In May 2011, was found to have a 1.3 cm RLL lung lesion plus 6-7 smaller nodules, primarily in the RUL, RML and LUL. 3 of these are ground glass with one having a subsolid component (size 6-8 mm)
Turns out the RLL lesion was evident but missed on a 2008 and 2010 chest xray.
Though it hadn't change, it was removed in Jan 2012. Hamartoma. Pathology report raised concern for a pulmonary htn arteriopathy but Echo x 2 are normal. Also have mild COPD. Stopped smoking 2 years ago after 30 + years.
Since May 2011, have had approximately 5 Chest CT scans which show the residual nodules to be stable in size though an adenocarcinoma in situ cannot be ruled out. Most are < 5 mm for for the 6-8 mm GGN.Since July 2012, starting having severe pain under the right and left rib cage that radiated up the back. MRI of abdomen negative. TAbdominal pain minimal now but since May 2013, having significant pain in upper mid back that radiates to the right and left shoulder. Also had one recent episode of acute right shoulder pain that lasted 15 minutes, that abated. My pulmonologist does not think we need to rescan sooner than Dec 2013 (one year since prior scan).
With nodules stable for 19 months but with the new onset of shoulder/back pain, would you concur with waiting to rescan? If this is cancer, is it likely indolent based on the duration of stability? Thanks
Reply # - August 12, 2013, 08:47 AM
Reply To: ground glass nodules
Hello, I'm sorry you're having these concerns. I will ask a doctor to reply.
I hope the pain you're feeling can be abated by other means. Know too that pain from cancer doesn't go away on it's own but usually progresses in intensity. How indolent or aggressive cancer is has a lot to do with how quickly the pain progresses. Know too that most people who've smoked have the type of small nodules you've got and aren't cancer.
It's not unusual that this forum gets a lot of questions like yours, people who have had nodules found on CT scans and the obvious worries of lung cancer that come after. This is a link to the specific forum that houses these discussions. I think what the doctors have to say in them can be helpful too, http://cancergrace.org/forum/lung-thoracic-cancer/work-up-staging-of-lu…
I hope your nodules stay put for ever,
Janine
Reply # - August 12, 2013, 10:04 AM
Reply To: ground glass nodules
Pulmonary nodules present a conundrum. On the one hand, we don't want to ignore something that could be cancer. On the other hand, we don't want to overreact and resect lots of nodules that aren't cancer, because we can do realm harm from the surgeries. We often resolve this problem by watching nodules carefully. Things that grow become more concerning for cancer. Things that do not grow are less concerning; the longer that they don't grow, the more reassuring the lack of growth is.
In the presence of known cancer, where the risk of any new symptoms being spread of cancer is highest, most back and shoulder pain will still not be from the cancer. That said, any patient with new pain, especially if it gets worse or fails to resolve, deserves to have it evaluated. New pain in locations that people commonly get pain does not necessarily change the optimal evaluation schedule for lung nodules, but that pain should be evaluated and addressed.
Reply # - August 13, 2013, 07:22 AM
Reply To: ground glass nodules
I agree with Dr Weiss's thoughtful summary. I think a persistent pain needs to be evaluated, independent of any lung nodules. This means a detailed office visit and physical exam, followed by carefully-selected lab tests or imaging.