Lung Abnormality/Nodule?

Please feel free to read, share your thoughts, your stories and connect with others!
AdAstra
Posts: 15
Joined: Mon Sep 20, 2021 5:41 pm

Lung Abnormality/Nodule?

Postby AdAstra » Fri Nov 05, 2021 8:39 am

So, my mom was diagnosed with colon cancer back in September. Last we knew, she was probably stage 2B/C; however, she hadn't had a CT scan since the pelvic/abdominal CT she had back in late-June. Back then, apart from the mass in her cecum, everything looked well, though the scan didn't look at her full thoracic cavity (just the lower chest).

At the beginning of October, my mom came down with a gnarly respiratory infection, along with sinus issues and pink eye. She went to a local urgent care, where she had a chest x-ray and was told that everything looked good. She was given medication and sent on her way. Well, nearly two weeks later, she received a call from the doctor at the urgent care saying a "minor abnormality" was found on her scan. He didn't say what the abnormality was or anything about its size, but he told her to follow up with her doctor to make sure it wasn't anything serious.

She has a chest, abdomen, and pelvic CT scheduled for next week, but I'm extremely freaked out in the meantime and thinking the worst. How freaked out should I be? How common is it for there to be lung mets when there was no lymph node involvement and a clear liver back in late June? I'm not 100% sure if this is relevant, but she's had pneumonia years ago, and she is a current smoker.
Caregiver to Mom (63)
Right hemicolectomy on 9/17/21; 5 cm x 4.5 cm cecal tumor (moderately to poorly differentiated ulcerated adenocarcinoma).
CT on 11/9/21: Multiple non-specific and bilateral lung nodules 4 mm and smaller.
CEA (smoker): 3.4, 3.8 (10/2021)
11/9/21: CAPOX
Current (tentative) staging: T4aN0Mx.
MSS, but no further mutational testing done yet.

MadMed
Posts: 54
Joined: Sun May 02, 2021 5:52 pm

Re: Lung Abnormality/Nodule?

Postby MadMed » Fri Nov 05, 2021 10:09 am

I'm not a doctor but i can share my experience.

Did they explain what they mean by "abnormality" ?
I went through a similar experience. A Dr read my CT and pointed out a nodule, the regular Dr that reads my CT had not. When we went back to him, he clarified that the nodule had been there for years, even before my diagnosis and had not changed. Lungs apparently have lots of nodules and only the ones that grow are suspicious.
I also have fibrosis in my lung that was mentioned once.

Hoping in your mom's case it's just a stupid, basic nodule. See this https://facty.com/ailments/body/what-are-lung-nodules/?style=quick&utm_source=adwords&adid=448728735313&ad_group_id=68028542592&utm_medium=c-search&utm_term=lung%20nodule&utm_campaign=FH-USA---Search---What-are-Lung-Nodules---Desktop&gclid=Cj0KCQjwrJOMBhCZARIsAGEd4VExZe4cDDTrtL8Bw8Zl20320lx7G9EBfqMh27l3Pyk86P7SBQY0N8gaAvXXEALw_wcB
52M DX: RC lower rectum, guessing now 2cm from AV 4/27/2021
T3N0M0 adenocarcinoma with signet ring cell features
Tumor size 30mm
Tumor grade: G3
Baseline CEA 1.0
MSI status: MSS pMMR
Started Folfox 5/12/2021
Switched to FOLFIRINOX from session 2. 8 rounds total.
CT+MRI tumor contained shrunk 80%, no spread to other organs.
CRT started xeloda + 28 days Radiation 9/27-11/04
Break before surgery scheduled 1/27/22

Claudine
Posts: 569
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Lung Abnormality/Nodule?

Postby Claudine » Fri Nov 05, 2021 10:28 am

How common is it for there to be lung mets when there was no lymph node involvement and a clear liver back in late June? I'm not 100% sure if this is relevant, but she's had pneumonia years ago, and she is a current smoker.


My husband had lung mets without any node or liver involvement; that said, like IsmaelMehdi wrote, it's not uncommon to have benign lung nodules, especially since she had pneumonia. Fingers crossed that's what this is!
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: high 81.1, low 3.2, now 66.1
Scan 03/19: Multiple small lung nodules, now gone/calcified
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 09/17/2021: stable

AdAstra
Posts: 15
Joined: Mon Sep 20, 2021 5:41 pm

Re: Lung Abnormality/Nodule?

