Lung nodules

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Markdale
Posts: 107
Joined: Wed Dec 02, 2020 4:45 pm

Lung nodules

Postby Markdale » Tue Aug 09, 2022 8:29 pm

Hi everyone,
I’ve had 5 lung nodules in my right lung. I had sabr to 2 of them that were most likely to be Mets, the other 3 are between 4 ~ 7 mm and one has grown 1mm in a year. I’m almost at 2 years since diagnosis and more than a year post chemo.
Has anyone had experience with stable nodules that started growing later on?


Mark
09/20:Diagnosed after colonoscopy for bleeding.
MRI and ct scan confirmed tumor at rectosigmoid junction aswell as lung nodules in RLL (1X1.2cm) and RUL (3X.5cm)
10/20: LAR tumour t3n2m1 4/24 lymph nodes.
11/20: pet scan confirmed Mets
11/20: folfoxiri - 10/6/21. 12 rounds in total
1/1/21 thoracotomy 1 met removed
2/2022 sabr to 2 lung nodule
09/22 PET scan progression of sabr’d nodules
10/22 phase 1 trial bispecific antibody
9/23 added pd1 blocker
12/23 bilateral VATS all visible (7) lesions removed

stu
Posts: 1612
Joined: Sat Aug 17, 2013 5:46 pm

Re: Lung nodules

Postby stu » Wed Aug 10, 2022 2:57 pm

Hi ,
My mum’s team watch three lung nodules for two years . Two grew to around 4 and 7 mm and stayed that way . Have not changed in the subsequent seven years .
However one they watched from two mm . When it started doubling in valve they removed it at 8 mm . It was malignant. Two benign , one malignant all showed up at the same time . No idea why they other two developed . But they did grow differently.
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 .

Utwo
Posts: 285
Joined: Mon May 23, 2016 10:14 am
Location: T.O.

Re: Lung nodules

Postby Utwo » Wed Aug 10, 2022 3:43 pm

I had quite a few "density anomalies" in my lungs.
So far on the follow up scans they were stable.
58 yo male at diagnosis: T1bN0M0, 0/15 nodes, low grade/moderately differentiated adenocarcinoma
03/2016 colonoscopy: 2 small polyps removed in left colon; CEA = 1.3
04/2016 colonoscopy: caecum sessile 3.5 cm polyp piecemeal removed with kind of clear margins
05/2016 "prophylactic" laparoscopic right hemicolectomy - bleeding, leak, infection
06/2017 CT scan, colonoscopy OK; CEA = 1.6
A lot of funny stuff discovered by CT scans in liver, kidney, lungs, arteries, gallbladder, lymph node, pancreas

roadrunner
Posts: 452
Joined: Sun Jan 12, 2020 8:46 pm

Re: Lung nodules

Postby roadrunner » Wed Aug 10, 2022 5:13 pm

I’ve seen many studies that use 120 days as the top end for VDT of pulmonary CRC mets. I’ve also seen individual reports where it was as much as 139. Keeping in mind that as inter-observer variability can be as much as 1.7mm, and there are other variables, there is some “play” here (especially given the small size), I think, but no growth in a year off chemo at 4-7mm initial measurement seems quite promising. Multiplying diameter by .26 is a decent surrogate for doubling in volume, so 4mm, for example, “should be” 8.4mm doubling at VDT=120 days over a year.

I’d be interested in (1) why your team thought these were mets—were any resected (I seem to recall you had something done, but you have no signature)? (2) Is there a plausible alternative explanation (e.g., are you a smoker?)? (3) what are they saying now that it’s been a year with no change?
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

Markdale
Posts: 107
Joined: Wed Dec 02, 2020 4:45 pm

Re: Lung nodules

Postby Markdale » Thu Aug 11, 2022 12:18 am

Thank you for the replys, and thanks for the info too

I had a thoracotomy and they managed to find one nodule that I didn’t know about and it was a met. The surgeon said he didn’t want to cut many bits out of a otherwise healthy lung. I was disappointed with this because the original surgeon I spoke with said it was possible to do it, but when you go through the public system here you don’t always get the surgeon you originally spoke to. The 2 that had sabr treatment had shrunk during chemo and regrew.
I asked the oncologist if she thinks the remaining nodules are Mets and she said yes because they are still there havnt resolved.
I have smoked in the past but not on a regular basis. I do get asthma and have had a few chest infections. I know nodules are pretty common in the general population but given my back ground I think they assume everything is a met.

Mark
09/20:Diagnosed after colonoscopy for bleeding.
MRI and ct scan confirmed tumor at rectosigmoid junction aswell as lung nodules in RLL (1X1.2cm) and RUL (3X.5cm)
10/20: LAR tumour t3n2m1 4/24 lymph nodes.
11/20: pet scan confirmed Mets
11/20: folfoxiri - 10/6/21. 12 rounds in total
1/1/21 thoracotomy 1 met removed
2/2022 sabr to 2 lung nodule
09/22 PET scan progression of sabr’d nodules
10/22 phase 1 trial bispecific antibody
9/23 added pd1 blocker
12/23 bilateral VATS all visible (7) lesions removed


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