The Colon Club

I had my 4 year scan on 12/18/2017 and I got my report yesterday. there is one lung nodule 3mm from my initial diagnosis(10/2013) only and it was stable till my last scan which was in April this year. In my yesterday report my lung nodule has increased from 3mm to 6mm which is freaking me out. Any thoughts ?
should I get it removed or wait and watch ?

I have a 4mm nodule that is being watched. I have a scan in January to check it. It is my understanding that a nodule must be at least 8mm to do a biopsy or for a pet scan to pick it up. Three years seems like a long time for it to be cancer. It is my understanding cancer generally grows fairly fast. My oncologist and pulmonologist both don't believe my nodule is a met as I do have scarring and inflammation in my lungs and they think it is from that. However the pulmonologist did throw out the possibility of a new lung cancer. (ugh), but have to wait and watch. What does the report say about the nodule? Mine just says non specific but because of past malignancy recommends follow up. My last scan showed no change. I'm not sure, but doctors may just recommend to continue to watch. I know it's so hard. Especially when generally if a nodule has not grown in 2 years it is considered benign.

Have you had a PET scan? That might be of assistance.

@susie report says serial followup to rule out malignancy. I wish your nodule to be stable or gone by December. Its very hard for me think that it has doubled its diameter after 3.5 years.

@Terri Pet scan was not done as oncologist thought its small for pet scan to pick.

Iitg ritesh wrote:@susie report says serial followup to rule out malignancy. I wish your nodule to be stable or gone by December. Its very hard for me think that it has doubled its diameter after 3.5 years.

@Terri Pet scan was not done as oncologist thought its small for pet scan to pick.

It does seem weird that is would grow after 4 years. Did it grow from the April scan? Or was it the April scan when it showed growth to 6mm? It may still be too small to do further testing, I don't know. I was told had to be at least 8 mm for biopsy or pet scan to pick up. I know you prob already know this. This is so hard, I'm sure you were told if stable for two years it's assumed to be benign. Did you contact your oncologist?

It was not grown in April scan. it was stable till that time. we saw this growth in yesterday oncologist visit. so most likely it has grown after April this year. yes PET scan will not be helpful at this point. yes in my last scan they told it is stable and looks like benign etiology. But in my recent report it is written for serial followup to rule out malignancy.

Yeah I'm not sure. Maybe call your oncologist. I'm sorry you have to worry about this. Hopefully it will turn out not to be anything to worry about.

I did call her and she is in favour of wait and watch. but I am not ready to wait another 3 month. Not sure what should I do.

During the course of my wife's treatment of nearly 4 years they kept an eye on some nodes in her lungs initially thought to be mets. But over that time period they never really showed any outward signs of being mets. They hardly changed at all. The only way to tell if they were mets would have been biopsies and the oncology team thought that too risky seeing as she had other known mets that they were treating already with FOLFOX, Then FOLFOX + Avastin then 5-FU and Avastin, followed by Irinotecan, Avastin, and Erbitux. No changes there at all. Measurements of small mets are kind of unreliable in my opinion on that scale. Also they are subjective as well depending on the person reading the scan. Same Radiologist both times? One might determine the boundary different than another.

About all I think you can do is take a wait and see position of this sort pf thing. Monitor all your blood work for potential markers (CEA etc....).

Good Luck.

GrouseMan

GrouseMan wrote:During the course of my wife's treatment of nearly 4 years they kept an eye on some nodes in her lungs initially thought to be mets. But over that time period they never really showed any outward signs of being mets. They hardly changed at all. The only way to tell if they were mets would have been biopsies and the oncology team thought that too risky seeing as she had other known mets that they were treating already with FOLFOX, Then FOLFOX + Avastin then 5-FU and Avastin, followed by Irinotecan, Avastin, and Erbitux. No changes there at all. Measurements of small mets are kind of unreliable in my opinion on that scale. Also they are subjective as well depending on the person reading the scan. Same Radiologist both times? One might determine the boundary different than another.