Postby AdAstra » Fri Nov 05, 2021 3:40 pm

IsmailMehdi wrote:Did they explain what they mean by "abnormality" ?


No, unfortunately, we don't have much info about what they meant. My guess is that it's probably not super large or noticeable if they didn't see it during her initial urgent care visit, but I can't be sure. The doctor apparently sent some info to her PCP, but the PCP didn't say much about it, either. She just said there was mention of an "opacity." It'll be good to get more info after she has her CT scan, but at the same time, I'm terrified of receiving bad news.
Caregiver to Mom (63)
Right hemicolectomy on 9/17/21; 5 cm x 4.5 cm cecal tumor (moderately to poorly differentiated ulcerated adenocarcinoma).
CT on 11/9/21: Multiple non-specific and bilateral lung nodules 4 mm and smaller.
CEA (smoker): 3.4, 3.8 (10/2021)
11/9/21: CAPOX
Current (tentative) staging: T4aN0Mx.
MSS, but no further mutational testing done yet.

AdAstra
Posts: 15
Joined: Mon Sep 20, 2021 5:41 pm

Re: Lung Abnormality/Nodule?

Postby AdAstra » Fri Nov 05, 2021 3:43 pm

Claudine wrote:My husband had lung mets without any node or liver involvement; that said, like IsmaelMehdi wrote, it's not uncommon to have benign lung nodules, especially since she had pneumonia. Fingers crossed that's what this is!


Has your husband had chemo continuously since his diagnosis? My mom would be really sad if she had to have chemo for life with no end in sight. I hope she doesn't have any mets, but if she does, I hope it's/they're operable and potentially curable.
Last edited by AdAstra on Fri Nov 05, 2021 5:05 pm, edited 1 time in total.
Caregiver to Mom (63)
Right hemicolectomy on 9/17/21; 5 cm x 4.5 cm cecal tumor (moderately to poorly differentiated ulcerated adenocarcinoma).
CT on 11/9/21: Multiple non-specific and bilateral lung nodules 4 mm and smaller.
CEA (smoker): 3.4, 3.8 (10/2021)
11/9/21: CAPOX
Current (tentative) staging: T4aN0Mx.
MSS, but no further mutational testing done yet.

Claudine
Posts: 569
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Lung Abnormality/Nodule?

Postby Claudine » Fri Nov 05, 2021 4:54 pm

Has your husband had chemo continuously since his diagnosis?


No! He's been off chemo since January 2020 (so almost two years). His oncologist isn't one to push it unless there's something to treat (right now my husband is stable, despite a rather high CEA value). The plan is to resume chemo if/when something pops up on scan (unless it can be resected or irradiated). Cancer, even stage 4, is more and more akin to a chronic disease, not a death sentence :)
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: high 81.1, low 3.2, now 66.1
Scan 03/19: Multiple small lung nodules, now gone/calcified
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 09/17/2021: stable

AdAstra
Posts: 15
Joined: Mon Sep 20, 2021 5:41 pm

Re: Lung Abnormality/Nodule?

Postby AdAstra » Fri Nov 05, 2021 5:10 pm

Claudine wrote:
No! He's been off chemo since January 2020 (so almost two years). His oncologist isn't one to push it unless there's something to treat (right now my husband is stable, despite a rather high CEA value). The plan is to resume chemo if/when something pops up on scan (unless it can be resected or irradiated). Cancer, even stage 4, is more and more akin to a chronic disease, not a death sentence :)


That's really encouraging to hear. Here and on Colontown, I've been really heartened to see so many long-term stage 4 survivors. Some people are even considered cured, which is really remarkable. I've also been really pleased to see the shift towards viewing advanced cancer as a chronic disease. I bet that in 10-25 years, having stage 4 cancer will be like having diabetes, heart disease, or even HIV; people will be able to live good, long lives while keeping the cancer in check.
Caregiver to Mom (63)
Right hemicolectomy on 9/17/21; 5 cm x 4.5 cm cecal tumor (moderately to poorly differentiated ulcerated adenocarcinoma).
CT on 11/9/21: Multiple non-specific and bilateral lung nodules 4 mm and smaller.
CEA (smoker): 3.4, 3.8 (10/2021)
11/9/21: CAPOX
Current (tentative) staging: T4aN0Mx.
MSS, but no further mutational testing done yet.

roadrunner
Posts: 179
Joined: Sun Jan 12, 2020 8:46 pm

Re: Lung Abnormality/Nodule?

