Small Lung Nodule

n3p
Posts:2

Background:
Previously had testicular cancer (the really "good" and "curable" kind) that was caught early, I'm in my late 30s -- this was ~18 months ago. Surgery as treatment. No sign of spread over 18 months since it was removed. Scans every 3 then 6 months since.

I had a very bad cold (covid-like) in 2019 over 6 months and I was coughing aggressively. Stupidly resisted conventional medicine for that cold so I think that contributed to the virus taking a long time to go away.

I'm a Non-smoker.

Nodule:
Incidentally, my Urologist mentioned on my 18-month testicular cancer follow-up scan that there was a lung nodule on the right lower medial lobe that was picked up. Measurement was 4x5mm.

Unbeknownst to me, it was also there 18 months ago as well, and in all my subsequent scans, just never written down (weird) and may have minimally grown from 3mm rounded 18 months ago.

Went to a pulmonologist and he said he couldn't say it definitely had grown, due to margin of error etc, after looking at the images. Pulmonoligst thought it could be scar tissue from the really bad cold. It's rounded and not spiculated, which he said was good. And seemed to think even if it had very slightly increased it was a really long period of time and favored a non cancerous outcome.

I get scans every 6 months for the testicular cancer monitoring, which picks up the lower portion of the lungs where this is located.

Now, I am wondering if I should do a full lung scan since technically I only have the bottom half. I had a full body MRI for unrelated back / spine stuff recently and nothing in the lungs were detected (I know they don't typically pick up anything under 1cm anyways). The pulmonologist was very 50/50 on subjecting me to any more radiation over this since I have had a lot for my other scans, and my future CT scans every 6 months for the other stuff will monitor this.

But considering I have 18 months of CT scan history already with very little if any change, I'm wondering how worried I should be about it. Even if I assume the slight growth is true, how worried should I be? The doctors have mostly brushed it off as very low odds of cancer. Also, I do wonder if there are any more nodules in the part not shown on the abdominal scan, though I have no reason to suspect it.

JanineT GRACE …
Posts: 651
GRACE Community Outreach Team

n3p, Hi and welcome to Grace. I'm sorry you have to check for new nodules. It does sound like your onc has good reason not to be alarmed that you have a probably stable nodule from the infection; it's a pretty common reason for that appearance on a CT. As for size change, I know tihe following ex is a different situation and todays ct resolution is higher than 11 years ago but the point is there's still lots of variability in sub-mm differences in CT scans reports.

Here's a quote from, Did My Cancer Grow In 10 Minutes?, "As an exercise to test the variability in CT scanning, they had 30 eligible patients with stage III or IV lung cancer and a minimum tumor size of 1 cm undergo a CT scan, wait a few minutes, and then have a repeat CT scan within less than 15 minutes on the same scanner. Any of 3 expert radiologists read the scans and did tumor measurements, blinded to the timing of the scans. What they found was that 57% of the patients had a measurable difference in tumor size of a mm or more, and a third had a detected difference of 2 mm."

"...you can have slightly different appearance from one scan to the next because the slices of the scans can capture the nodule/mass at levels of slightly different thickness...".

 

With cancer, anything is possible, 3 months is usually considered the minimum time before you would see changes on a CT.  I don't know about timing of cts in your situation and 6 months may be a perfectly appropriate time before you check back in.  I hope you remain cancer free, it's so so probable. 

Best of luck,

Janine

I joined GRACE as a caregiver for my husband who had a Pancoast tumor, NSCLC stage III in 2009. He had curative chemo/rads then it was believed he had a recurrence in the spine/oligometastasis that was radiated. He's 10 years out from treatment.

n3p
Posts: 2

Thanks for the thoughtful response, I really appreciate that! All your points make sense. I will check back in later.

JanineT GRACE …
Posts: 651
GRACE Community Outreach Team

Please do check back in. It looks like I forgot to paste in links for that article. I'm going back to edit in the links.

I joined GRACE as a caregiver for my husband who had a Pancoast tumor, NSCLC stage III in 2009. He had curative chemo/rads then it was believed he had a recurrence in the spine/oligometastasis that was radiated. He's 10 years out from treatment.