lung nodules

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lung nodules

Postby fdcfromkcmo » Sat Jul 07, 2018 12:44 pm

Hi! I thought I just posted this but I guess not. :/

I'm 32 y/o female recently completed 6 months of FOLFOX, after a LAR 11/2017 for Stage 3 rectal cancer. I had chemoradiation last August as well. My surgery went well with 1/16 lymph nodes involved and I have reversal scheduled for July 31. I was excited to get my CT scan results but heartbroken when they showed two small (1mm & 4 mm) lung nodules.... now I've gone from being confident, proactive & goal-oriented to a total mess. :(

The nurse said they weren't noted in previous CT scans but they may not have been looking for them either. I'm like: why not? I have cancer!

My communication with my onc is not great and if cancer were to return I would definitely be shopping for a new oncologist. In the meantime I trust his judgment to wait 3 months but am having a hard time managing my stress or finding any reliable source of information/comfort. I have made so many compromises this last year, endured so much humiliation & put up with 12 rounds of aggressive chemo hoping it would "mop up" what was left, so to see these results within 5 weeks of my last treatment is a shock. My pathology reports didn't indicate any kind of aggressive/metastatic cancer and my intuition up until now has been very good. I know too though that I am jumping to conclusions and thinking a bit irrationally. Any advice would be appreciated.

BTW, my doctor has never ever mentioned my CEA levels; these are something I've only read about online.

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Re: lung nodules

Postby heiders33 » Sat Jul 07, 2018 6:43 pm

I hope someone else can chime in to help; I can only say that I’ve read of plenty of survivors who have had lung nodules. I just want to add that my doctor never once mentioned CEA either. I read about it on here and had to specifically ask for it. I don’t even know what my starting CEA was so I don’t know if it was a good marker for me.
36 year-old female
May 2017: Dx rectal cancer at T3N2M0
June-July 2017: 28 days of chemo/radiation
September 2017: laparoscopic LAR surgery with loop ileostomy
October 2017 - February 2018: XELOX six rounds
March 2018: reversal
April 2018: CEA 2.1, all blood counts normal
May 2018: CT scan showed liver spot
August 2018: Abnormal PET, CEA 2.4
September 2018: liver resection with HAI pump

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Joined: Sat Oct 21, 2017 1:34 pm

Re: lung nodules

Postby retiredteacher » Sat Jul 07, 2018 8:33 pm

My oncologist never mentioned CEA. The surgeon did - it was notable only because it was so low - and it's not a guaranteed marker for everyone. Consider getting copies of ALL your diagnostic and blood reports and keeping them in a binder. Lots of people here have noted lung nodules - they can be a result of lung irritation or scarring from old inflammations. In other cases there are solid reasons for waiting. I have a couple tiny spots I believe were there long before and did show up on the PET but noted that may be old scarring. Radiologist guessed may be valley fever since I live in the Calif Central Valley and lived in a hot spot area many years. At any rate, they will have to be watched. This is a tough situation for you to be in - if you aren't comfortable with your oncologist, perhaps start shopping now? As you will have literally years of followup, wouldn't it be nice to have someone with great communication? I changed surgeons right in the middle for similar reasons and it made a world of difference in my outlook ... You are still proactive and goal oriented! This has not changed - this is a bump. Hang in there and best wishes ...

RC, F, 63 at diagnosis, Sept. 2017
Adenocarcinoma 6.3 - 7 cm tumor (PET)
Initial path, MSS, G2,
Stage est. T3N0M0 PET only
2500 Cap/RT Oct/Nov18; 25 treatments
"Near complete metabolic response" PET Jan 2018
CEA 0.5 Oct. 2017, Jan. 2018
MRI Feb. 2018 for Presurgical staging yT2 N0 12 cm from AV 3 cm in size
LAR Feb 20 yT1N0M0 0/21 G1 0.3 cm in size
CAPEOX starting March 2018, oxi and cap reduced to 80% at cycle 3
Completed 4 cycles CAPEOX; stopped due to gut issues.

