I had giant cell lung cancer 10 years ago and have had no evidence of disease until one month ago when a 9mm growth was found by ct in my middle right lobe (previously had URL removed along with 4 ribs and chest wall). I had chemo, radiation, surgery, and more radiation. Due to my history and the difficulty of biopsying this growth (technically difficult due to proximity to my heart) it has been suggested that I have a lobectomy. Next week I am undergoing some pre-surgical tests (head MRI, Pet scan, PFT). My concern of course is that there be any spread. My understanding is that it is highly unlikely that a tumour of this size would have spread and I am just wondering if you have any data or thoughts on this. Thank you and I look forward to your reply. Also should add that I am a 55 year old female who otherwise is in good heath, my weight has been stable and I have had no symptoms.
Fri, 10/17/2014 - 22:45
Presuming it's cancer, the probability of metastatic spread if it's a non-small cell lung cancer smaller than 1 cm is less than 10%; that's presuming this is a second primary cancer, unrelated to the first one, which is a very good probability after a 10 year interval.
Though we're always concerned when someone shows evidence of a new nodule, a lobectomy is a rather large commitment for a very small nodule that hasn't been proven to be cancer -- especially after having lost lung function from prior surgery and radiation. I would just ensure that you're confident this aggressive approach is the right one, because you can't undo that decision after having a lobectomy. It would be very unfortunate if that nodule weren't cancer after all. If you have concerns, it would be very appropriate to get another opinion from a pulmonologist or very well trained thoracic surgeon, as it may be possible to work up the nodule further before making an irreversible decision to perform a lobectomy.