Ground Glass nodule in lung - 1261333

dingdongding
Posts:6

Hi,

I've a persistent cough but very mild for a year that I didn't pay attention to (just feel like ichy thoat). but recently I felt chest and back pain, plus lost weight (5 pounds in 2 weeks) without identified reason. I went for X ray and CT scan. Found a 7mm ground glass nodule in my left lower lobe. also a 3mm nodule on my right lung but is less aggressive. My pulmonologist appointment is another 2-3 weeks, so I am still waiting for them to call me. The waiting part is very hard if not hardest. So here I want to get some opinion on my next step.

I am 27 years old male with no smoking history. In my family history I am not aware of anyone have lung cancer (although some family members had some form of cancer). I understand this background tend to have lower risk, and according from what I read online and articles, a follow up "wait and watch" is the most common way to deal with it. However, as I also understand that some lung cancer are grow in very slow speed and grow and shrink over time possibly depends on health status. even a 2 years follow up makes no guarantee (and i understand there is no guarantee for everything), some nodule or potential cancer could grow eventually after 2 years "probation" period. Plus the consistent radiation from CT scan is potentially harmful, even though some would argue there is no strong proven CT directly cause cancer. Also it's hard to define whether the nodule would stay there forever as a good nodule or not.

I am thinking if VATS or some other low risk surgery is an option for this nodule, and what would be the risk for such surgery? I just thinking I am still young for the recovery of the surgery. Plus psychological stress (plus family stress) worrying about the nodule in my body is a potential harm in quality of life.

But first I want to understand what would be the risk short-term and long term if I choose to take a surgery.

Any comment is appreciated.

Thanks!
Marcus

Forums
Full Archive

Reply # - January 3, 2014, 05:52 PM

catdander
Posts:

Marcus, You seem to understand a lot about your situation. What you want to know is if a VATs with the possibility of an open thoracotomy is less damaging (physically/mentally) than waiting to see whether the nodule is invasive. We can't tell you what is best for you and too doctors here see patients who already have a cancer diagnosis. With that said we get a lot of questions like yours. These discussions can be found in the lung cancer work up and staging forum where most of the 70 threads can help explain, http://cancergrace.org/forum/lung-thoracic-cancer/work-up-staging-of-lu…

A thoracotomy is one of the most difficult surgeries from which to recover. My husband had surgery 4 1/2 years ago and still has, sometimes severe other times only unnerving, nerve pain that follows the line between incision and chest tube. Surgeons take VATs and open thoracotomies very seriously and won't perform them unless necessary. That's not to say you won't find a surgeon that would do it.

Waiting is one of the very worst positions to be in but if your nodule stays put or goes away you will know you're ok. Many people have them and the overwhelming majority of them are benign. Each time you have a good scan you'll be more comfortable with watching...and waiting. If it grows within the 3 or 6 months you'll be on top of it. If you find you have cancer watching and waiting hopefully doesn't go away, it's still difficult but it's better than uncontrolled growth. I guess what I'm saying is don't be in too much a hurry to find something out; surgery may not take the worry away but could add a great deal of long lasting significant damage.

Check you the forum I link to above and do some reading before you move forward.

I'm very sorry you're in this situation and hope you find a way to move through this with less stress than you anticipate.

Janine

Reply # - January 3, 2014, 09:40 PM

Dr West
Posts: 4735

Janine has provided a very valuable perspective and some direction on good resources. I agree that it sounds like you have a good knowledge of the complexities of the situation. I'm sorry that, because we are a website really dedicated to how best to manage a diagnosed cancer, and issues around a workup of a questionable lesion are often very anxiety laden, as a policy we've had to decide not to get entangled in the very common question of how to provide the greatest level of assurance that something isn't cancer.

-Dr. West

Reply # - January 4, 2014, 07:20 AM

dingdongding
Posts: 6

Thanks Janine/Dr West for replying this. And thanks for the source.

I just also wondering, would the ground glass nodule ever go away? If yes, what are the odds?

Reply # - January 4, 2014, 11:04 AM

catdander
Posts:

A GGO can represent infection or inflammation so you would expect it to go away when the cause does; note the body resolves lots of these we aren't even aware of. So yes you can expect it to disappear on the next scan. I sincerely hope it does. On a personal note, a trick I play with my anxieties is to have "expectations" that this or that will have the best outcome (while being prepared of course).
Note that repeat scans are discussed in the forum I posted above, be judicious but use them when needed.

Below is a quote from Dr. West on the subject of follow up scans of GGOs, "non-solid, hazy GGOs are another form of lung lesion that might possibly represent a lung cancer but are also the way a little inflammation or small infection would appear. Even when they turn out to be something technically called cancer based on its appearance under the microscope, it’s often a non-invasive adenocarcinoma (sometimes termed bronchioloalveolar carcinoma, or BAC, but shifting in terminology to adenocarcinoma in situ, or AIS) or minimally invasive adenocarcinoma (MIA), in which the invasive component is less than 5 mm in diameter. Even when they grow, it can be at an extremely slow pace." http://cancergrace.org/lung/2013/04/13/follow-up-duration-for-ground-gl…

All best,
Janine

Reply # - January 8, 2014, 08:01 PM

datadriven
Posts: 2

Hi Marcus,

I would offer the following observations:

1) About 90% of the screening-detected pure ground-glass opacity lung nodules did not grow during long-term follow-up in subjects with no history of malignancy and most of growing nodules had an indolent clinical course.

http://www.chestmed.theclinics.com/article/S0272-5231(11)00077-3/abstra…

2) There were only 51 cases of lung cancer in the entire U.S. for males between the ages of 25-29 in 2010

http://apps.nccd.cdc.gov/uscs/cancersbyageandrace.aspx?Gender=Male&Coun…

I think the data supports the conclusion that your type of nodule and very young age would indicate a pretty low probability of lung cancer.

Good luck and stay positive.

Previous PostNext Post