Postby roadrunner » Fri Nov 05, 2021 6:37 pm

Just a little reality, which fortunately for you should be very comforting (too often it is not). You say your mother is “a current smoker” and just had a respiratory infection. Nearly all such patients would have pulmonary “abnormalities,” opacities, nodules, scarring, etc. Well, it’s probably not “nearly all” on CT. It’s “all.” Plus the doctor called it a “minor abnormality,” which makes what I said even more significant. But there’s more. Your mother had colon, not rectal cancer. In that situation, lung mets without liver mets are very uncommon, if not rare (and she had a CT that covered the liver). The only issue here is the fact that this was an x-ray, not a CT. I don’t know much about x-ray findings in the lungs (CT is usually used for cancer, or PET-CT). But I doubt that changes the picture too much.

So: Is it good to get a thoracic CT? Sure! One never knows. But please don’t be “freaked out” or “terrified.” That’s an overreaction to this situation IMO. It’s understandable to be scared once you (or someone close) gets a cancer diagnosis. But this fact pattern is very likely to end well. (Well, other than the smoking!) Good luck!
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (lots of side effects/reduced size est. 70-75%)
neoadjuvant chemorad 11/19
4 rounds of FOLFOX July-August 2020
ncCR found 10/20; multiple biopsies negative
TAE 11/20, small amount of tumor removed, lung nodules orig id’d 6/20 stable Nov 2020
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
Stable in 6/28 scan.

AdAstra
Posts: 15
Joined: Mon Sep 20, 2021 5:41 pm

Re: Lung Abnormality/Nodule?

Postby AdAstra » Sat Nov 06, 2021 4:16 pm

Thanks, roadrunner. Your post made me feel a lot less worried. I'm pretty neurotic, so I'm still a bit worried, but I'm not freaking out as much any more. I'm hoping her liver is still clear since it's been four months since her CT, but I'd imagine her surgeon would have seen her liver during her right hemicolectomy in September.
Caregiver to Mom (63)
Right hemicolectomy on 9/17/21; 5 cm x 4.5 cm cecal tumor (moderately to poorly differentiated ulcerated adenocarcinoma).
CT on 11/9/21: Multiple non-specific and bilateral lung nodules 4 mm and smaller.
CEA (smoker): 3.4, 3.8 (10/2021)
11/9/21: CAPOX
Current (tentative) staging: T4aN0Mx.
MSS, but no further mutational testing done yet.

boxhill
Posts: 756
Joined: Fri Apr 06, 2018 11:40 am

Re: Lung Abnormality/Nodule?

Postby boxhill » Mon Nov 08, 2021 1:16 pm

Little lung nodules appear in the majority of the general population, and the vast majority of them are nothing to worry about. Left over from an infection or whatever. I have one. They took a look at it a couple times, decided it was nothing, and haven't looked since.

If you want to worry about something, worry about her smoking! Maybe you can get her to quit. There are drugs that help, nicotine patches, etc.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/19 MRI stable/NED
6/20 Stop Key
All MRIs NED

AdAstra
Posts: 15
Joined: Mon Sep 20, 2021 5:41 pm

Re: Lung Abnormality/Nodule?

Postby AdAstra » Mon Nov 08, 2021 8:42 pm

boxhill wrote:If you want to worry about something, worry about her smoking! Maybe you can get her to quit. There are drugs that help, nicotine patches, etc.


I told her that even if the abnormality turns out to be nothing (fingers crossed!), there's a not-so-insignificant chance that she'll end up with lung cancer in the future if she keeps smoking. She really wants to quit, so I hope she will now that she'll be starting chemo. She'll be on CAPOX, and I'd imagine the dry mouth one can get from smoking might put her more at risk for mouth sores, so that's another good reason to quit soon.
Caregiver to Mom (63)
Right hemicolectomy on 9/17/21; 5 cm x 4.5 cm cecal tumor (moderately to poorly differentiated ulcerated adenocarcinoma).
CT on 11/9/21: Multiple non-specific and bilateral lung nodules 4 mm and smaller.
CEA (smoker): 3.4, 3.8 (10/2021)
11/9/21: CAPOX
Current (tentative) staging: T4aN0Mx.
MSS, but no further mutational testing done yet.

