There are a few issues here:
(1) ecretriever: You say above that it’s a lung nodule but then ask about a “small growth on the liver.” Was that just a mistake?
(2) It’s unclear to me whether the nodule is 1-1.5mm in diameter or whether it *grew* 1-1.5mm. In one place you say it “grew 1-1.5mm,” but in another you say it “is only 1.5mm.” This is crucial for several reasons. 1-1.5mm is very small, and that affects the likelihood of it being a met significantly. It is impossible (or nearly so) to evaluate by scans or biopsy at that size as well. If it *grew* by 1-1.5mm, then what size is it and how fast did it grow? The key issue there is volume “doubling time.” Grossly, this can be determined by the diameter. A .26x increase in diameter means the nodule has doubled in volume. There are time periods for doubling of CRC pulmonary mets, but I *think* it’s usually 30-120 days. (Somebody can check me on that.) Too slow/fast and it’s not likely a met.
But further, if it’s 1-1.5mm or thereabouts, all of that is pretty useless. You cannot really see diagnostic characteristics at that size, and observer (radiologist) error/variation in size is about 1.72mm. So we’re back to the question of size vs. growth.
Next, you need to look at your scan history (that should be obvious from the above). When were the scans that showed the growth (if any)?
Finally, as to chemo after pulmonary metasectomy: This is a debated issue. The available studies I’ve seen show benefit in PFS (progression-free survival) but not OS (overall survival). The trouble is that chemo doesn’t usually eradicate lung mets. 10-year survival can approach 30%, though of course YMMV (e.g., longer disease-free interval means you’re better off, as would extensive pre-treatment and lack of other known mets (e.g., liver)). Size also matters.
IF you have a pulmonary micronodule (1-1.5mm), I think everybody is going to advise you to watch and wait ‘til it declares itself one way or the other. It will need to be substantially larger than 1-1.5mm to resect and test, in any event.
Hope this is helpful.
7/19: Rectal cancer: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (side effects/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 small growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
CT 3/22: Clear
Thoracic CT 5/19/22 Clear
6/20/22 TAE rectal polyp benign
CT/MRI 9/11 Clear