I’m still not sure this picture is clear. It *sounds* like your wife had a 1mm (or so) nodule in April which grew “1-1.5mm” by July. Thus, it would now be 2-2.5mm.
There are several things that make me wonder there. First, MD Anderson is apparently contemplating a “biopsy”? That seems curious. If the above is accurate, this is so tiny it would be very hard to find. The procedure would almost certainly be a resection, but even that might be very challenging at this size. Also, while growth of a pulmonary nodule is generally concerning, the growth pattern above doesn’t suggest CRC metastasis. It’s likely too quick (maybe a 30-day doubling time could get you close, but that’s all at the margin). But that suggests more that the data is wrong rather than anything else. At that size, growth evaluations are really difficult, as different observers see different things, contrast/no contrast has a potential material effect, the quality of the scanner can affect results, etc. (You even noted that the most recent scan was done on a more accurate scanner.)
Also, it would seem premature to try to biopsy/resect at the apparent size involved here. If it is a met, it might be very important to have sufficient tissue to do testing. That seems unlikely at this size, at least beyond determination of whether it is in fact adenocarcinoma (which may or may not be possible). VATS surgery to remove it is generally pretty tolerable (depending on location), but it is not something I would do unless I felt strongly that a nodule was a met. At this (apparent) size, very few are, even in a CRC patient.
What I would suggest is an outreach to your wife’s team to understand and discuss the precise history of this nodule (including sizes, types of scans, and timetable), implications thereof, and a specific recommendation on how to proceed.
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