The Colon Club

I have a few small new nodules on the last CT scan.
According to their interpretation they are of inflammation nature.
They recommended a follow up scan in 4 month.

Is this typical in a similar case to get referred to a pulmonologist?
I have not received such referral so far.

Utwo wrote:I have a few small new nodules on the last CT scan.
According to their interpretation they are of inflammation nature.
They recommended a follow up scan in 4 month.

Is this typical in a similar case to get referred to a pulmonologist?
I have not received such referral so far.

I have a pulmonologist because my first scan after finishing chemotherapy my lungs showed scarring and inflammation. Was not sure if it was caused by chemo or other reasons. Pulmonologist believes it is from an auto immune disorder and may have been made worse by chemo. Now I see her every 6 months to have breathing tests, and monitor the progress. She then referred me to a rheumatologist who monitors me for auto immune disorder. I have no other symptoms but I am being watched for scleroderma, lupus, sjogrens, and rheumatoid arthritis. All of these can cause interstitial lung disease which is what I have. So normally, just your oncologist would prob monitor nodules. My nodule didn't show up until one year after I was referred to the pulmonologist, so that is why she is kind of in charge of my lung issues.

My husband has had several scans he has lung nodules too, but they felt it was an inflammatory process as opposed to any metastasis. It can happen, they haven’t changed and the guess is he had pneumonia a while back, or maybe from chemo? Dunno but the docs don’t seem concerned and he gets scans every couple of months. Hope this helps. I guess they can tell by looking at them what’s going on and if there’s more or they grow.

Figured I'd give an update. Mom had her 6 month follow up scan and her nodules all either disappeared or shrunk! Wow! Follow up scan in 6-12 months.

Good news!

Hi,
I had a lung nodule in the up0per left lobe removed 1.5 years ago and then before Christmas they found a 4mm nodule that in the last scan was 2mm (really small) in the same lobe. So I am doing the follow up 3/20. I would like to hope that it turns out to be nothing, but not really sure that's reasonable. Anticipating some form of radiation ablation.

James

I have been a smoker for 49 years, I have a 4 mm nodule. It has been there throughout my cancer travel . It never picked up a hit on the Pet Scans, although it does show up on CT's. It also shows up on X-rays, so's I get the X-ray instead of CT's as it cost way less. There has been no new growth, in 4 years !
Michael

HI susie0915 how often are you getting a full CT scan for the lung node? OR how many months apart are all your scans? I have a 2mm node that has been stable for a year. I had stage 1 T2, 0/27 nodes. 1 year colonoscopy was clean. So far its been 18 months since my surgery and I had CT before surgery, Ct 6 months, Ct at 1 year. I thought I would be able to go a year without a scan since my 2mm node hasn't changed and everything else is good. Stage one usually doesn't not have follow up with so many scans. Any one have a similar experience?

How often do they scan for a 2mm lung node if its been stable with no change after 1 year? I had stage 1 T2 O/27 nodes. Usually Stage 1 do not get full body scans every six months. My first year I had six month apart scans and now its the 18 month and she orders another. My last scan was September which was 6 months ago. Everything was stable and good. I would think I could get just the chest and then a full body next September ( 2 year) but she order a full scan now and then again in another six months 2 year. I am being teated like stage 2 not stage 1. Can anyone tell me their experiences with lung nodes and the frequency of scanning?

jaybel wrote:HI susie0915 how often are you getting a full CT scan for the lung node? OR how many months apart are all your scans? I have a 2mm node that has been stable for a year. I had stage 1 T2, 0/27 nodes. 1 year colonoscopy was clean. So far its been 18 months since my surgery and I had CT before surgery, Ct 6 months, Ct at 1 year. I thought I would be able to go a year without a scan since my 2mm node hasn't changed and everything else is good. Stage one usually doesn't not have follow up with so many scans. Any one have a similar experience?

Once it was found on my one year ct scan, I had a repeat at 3 months of the chest. No change, then had another chest scan 6 months later. No change. Now my pulmonologist says she doesn't need another chest scan for one year. However, my oncologist will be ordering my regular scan when I see her in May, so I will probably have another in June which will be 6 months from my last chest scan. So long as the nodule hasn't changed and nothing else is found, I think I will have another scan either 6 months or one year later. I'm not sure. My last scan of pelvis/abdomen was in October, and my pulmonologist says my chest scans can now be done with my abdominal/pelvic scan. I think with tiny nodules like yours 1 year follow ups would be standard.

susie0915 wrote:Once it was found on my one year ct scan, I had a repeat at 3 months of the chest. No change, then had another chest scan 6 months later.

Susie, what kind of scans were your lung scans?

In my case they used low dose without contrast IV drugs scans for lungs.
What is a difference beween these two types of CT scans?
When do they use one or the othe type?

I am really confused on what to do. My doctor won't change the order to lung only and my GP thinks I don't need so many scans since I had stage 1 and my node had been stable for a year. I need a new oncologist to follow me. My 2mm node was on my lung when I was diagnosed so they found it on my first scan before my surgery. Six months later I had another scan and then again at the 1 year. So now its been 18 months and my oncologist ordered another full body scan. So far the node has been stable and there is nothing new. My CEA was normal to begin with and although its gone up over the last 18 months from .3-.9 its still within normal range. And I have had it checked at other labs and it went back to .5 so it depends on the lab. I think I should of had a lung scan at 6 months, full CT at 1 year and now at 18 months a lung CT and then a full one at the 2 year. I don't want to keep getting full scans every six months. My cancer was stage 1,T2, 0/27 nodes and the guidelines for followup is not a full scan every six months. Anyone have any a good oncologist in the Southern California? Thanks for any advice or help.

Utwo wrote:

susie0915 wrote:Once it was found on my one year ct scan, I had a repeat at 3 months of the chest. No change, then had another chest scan 6 months later.

Susie, what kind of scans were your lung scans?

In my case they used low dose without contrast IV drugs scans for lungs.
What is a difference beween these two types of CT scans?
When do they use one or the othe type?

Yes. the chest scans were without contrast. Only my abdominal/pelvic scans have been with contrast.

jaybel wrote:I am really confused on what to do. My doctor won't change the order to lung only and my GP thinks I don't need so many scans since I had stage 1 and my node had been stable for a year. I need a new oncologist to follow me. My 2mm node was on my lung when I was diagnosed so they found it on my first scan before my surgery. Six months later I had another scan and then again at the 1 year. So now its been 18 months and my oncologist ordered another full body scan. So far the node has been stable and there is nothing new. My CEA was normal to begin with and although its gone up over the last 18 months from .3-.9 its still within normal range. And I have had it checked at other labs and it went back to .5 so it depends on the lab. I think I should of had a lung scan at 6 months, full CT at 1 year and now at 18 months a lung CT and then a full one at the 2 year. I don't want to keep getting full scans every six months. My cancer was stage 1,T2, 0/27 nodes and the guidelines for followup is not a full scan every six months. Anyone have any a good oncologist in the Southern California? Thanks for any advice or help.

jaybel, the first principle of moderm medical ethics is "Patient's Autonomy".
According to this principle, it's up to you to accept or not to accept a doctor's recommendation.
Just tell your doctor that you are not comfortable with high dose full body scan every 6 month and ask to change the requisition to low dose lungs only.
Change your doctor if she refuses to accomodate your request (or ask your GP or surgeon instead of oncologist to order low dose scan).

Thats exactly what I am doing. I asked why the need for another full scan and she said no reason I do the same with everyone. I still might go ahead and get the scan but I just want a few other opinions before I go in for another full CT. It just makes it stressful when communication is poor between patient and doctor.