Hi GRACE staff,
I have used this site to increase my knowledge of this awful disease. I have a question regarding nodules and SCLC. On the internet there is a huge amount of information, much of which doesn't have the context to help you understand the details and this is where I find GRACE a much more reliable source of knowledge.
I am wondering if there is any more up to date information on SCLC presenting as solitary nodules? An archive in GRACE has the venerable Dr West saying:
"Moreover, SCLC isn't a diagnosis that smolders for a year or two, and it's also not a cancer that appears as a 6-7 mm nodule (at least not for 99.99% of cases)"
http://cancergrace.org/forums/index.php?topic=9521.msg75651#msg75651
However much of the information I've found from seemingly reliable sources quote 5 to 10% of SCLC as presenting as solitary pulmonary nodules. Am I missing something (as usual!) or has there been a change in how data is collected?
I'm worried about a 4mm nodule that has appeared since my last scan and this archived thread has been quite reassuring for me, so I'm just checking if it is still valid.
Thank you again for being here and listening,
Aaron
Reply # - February 18, 2016, 12:39 PM
I believe what Dr. West was
I believe what Dr. West was saying is it's almost unthinkable/99.99 that a 6mm nodule and symptoms for 2 years is a reason to suspect cancer; he's not quoting data as you've suggested. It's wholly different from the data that suggests somewhere between 5 and 10% of nodules are sclc. The nodules in the study are biopsy size at least 10mm and most were larger. This is apples compared to oranges/not really relatable.
Dr. Goodgame go on to say, "Finally, when docs say, "don't worry about it, we'll check in 6 months," that only means in the absence of any new symptoms. If you are having new pain, cough, or shortness of breath or other worsening symptoms, you should call your dr."
A radiologist is trained and experienced at reading and interpreting scans while a pulmonologist is trained and experienced at treating respiratory issues. It's very common for pulmonologist to consult radiologists about scans.
All best,
Janine
Reply # - February 18, 2016, 12:57 PM
You might want to read this
You might want to read this as well. Dr. West starts,
"...the likelihood of cancer among nodules that measured under 5 mm is generally in the 0-1% range. Nodules in the 5-10 mm range have been found to be cancer in up to about about 28% of cases, with most studies showing the risk of cancer in this range to be one in four or five. SPNs in the 1-2 cm range are found to be cancer about 40-50% of the time, and beyond that, the risk is up to about 60-80%. But even among the larger ones, that go from being a nodule to a mass (3 cm cutoff), the likelihood of cancer isn’t 100%, and there are many things that turn out to be infection or inflammation or another benign cause." http://cancergrace.org/lung/2007/11/10/risk-of-ca-among-spns/
Reply # - February 18, 2016, 01:49 PM
Brilliant, thank you for such
Brilliant, thank you for such a clear response. I am learning more each day and the help and resources available on this site are a god send.
Take care
Aaron