Multiple nodules

rutbats
Posts:2

First things first, my sincere thanks for maintaining this forum in which people with a diagnosis or a suspicion of lung cancer can raise our doubts and expose our fears. I am scared to death.

I have a recent diagnosis of rheumatoid arthritis. I am a 55 yeor-old smoker (one pack per day since I was 17). As part of that diagnosis, I had a chest CT scan in April 2023 which revealed a solitary 8mm nodule in the lower lobe of the left lung, as well as moderate enphysema. As a follow-up, six months later (October 2023) I had a second CT scan. In this second CT scan, the 8 mm nodule had not grown, BUT three new nodules (5 mm each) appeared at the lower right lung.

The rheumatologist, I don't know why, thinks the nodules have nothing to do with my rheumatoid arthritis and could be either lung cancer or a cancer elsewhere with metastases in the lungs, even if he has not even observed the images themselves. His opinion is that I should undergo a biopsy as soon as possible.

My doubts are:

1) What can explain the fact that the 8 mm nodule has not grown in 6 months, and yet three small 5 mm nodules have appeared in the other lung, very close to each other?

2) Could it be lung cancer, or a metastasis in the lung of a cancer in another part of the body?

3) Should I undergo a biopsy, or watch and wait?

Thank you very much for your help.

JanineT GRACE …
Posts: 606
GRACE Community Outreach Team

Hi Rutbats,  Welcome to GRACE and thanks for the kind words. 

 

We can't say what you should or shouldn't do and I can't say why your RA doc made their recommendations.  With that said, It's more typical to watch and wait than to biopsy a lung nodule less than a cm.  If a nodule doesn't grow in 6 months it's likely not cancer.  An explanation for the 3 additional nodules could be infection or inflammation.  3 month follow up scan may be an appropriate next step instead of biopsy.  Tumor markers such as CEA, FR positive circulating tumor cells, LG3BP, and C163A may also aid in evaluating SPN when distinguishing between benign versus malignant.  A consultation with a pulmonologist would provide the best input. 

 

On a personal note, my husband has been going through a similar process though his scans and lung cancer history made the possibilty of cancer much more likely (new 3cm nodule with suv of 10 plus other smaller new nodules which certainly called for biopsy).  This started in January this year.  The most recent scans last week showed no change and his oncologist seemed much more at ease with the idea that this isn't cancer.  He's gone from a 3 month follow up to 5.

 

I'd like to say not the worry but I also know it isn't likely to work.  But I hope my husband's story is a hopeful example. 

All the 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.

rutbats
Posts: 2

Thank you very much for your quick answer, Janine.

I have an appointment with a pulmonologist in 10 days. I will summarize the conversation with him here, so that other people may potentially benefit from my experience.

All the best,
Rut

JanineT GRACE …
Posts: 606
GRACE Community Outreach Team

Glad to know you're moving forward with a pulmonologist.  The more you know the better the conversation with your pulmonologist.  Remember you can help your docs know what level their conversation needs to be if they understand where your knowledge base is.  Thanks for keeping the GRACE community up to date on your journey.  Keep your mind busy.

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.