About all I think you can do is take a wait and see position of this sort pf thing. Monitor all your blood work for potential markers (CEA etc....).

Good Luck.

GrouseMan

Agree with GrouseMan on taking a wait-and-see approach combined with active monitoring of blood markers.

My story: I had a nodule that started growing and was flagged by a radiologist as "likely to be metastatic." Its shape was irregular which is frequently a sign of a met. Because biopsies are usually inaccurate in these situations and there was some fear of "seeding" if it turned out to be a met, the decision was made to simply remove it via a VATS procedure.

It turned out to be a benign granuloma -- not cancer. The key thing though was that my CEA did not go up when the nodule started growing. So hence my advice on monitoring CEA and other bloodwork (LDH, etc) to see if there's any inflammation. If bloodwork remains stable, then there's a strong likelihood (but not certainty) that it's nothing. Still, some thoracic surgeons like to remove even benign nodules if they are growing, following the "better safe than sorry" school of medicine.

Hope this helps.
Juliej

I had a stable nodule for almost two years. Unfortunately, my last scan showed growth.

We opted to remove it despite a negative biopsy and I’m so glad we did as it was positive for cancer. This decision was made based on an increasing CEA (an excellent indicator for me) along with the growth.

I’m so sorry to hear you’re going through this and am sending up positive thoughts and prayer for a benign nodule.

Beccaschocked wrote:I had a stable nodule for almost two years. Unfortunately, my last scan showed growth.

We opted to remove it despite a negative biopsy and I’m so glad we did as it was positive for cancer. This decision was made based on an increasing CEA (an excellent indicator for me) along with the growth.

I’m so sorry to hear you’re going through this and am sending up positive thoughts and prayer for a benign nodule.

Yes it is a good thing. Hopefully, that'll be it for you. because we get scans regularly the good thing is things are picked up early. Your story is why I get nervous every time I have a scan. Never know when it will start growing.

susie0915 wrote:

Beccaschocked wrote:Yes it is a good thing. Hopefully, that'll be it for you. because we get scans regularly the good thing is things are picked up early. Your story is why I get nervous every time I have a scan. Never know when it will start growing.

Susie I hope my story doesn’t discourage you, I mostly wanted to share that there was also an increase in CEA, which is why we moved forward.

Sounds like there are many out there who’ve had benign nodules grow. Praying that’s the case for you as well.

I know waiting is the hardest part though!

Beccaschocked wrote:

susie0915 wrote:

Beccaschocked wrote:Yes it is a good thing. Hopefully, that'll be it for you. because we get scans regularly the good thing is things are picked up early. Your story is why I get nervous every time I have a scan. Never know when it will start growing.

Susie I hope my story doesn’t discourage you, I mostly wanted to share that there was also an increase in CEA, which is why we moved forward.

Sounds like there are many out there who’ve had benign nodules grow. Praying that’s the case for you as well.

I know waiting is the hardest part though!

It's okay. I know there is always a chance it can grow. My CEA has never been higher than 1.1 which was during chemo, usually is less than .5 so I don't know if it is a marker for me. I never had it taken until after I finished radiation/chemo before surgery and is was less than .5. So we will see next week how my scan goes. I try to stay positive most of the time. I have lung issues now (scarring and inflammation) that was either caused by chemotherapy or could be an autoimmune disorder. So now I see a pulmonologist every 6 months and have tests to test my lung capacity, and have to see a rheumatologist if it is an autoimmune disorder. Lol. I am officially one of those that is always has some kind of doctor appointment. It sounds like you are doing well now.

PET scan picked up small lung nodule 1 year post surgery. Too small to biopsy. I had it removed by VATS at Mass General. It was colo-rectal cancer. I am now doing Folfox. The difference with me, it had not appeared in any previous CTs (June, Feb and June). When it showed up in the 2nd June scan I got a PET scan. And had it removed.