New Lung Nodules Found On Latest CT Scan

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stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby stu » Sun May 16, 2021 5:03 pm

Hi ,

This subject unfortunately comes up a lot here and at that size it’s really hard to know what’s going on . After chemo my mum developed three lung nodules . One was 7 mm but having watched it for two years it never grew . One is 4 mm and again they watched it for two years and it never grew . One started at 2 mm and grew to 8 mm and was removed and in fact cancerous.
She did have a pet scan which the one did show uptake!
I can categorically say she did not have them prior to chemo or after chemo as in our country it would have disqualified her for liver surgery back then . They came after all that yet two were completely benign . Five years later and they are still the same .

For my mum they did a watch and watch to see what happened to them . It took two years to get to a conclusion and they were able to do a Pet scan . Not sure how kern they are on biopsies in the lung but certainly something to chat to your team about ! However I do wonder what caused the other two to pop up .
Hope your team can help you . Certainly my mum’s oncologist was able to show her the difference between the two on her scan !
Take care ,
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby stu » Mon May 17, 2021 2:56 am

Is the information you provided in your first post from a recent scan or measurements from your scan in Nov !

It certainly sounds as though you have had some form of infection or inflammatory reaction in your lungs from the Oct / Nov reports !
Did the radiologist make any determination on the appearance of the measured ones you referred to in your first post ?

It is an anxious time but I notice you had an excellent response to treatment before so hold onto that as an insurance policy for the mind !
Take care ,
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

claudine
Posts: 809
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: New Lung Nodules Found On Latest CT Scan

Postby claudine » Mon May 17, 2021 10:19 am

I'm sorry about the nodules and anxiety they are causing, prayingforcrc. I hope they're benign! But in case they're not - my husband developed "a multitude" (radiologist's words) of small nodules <5mm in both lungs over 2 years ago. He had systemic chemo (Folfiri + Avastin) and they all resolved (there are still a few, but they've been unchanged for several scans so likely calcified). Keep us posted XXXXX
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary

Tumors: L4 04/18; left adrenal gland & small lung nodules 03/19
rectum 02/22 (pT3 pN0 stage 2A); L3 09/22

Surgeries: intestinal resect. 05/18 (no cancer - Crohn's); adrenalectomy 02/20
L3-L4-L5 fusion and corpectomy 05/20; LAR 04/22; ileo reversal 09/22
L2-L3 fusion and corpectomy 09/22

Treatments: EBRT 04/18; SBRT 02/19; Failed adjuvant Xelox ; Folfiri/Avastin 03/19 - 01/20
adjuvant chemorad (Xeloda) 06/22; SBRT 11/22; Xeloda/Avastin since 01/24

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby roadrunner » Mon May 17, 2021 11:13 am

I wish you the best with this. To understand this better, we need more information. For example, what was the radiologist’s recorded “impression” on the recent scan report? If there was a concern for metastatic disease, he or she would usually note that. Also important—you mention your October and November scans, but you don’t advise whether any of these nodules were found on those scans. The nodules you mention, while not large, would have taken a while to grow if they are CRC mets. If they were absent on the November 2020 scan, the apparent growth rate for some would likely exceed the maximum recorded rate for CRC mets. Some radiologists ignore nodules below a certain size, but on my scans they’ve noted them down to 1-2mm. Finally, did the radiologist note a shape for any of the nodules?
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby roadrunner » Mon May 17, 2021 11:48 am

Thanks for the information. I agree with you that the radiologist’s impression is expected in this circumstance, and is not ominous in and of itself. There is a range of possibilities, but the fastest “doubling time” I’ve seen is 27 days, with medians much higher. While I suppose it’s possible that these were visible before but just not noted, which could bring them into that range, there does still seem to be a real possibility that these have grown too fast to be CRC mets. I hope that's the case. Obviously, your MSK oncologist’s views are crucial.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby roadrunner » Mon May 17, 2021 11:55 am

Any discussion of these nodules should cover the scan history. For example, is the 2mm one from November larger, or stable, or smaller/gone? Were the others there but just not noted? Do the radiological findings suggest anything, even if not definitive?
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby stu » Mon May 17, 2021 5:37 pm

