Hello,
I wanted to get some advice for my sister, who has a lung nodule. I myself have stage IV lung cancer. Her doctor is recommending that she just keeps an eye on it, the watch and wait approach. From my experience I say it should be biopsied ASAP, or removed, regardless of the possibility of it being benign. My sister has smoked heavily for 35 years. I feel like I am nagging her too much. I would think that it would be a no-brainer to have the nodule removed seeing how lung cancer is already present in a family member. I am hoping for some replies to help me state my case, and to keep my sister from burying her head in the sand. I know she is scared, and that she is afraid she will have to go throgh what I have been through, which was a lower left lobectomy, and chemo. Presently I am on Alimta maintenance, second treatment. I tell her that one nodule is easy to remove. I wish I would have discovered mine when it was so small. Any input would be greatly appreciated.
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Reply # - July 21, 2013, 12:44 PM
Reply To: My sister's nodule
Hello, I can only imagine your worry. Our doctors can't give advice to anyone who isn't a patient but perhaps our pulmonologist can shed light on how he goes about moving forward with info such as you've given.
The size and location of the nodule may play a part in the thinking process. Can you provide one or both before our doctor responds?
Best hopes,
Janine
forum moderator
Reply # - July 21, 2013, 05:55 PM
Reply To: My sister's nodule
CT scans still detect far more benign nodules than cancers, even in people with a family history of lung cancer and a smoking history. If it's small, it still makes a lot of sense to follow it before removing the nodule. Yes, removing small nodules is generally safe, but if it's very small (well under 1 cm), it's quite likely to be benign, potentially challenging to biopsy (and not entirely free of risk), and would have extremely little risk posed by waiting until seeing it grow before doing anything more aggressive. If it's a centimeter nodule or larger, that's one thing, and a biopsy may be justified if the risk of cancer is high enough, but for a very small nodule, it's often very appropriate to follow a small nodule to see progression before doing any invasive procedure.
Good luck.
-Dr. West
Reply # - July 21, 2013, 08:10 PM
Reply To: My sister's nodule
Thank you for your replies. My sister is new to all this and did not ask the size of the nodule. I understand the reasons to wait for biopsy or removal. Your input makes sense. The last thing I want to do is be an alarmist.
Reply # - July 24, 2013, 02:39 PM
Reply To: My sister's nodule
flovesee, I received a comment from Dr. Silvestri via email. He states, "... there are many factors that go into whether or not a lung lesion should be biopsied. They include patient factors (age of patient, smoking history, history of a previous cancer and family history of cancer) and nodule factors (size, location, x-ray characteristics). In addition, how it would be biopsied (is it amenable to needle biopsy or would surgery be required) and the patients underlying health (can they safely tolerate a biopsy). Finally, patient preferences are extremely important. Does the patient prefer watchful waiting or would they want it out even if it were low risk for cancer and they could have a complication of the procedure.
Keeping an eye on a nodule is a reasonable approach. If it grows then aggressive biopsy or removal is warranted. Perhaps the most important advice is that she is in a place that deals with this all the time – a multidisciplinary cancer clinic with a pulmonologist and a dedicated thoracic surgeon. "
I hope you and your sister are feeling alright,
Janine