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Location: Michigan

Re: lung nodules

Postby susie0915 » Sun Jul 08, 2018 8:12 am

I had my first CEA drawn after I finished chemo/radiation before surgery. So I also don't really know if it is a marker for me as after chemo/radiation my surgeon did a sigmoidoscopy and said all that was left was scar tissue. I did have surgery and pathology showed minimal residual cancer cells, 0/24 lymph nodes, and clean margins. I did do adjuvant chemo for 6 rounds. My CT scan after finishing chemo did show scarring and inflammation in the lungs. My oncologist this could be caused by chemo and referred me to a pulmonologist. The pulmonologist has been monitoring me, as she believes the lung issues are caused by an auto immune disorder although I have no other symptoms. My scan one year after finishing chemo did indicate a 4mm lung nodule in May, 2017. The pulmonologist said it was too small to biopsy and too small for a pet scan to pick up. So she ordered a scan 3 months later, and 6 months after that to watch for growth. She said it would have to double in size before any testing could be done, but if it stays stable or shrinks they know it is not cancer. Both my oncologist and pulmonologist don't believe it is a met, but the pulmonologist did say always possible it could be a new lung cancer. However, the nodule has stayed the same for one year and it now attributed to the scarring and inflammation in the lungs. Your nodules are probably too small to test, so my guess is that your oncologist will want to do some repeat scans to watch for growth. Nodules can pop up for different reasons such as any type of lung infection. Hopefully these nodules will disappear which has happened to many on the forum, or shrink or stay the same. They are both very tiny and cancer I believe tends to grow fast. Each scan I had that showed no growth helped me deal with the anxiety. Keep us updated as to what your oncologist decides to handle this.
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoid/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod
7/17 no change lung nod
10/17 Clear pel/abd CT
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, clear CT pel/abd/lung nod no change

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Location: T.O.

Re: lung nodules

Postby Utwo » Sun Jul 08, 2018 11:52 am

fdcfromkcmo wrote:I was excited to get my CT scan results but heartbroken when they showed two small (1mm & 4 mm) lung nodules.... now I've gone from being confident, proactive & goal-oriented to a total mess. :(
These are too small.
They could have been missed on a previous CT scan.
They can also be of non-cancerous nature.

In a similar situation they just scheduled a follow up scan (low dose, lungs only) in 3 months.
After a follow-up they told me that it was not cancer.
58 yo male at diagnosis - T1bN0M0, 0/15 lymph nodes, low grade/moderately differentiated adenocarcinoma
03/2016 colonoscopy #1: 2 small polyps removed in left colon; CEA = 1.3
04/2016 colonoscopy #2: caecum sessile 3.5 cm polyp piecemeal removed with kind of clear margins
05/2016 CT scan, blood test ...
05/2016 "prophylactic" laparoscopic right hemicolectomy with a few complications (bleeding, leak, infection)
06/2017 CT scan (lower body), colonoscopy OK; CEA = 1.6

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Re: lung nodules

Postby Dionca » Sun Jul 08, 2018 2:16 pm

Try not to worry - they are tiny and could be unrelated to cancer. I've had liver, and then lung nodules pop up, but so far they haven't grown, so are hopefully benign. I think all they can do at this stage anyway, is to wait to see if they grow.

Regarding CEA - check your blood test results, it should show on there. They often don't test CEA during chemo because it can rise, and may not come down until several weeks after chemo. If you haven't been tested, then ask why.
May 2015 right hemi CC cecum
removed terminal ileum, illeocecal valve, appendix, cecum and ascending colon, omentum
stage 3b T3 N1b MX 2/27 nodes (isolated tumour cells in 1 additional node)
moderately differentiated
PNI - positive
LVI - positive
Folfox 12 sessions (oxi discontinued for 11 & 12)
Neulasta with 3-12 due to low WBC count
CEA at diagnosis 8.6 and after surgery 1.2
CEA during chemo 4.6 / 3.3 / 2.3
CEA after chemo 1.5 / 1.2 / 1.2 /1.2 /1.2 / 1.4 / 1.1 / 1.2 / 1.9 / 1.3 / 1.6

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Re: lung nodules

Postby fdcfromkcmo » Sun Jul 08, 2018 7:06 pm

Thank you guys. It's hard when you have a positive mindset to have your confidence shaken; I've read so much about mind/body connections that doubt & fear seem like the first stages of metastasis, it's hard to be scared without feeling extra bad for being scared....! I don't want to mention this to my mom so also allowing myself to feel relieved that chemo is over & surgery is soon, accepting congratulations from friends & family AND knowing that the price you pay for survival is vigilance and occasional paranoia.... ugh it's just a lot to hold in yr mind at once. but yall knew that :)

back on my xanys!

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