But one previously measuring 1.5 cm has since disappeared?
That just shows how complicated nature of this situation !
I think with a previous cancer diagnosis the goal posts shift to ruling everything out rather than ruling in .
Hopefully your team will find a way to clarify what is going on and ease this anxiety!
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby stu » Tue May 18, 2021 2:50 pm

Hi ,
Just spoken to someone who would know a bit about that and they would not anticipate that to occur .
Hope you get some answers and they disappear as quickly as they came .
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby roadrunner » Tue May 18, 2021 3:52 pm

I would ask them to look closely at scan history, and of course consider therapeutic choices with them. As someone said above, there are chemotherapeutic/radiation options even if these are, or some of these are, metastases. Waiting three months may be ok, but you should make sure that the passage of time will not make treatment tougher if the odds favor metastases. That’s one reason to look closely at the history—they may well be able to give you a doubling rate(s), and determine if any thoracic structures would be potentially affected by growth, or if therapeutic options might be foreclosed thereby. You’ve got MSK going for you. They will know the options, if it comes to that.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby stu » Tue May 18, 2021 5:48 pm

Definitely not without hope ! Claudine’s husband bears testimony to that and also remember you respond to treatment very well .
I think Roadrunner made a really valid point about not looking at these in isolation but casting an eye over the previous two scans to provide a better understanding.
take care ,
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby roadrunner » Wed May 19, 2021 8:14 pm

I am very sorry to hear you got that news. I wish you good fortune with the treatment plan you and your doctors choose. There are still chemotherapeutic and/or radiation options I hope, and perhaps these can create a road to better things.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

User avatar
beach sunrise
Posts: 1034
Joined: Thu Mar 05, 2020 7:14 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby beach sunrise » Thu May 20, 2021 12:57 am

I am so very sorry to hear your news!
Yes, get 2nd/3rd opinions on treatment and surgery.
Keep us updated with your search for better options.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby stu » Thu May 20, 2021 2:42 am

Hi ,
So sorry to read your update !

Take the time you need to stabilise after such news then read over again Claudine’s husbands story and draw strength from a good treatment plan .

My mum started out on an Non curative plan back in 2009 and I am just about to take her out for coffee .

Once you have got over the initial blow focus on finding a good team to take care of your treatment . Remember not all of them may be malignant. At the same time my mum’s one malignant one popped up two benign ones did too!
Praying for you !
Stu
Last edited by stu on Thu May 20, 2021 3:44 pm, edited 1 time in total.
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

claudine
Posts: 809
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: New Lung Nodules Found On Latest CT Scan

Postby claudine » Thu May 20, 2021 10:26 am

I am so sorry to read this, prayingforccr. But not altogether surprised, unfortunately... Cancer is a sneaky beast. But as Stu's mom's story attests, it can be beat! Many people start with a "chemo for life" or "no curative intent" prognosis yet move on to being NED. You can too! I hope you find a team you are happy with; please keep us updated on your treatment plan.
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary

Tumors: L4 04/18; left adrenal gland & small lung nodules 03/19
rectum 02/22 (pT3 pN0 stage 2A); L3 09/22

Surgeries: intestinal resect. 05/18 (no cancer - Crohn's); adrenalectomy 02/20
L3-L4-L5 fusion and corpectomy 05/20; LAR 04/22; ileo reversal 09/22
L2-L3 fusion and corpectomy 09/22

Treatments: EBRT 04/18; SBRT 02/19; Failed adjuvant Xelox ; Folfiri/Avastin 03/19 - 01/20
adjuvant chemorad (Xeloda) 06/22; SBRT 11/22; Xeloda/Avastin since 01/24

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

Re: New Lung Nodules Found On Latest CT Scan

Postby roadrunner » Thu May 20, 2021 2:24 pm

In addition to Stu’s and Claudine’s uplifting stories, there are accounts of similar success stories in the literature. I assume your team has plans to do genetic testing for this purpose, and to make any therapy more effective. (If not it’s something to look into). I agree with the statement above that your prior response to treatment is likely a plus also. Plus, recall that with the rapid development of therapeutic options extensions of time can open up new options in some cases. Another way palliative care can turn curative.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23


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