AdAstra
Posts: 15
Joined: Mon Sep 20, 2021 5:41 pm

Re: Lung Abnormality/Nodule?

Postby AdAstra » Wed Nov 10, 2021 8:33 am

Update: My mom had her thoracic, abdominal, and pelvic CT scan yesterday, and it seems the results are indeterminate. Thankfully, her liver and her lymph nodes look okay, but she has "scattered non-specific 4 mm and smaller bilateral pulmonary nodules, for example 4 mm left lower lobe pulmonary nodule (series 4 image 42), and 4 mm right middle lobe pulmonary nodule (series 4 image 35). Pleural-parenchymal scarring at the bilateral lung apices." The radiologist recommended that we keep an eye on them, but otherwise wrote that there was no definitive evidence of metastatic disease.

I'm not sure what to think. Thoughts? Should I be worried? I guess I was thrown by there being several of them, though I'm glad they're pretty small at this point.
Caregiver to Mom (63)
Right hemicolectomy on 9/17/21; 5 cm x 4.5 cm cecal tumor (moderately to poorly differentiated ulcerated adenocarcinoma).
CT on 11/9/21: Multiple non-specific and bilateral lung nodules 4 mm and smaller.
CEA (smoker): 3.4, 3.8 (10/2021)
11/9/21: CAPOX
Current (tentative) staging: T4aN0Mx.
MSS, but no further mutational testing done yet.

roadrunner
Posts: 179
Joined: Sun Jan 12, 2020 8:46 pm

Re: Lung Abnormality/Nodule?

Postby roadrunner » Wed Nov 10, 2021 9:50 am

This is probably as good a result as you could have received. I believe in excess of 50% (possibly well in excess) of healthy people in your mother’s situation (smoker, 63) would have small pulmonary nodules on CT. Even more because of the recent respiratory infection you reported. Also, her liver’s clear, and since she had colon, not rectal, cancer the chance of “skip” metastases is quite low. The vast majority of sub-5mm nodules are benign. That said, she’s a crc patient and a smoker, so these bear watching (which is exactly what they are doing). They could theoretically reflect metastatic disease or a primary lung cancer (again because of the smoking). I think the CEA is also pretty much normal for a smoker. If it were me, I’d feel pretty good about it but get a scan in 3 months (to check for growth). Usually the radiologist’s report will include a follow-up recommendation. Though if I recall right, she’s going to do adjuvant chemo, so growth, shrinkage, or stability are all possibilities. It may just not be easy to tell for a while.
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (lots of side effects/reduced size est. 70-75%)
neoadjuvant chemorad 11/19
4 rounds of FOLFOX July-August 2020
ncCR found 10/20; multiple biopsies negative
TAE 11/20, small amount of tumor removed, lung nodules orig id’d 6/20 stable Nov 2020
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
Stable in 6/28 scan.

AdAstra
Posts: 15
Joined: Mon Sep 20, 2021 5:41 pm

Re: Lung Abnormality/Nodule?

Postby AdAstra » Thu Nov 11, 2021 11:13 am

Hypothetically, if they grow or shrink, would that necessarily indicate cancer, or would it take a few scans to be sure? If they're mets, I'm hoping she'd eventually be a candidate for surgery, but if not, do other procedures like cryoablation work well to keep them at bay? I know I shouldn't get too ahead of myself, but I also want to be prepared if worse comes to worse.
Caregiver to Mom (63)
Right hemicolectomy on 9/17/21; 5 cm x 4.5 cm cecal tumor (moderately to poorly differentiated ulcerated adenocarcinoma).
CT on 11/9/21: Multiple non-specific and bilateral lung nodules 4 mm and smaller.
CEA (smoker): 3.4, 3.8 (10/2021)
11/9/21: CAPOX
Current (tentative) staging: T4aN0Mx.
MSS, but no further mutational testing done yet.

boxhill
Posts: 756
Joined: Fri Apr 06, 2018 11:40 am

Re: Lung Abnormality/Nodule?

Postby boxhill » Fri Nov 12, 2021 2:29 am

If you want information about lung mets, the Lungston "neighborhood" of Colontown--a large, private community on Facebook--would be a good place to look. Colontown is a superb resource for support and science-based information, and posts are visible only to members.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/19 MRI stable/NED
6/20 Stop Key
All MRIs NED


Return to “Colon Talk - Colon cancer (colorectal cancer) support forum”



Who is online

Users browsing this forum: No registered users and 36 guests