Hello! I am just seeking advice. In June 2015, I was told that I had a 4mm lung nodule on my URL. I had another scan in December 2015, with no changes. I had a third scan in October 2016 (different place) and was told that this module was now measuring 5mm. At that time, I went to see a pulmonologist for assistance. He had me rescan in May 2017 at the same place and it measured the same, 5mm. He told me that we could a final one in a year and if all is well, he would release me. I recently had my 5th Scan at a 3rd location (new location due to cheaper out of pocket) and was told that it now measures 6mm. I am terrified although he didn’t seem to have many concerns. My concern is that it is growing, the location and that both my mom and aunt were diagnosed with lung cancer. He said we could have a follow up scan in a year (marks 4 years) and we will see at that time.
He didn’t feel that it was substantial growth and said that the 4th location did not have any scan to compare to. I am currently 35 and a never smoker but have a family history of this disease.
Should I seek a second opinion?
Reply # - July 18, 2018, 03:33 PM
Welcome to GRACE, rki9998.
It's natural to be concerned about a slowly growing nodule especially with your family history, but since you are a never smoker and young, and the nodule is quite small, it is less likely to be cancer.
Since it is slowly growing, it makes sense to wait for a year before rescanning. That way the doctor will have a better sense if it is stabilizing or still growing.
It is too small for a PET scan to be useful and too small to biopsy. Unfortunately there is nothing to do but to watch and wait. I would try to go back to the same place that did a scan previously as . sometimes differences of machines can cause a mm or so difference in measurement.
Does the report say if it is a solid nodule or subsolid "ground glass"?
I personally do not think a second opinion is needed at this point but if would ease your mind then it makes sense.
Reply # - July 18, 2018, 03:38 PM
Thank you so much. It doesn’t say on any of my scans. It simply says suplueral nodule.
Reply # - July 19, 2018, 12:33 PM
Even if there is growth 2 mm in 3 years is a minute growth rate. Just as or more likely the scans are and radiologists are interpreting differently.
In an article written by Dr. West he discusses the findings of a study that looked at how much the human element as well as a difference in where the image is showing effects written scan reports, "Instead, what this should underscore is that tumor measurements aren’t perfect. First, 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 (imagine cutting 1-2 cm thick slices of a tennis ball: you might get different sizes depending on whether you catch the dead center of the ball or just on either side of it). More significantly, and likely far more commonly, you can get small differences based on the measurements of one radiologist vs. another or even the same radiologist reviewing a scan at two different times. There is a human element in the interpretation, which means that there is room for variability." http://cancergrace.org/lung/2011/08/09/limits-of-ct-scanning/
I hope you continue to see little to no change.