Small nodule big symptoms - 1274169

robertcastle533
Posts:10

Hi, I was wondering if anyone here had experienced similar symptoms. I am 49 and an ex smoker. Gave up at age 47. In 2014 I started having investigation for the onset of hypertension. Blood results showed sodium at 141, which was good. Since then I have lost weight, suffered from fatigue, general malaise, foggy head and an occasional strange ticking feeling in my lung when I breathe. After a number of tests I noticed my sodium was down at 130. My doctor told me not to worry but as it was showing abnormal I looked it up and thought that it may be related to siadh.. My doctor told me that this was pretty rare but said that in light of my smoking history that we could go for a LDCT scan. This showed a 5 mm nodule. My doctor said that it was unlikely that this little thing could be contributing to all my symptoms and has said another scan in 6 months might be appropriate if I still feel unwell. After reading about siadh I thought that it could be connected to the start of a small cell lung cancer? Surely 6 months would be too long to wait for a rescan. From my research this thing could double 6 times in this period. I was going to try and get another scan done earlier as I know in 2014 my sodium was sitting comfortably at 141 and now it hovers around 130. Would another scan in say two months be beneficial or should I try for a PET scan? I am quite worried and the fatigue is a constant reminder that all is not well.

Forums

catdander
Posts:

Hi Robert,

Welcome to Grace. I'm sorry you're having this scare but hope that's all it is. It's not unusual for smokers and ex-smokers to have solitary nodules especially that small. I'm not sure if the added sodium deficiency adds concern for sclc so I'll ask one of our faculty to respond.

All best,
Janine

Dr Pennell
Posts: 139

Hi Robert, I certainly can understand you concerns, but small cell lung cancer would not be near the top of my list of possible reasons for a low sodium (hyponatremia). As for your CT scan showing a 5mm nodule, probably half of people out there have similar tiny nodules and almost all of them are not cancer (over 95%), but given your age and smoking history it does need to be followed to make sure it doesn't grow. The guidelines for a 5mm nodule would indeed be to repeat the scan in about 6 months so I think that is reasonable. A PET scan usually isn't helpful with nodules that small.

It might be worth investigating the cause of the low sodium though. A simple blood and urine test can usually diagnose the general cause of the low sodium, such as SIADH, and then a proper workup of causes could be undertaken (medications for example are a common cause).

You symptoms are very nonspecific and may indeed be a sign of something wrong, but there are many possibilities so I wouldn't narrow them down to lung cancer as the top suspect.

robertcastle533
Posts: 10

Janine and Dr Pennell, thank you both for such prompt replies. I will calm down and wait the 6 months. I wish I had found this site earlier, it is full of great information. I cannot explain how much this response means to me, I have been in a panic for days. You should be proud of your contribution to this resource, it has a positive impact on so many. My family and I appreciate your input.
Robert