Lung Nodule and Immunosuppressive Drugs

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Lung Nodule and Immunosuppressive Drugs

Hi All,

I am in the unfortunate position to have both an autoimmune disease and a possibly malignant Lung Nodule.  Due to the autoimmunity, which by the way is Sjogren's Syndrome, I am forced to use Immunosuppressive Drugs to control the symptoms, not the best idea, but necessary.   This can certainly cause issues with my Lung nodule and keeps me up at night wondering.  BTW, if it makes a difference, the drug I use is called Cellcept, it is usually used for recipients of Organ Transplants to prevent rejections.   My question is since I am possibly increasing my chance of restarting a nodule in Cell Cycle Arrest by using this drug should I be more vigilant  in my followups with CT Scans, in other words, should they be done more often to stay on top of things.  What is the recommended intervals to have them done.  Also, my nodule is 1.4cm x 1.1cm, would I be able to use X rays on occasion in lieu of the CT to save on the radiation?  Thank you for any info you can pass on.



JanineT Forum M...
HI John, Welcome to Grace.  I

HI John,


Welcome to Grace.  I'm sorry you're going through this process and hope it proves benign.   I should start by saying we don't have expertise in the diagnosis of lung cancer and you should use this information as a way to start discussions with your pulmonologist but she will be better versed in how to best work up and follow your case. At Grace we want people to be informed so they can have frank and honest discussions with physicians and be a partner in decisions.  


From the 2 passages below you can see that the rate of people with lung cancer and autoimmune disease is the same as people with just autoimmune disease.  So there's no correlation between the 2.  The recent discussions about autoimmune disease and cancer are that people taking systemic treatment for an autoimmune disease are more likely to have adverse events from anticancer immunotherapy which are relatively new in cancer care.  Researchers and oncologists are still trying to figure out how to manage this new situation so there is a lot of chatter about it online. 

"Approximately 50 million Americans, 20 percent of the population or one in five people, suffer from autoimmune diseases."

And from the discussion section of this JAMA article, "Among patients diagnosed with lung cancer, approximately 14% to 25% have autoimmune disease." 


Low-resolution CT scans are often used instead of high res CTs to follow lung nodules and create less radiation.  A chest xray is only able to pick up that a nodule exists at about a cm but gives little more info than that.  CTs give detailed info such as where a nodule is located and what it looks like both of which supply a lot of info about what might be going on.  So your pulmonologist will probably want to at least use CT some during follow up.  When following a suspicious nodule scans every 3 months is pretty normal (it usually takes that long to see changes) for the first year then 6 months or yearly for another 5 years to make sure it stays put.  There aren't standards of care about how often and for how long to follow a single lung nodule but the article linked to below gives a solid example of how to closely a pulmonologist might watch and wait before doing anything more invasive.


I hope you do well,