Hello, I had vats surgery feb/2015 for an 8 mm nodule, while i was advised to wait and watch i decided for surgery and the report came back adenocarcinoma in situ. was told to follow up with scans.. so 6 months later in august i go for my scan and the report came back clear and when i took the disk and had my followup my theoretic surgeon also said i was good. Now just a week ago i have another scan and my report states There is a left upper lobe groundglass nodule measuring 4 mm on scan 16 which in retrospect was
present on the prior study, and is stable. Overall stable examination with no evidence for recurrent or
metastatic disease to the thorax or abdomen. There is trace residual
left pleural fluid and postoperative parenchymal scarring. There is
also an unchanged 4 mm left upper lobe groundglass nodule.
Im confused how both my report and my dr both said i was good. Now this! I'm so upset and don't see my dr for two more weeks? Can anyone help
Reply # - February 1, 2016, 08:06 AM
Hi melb106,
Hi melb106,
Welcome to GRACE. I'm sorry that these latest findings have caused you such frustration and worry. I'd only be able to speculate why the two smaller nodules were not discussed previously. Aside from their small size, there may have been other factors which led your doctors to feel they were not significant.
The good thing is that they have both been stable over a significant interval, which is not unusual for adenocarcinoma in situ (also known as BAC - Bronchioloalveolar carcinoma). That indolence is the reason your doctors were recommending that you watch the 8mm nodule for a while before deciding on surgery. With regard to the two existing but stable nodules, I would not be surprised if your doctors make the same recommendation.
Dr. West has created an algorithm for the management of such cases, which you can find here as well as another post in which he describes the indolent nature of such cancers and cautions against over-treatment: http://cancergrace.org/lung/2010/03/02/watching-ggos-over-time/
I realize it is much easier for me to tell you to try not to worry, but I will say it anyway. You have good evidence that your adenocarcinoma in situ is indolent, and may not require treatment any time soon. I hope you have a good meeting with your doctor.
JimC
Forum moderator
Reply # - February 1, 2016, 09:43 AM
Thank you for your quick
Thank you for your quick response, I'm actually glad that i didn't listen to drs about the wait and watch and i decided to get that out.. But honestly i don't want to get surgery again but rather be safe than sorry. Do you or anyone know if its possible for a ground glass nodule to disappear?
Reply # - February 1, 2016, 12:08 PM
It's certainly possible,
It's certainly possible, although after these months have passed it's probably more likely that it will remain stable or grow very slowly. I think the biggest positive in your having had the surgery is that you found out it's adenocarcinoma in situ. That knowledge will help in making treatment decisions now and later.
As far as being safe than sorry, it's good to remember than every surgery carries with it a certain level of risk, so if surgery can be avoided, that's often a good path to follow.
JimC
Forum moderator
JimC
Forum moderator