart attack at 76? Wow, it seems like that drug Tagrisso does wonders. I am happy that it is working for you with minimal side effects. Happy for you buddy. Im sorry, sounds like you were a walking radiation toy for awhile. Hey, the metastasis gone away, right on my friend! Thats the best news of all! I bet you were devastated hearing the news on the skull and lymph node. Man, that is absolutely horrible. That is incredible, your oncologist has a patient who is 16 years in remission, wow! That is very encouraging! Great for him! I am happy that you were able to overcome those hiccups with the side effects and feeling better. Thank you for wishing me good news on the 18th but I seriously doubt it. Having 2 upper lobe nodules and smoking with a one time big exposure with abestos. I can almost guarantee a cancerous diagnosis. I seriously hope not but that is what my gut is telling me. I will definitely let you know. I have a phone number if you want to keep in contact my friend? Just let me know. Thank you sir.

@joe88 I like this suggested list of questions to ask your doctor from the American Cancer Society. They have a printable copy of it, too. It's pretty exhaustive, so you can choose what seems pertinent for you.
https://www.cancer.org/cancer/making-treatment-decisions/questions-to-ask-your-doctor.html
When my nodules were found in 2018 I had "35-40". 🤕 (My situation is more unusual. I was born with a genetic mutation, EGFR T790M, that makes it easy to develop lung cancer.)

@mamajite thank you so much! That is a lot of questions as it should for such a horrible disease such as cancer. Thank you so much mamajite! Wow, you had that many nodules, between 35-40? Holy Moly. Im sorry you are predisposed to lung cancer with the gene. Wow! I hope i dont have any mutated gene as such. thats scary. Bless you mamajite and thank you again!