Six Year Scan Ground Glass - 1252212

Fri, 01/04/2013 - 19:54

I was dx with NSCLC in 11/06 had VATS to remove my RUL which was staged as 3B because of satellite nodule. Received 4 cycles of chemo in 07,.I have been NED since, or so I thought. I was released by my oncologist in 2012, and went under a pulmonologist for annual CT scans.

I had my 6 yrs scan this week and it's very scary "In the left lower lobe on image 66 there is a vague small ground glass attenuation nodule measuring approx 5mm. No definite change from prior. This was vaguely present on 12/18/10 however currentlly appears more conspicuois. Stability compared to 2008 cannot be demonstrated."

I have an appt with pulmonologist on 1/8 but in the interm can you tell me

What is a vague nodule? Appears more consipicuous...does that mean it is dense now? I am so surprised that it was present in 2010 and never mentioned in the report, and I guess it became conspicuous in 2011, becuae report states no change from prior scan which was 2012. Do you see these types of nodules in lung cancer patients often? Are these nodules usually cancerous in patients with a history of lung cancer? Any imput would be greatly appreciated.

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Dr West

This sounds like a very tiny, extremely slowly changing nodule that may technically be cancer but sounds like it is on a pace that is unlikely to be threatening for years and years, perhaps decades, and very possibly never. Even if there are changes, if those changes are occurring at a pace that could translate to a threatening situation in 30-50 years, I would submit that this is not a clinically significant cancer, at least not in the foreseeable future.

I don't mean to minimize your situation, but rather to counterbalance what I fear is unjustified anxiety about what sounds like an extraordinarily slow-growing process that is at greater risk for being over-treated than under-treated. There can be real harms from over-treatment of cancers that are not a meaningful threat. I think there could be a far greater risk of dying from driving to your scans over the next 5 years than from the cancer itself.

-Dr. West