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lung nodules

1 Mar 2013 08:28

Im looking for advice/reassurance.

A recent ct scan shows 4 and 5 mm modules, one in lower lobe of each lung. I have a rescan in 4 months. What are the chances of these being lung cancer or metastases from elsewhere.

Im very worried but I guess if its lung cancer it should be caught early.

Any advice or comments much appreciated.

Re: lung nodules

5 Mar 2013 08:50 in response to andrea15

Hello Andrea15,

Thank you for posting.  I¿m afraid I just can¿t say what the chances are of these nodules being cancer.  I don¿t know how much has been explained to you by the lung specialist. 

Based on what they know about your circumstances, a doctor may be able to estimate what your risk is of these being cancerous.  But even the doctor may not be able to know for sure.

I can give you some general information about lung nodules and I hope this is helpful.  CT scans of the chest commonly detect lung nodules that are not always seen on a chest X-ray.  In some people, nodules are found incidentally when they have a scan for something else and they do not usually cause symptoms. 

Most nodules are not cancer (benign) and could be due to other conditions, for example past infection with TB (tuberculosis).  So if the nodule is small, doctors often choose to keep an eye on it by repeating the CT scan.  The doctor considers a number of factors when deciding whether someone should be monitored. These include the size and appearance of the nodule, the age of the person and whether they are smokers, or have ever been smokers.  These factors will also determine the frequency of the scans and how long they should carry on for.  Benign nodules do not grow, or grow very slowly.  So if any the nodules become bigger, the lung specialist may arrange for other tests such as another type of scan, a biopsy, or sometimes surgery.

I appreciate that this can be a worrying process for people to go through, particularly when the time is approaching to scan again   The benefit is that cancer may never be found and (although people have regular CT scans) they will have been saved from further tests that would not have been necessary.

 

If a person is diagnosed with cancer, there is a possibility that this may be cancer that has spread from elsewhere in the body (I don¿t know how often this happens).  Or, as you say, it could be lung cancer.

I¿m sorry I can¿t be more definite, but hope this is useful.

Take care,

Helen    

Re: lung nodules

6 Mar 2013 18:00 in response to CRUK Nurse Helen

Hi. Thanks for the replly. Surely it would be unusual to discover lung mets without any evidenceor symptoms of a primary tumour? What cancers tend to spread to the lungs?

also I am only 42. Does that make cancer less likely?

Re: lung nodules

8 Mar 2013 15:08 in response to andrea15

Dear Andrea,

Thank you for getting back to us.

I can appreciate that you are trying to work out what might be the matter as this must be a concerning time for you. But as you know there are a number of possible scenarios that can explain the nodules that were seen on the CT scan. Unfortunately I do not think my answers to your questions will put your mind at rest. This is because occasionally doctors can discover lung secondaries as an incidental finding when they are doing tests for other things. But as you suggested it is it is not a particularly common situation. Also almost any type of cancer could potentially spread to the lungs and again I fear that knowing this is possibly going to be even more unsettling for you.

Although it is difficult, the important thing to focus on is the fact that your doctor is not rushing in to do anything right now. If they were seriously concerned about cancer they would not be asking you to have a repeat scan in a few months time.

Kind regards,

Jean

Re: lung nodules

8 Mar 2013 18:53 in response to CRUK Nurse Helen

hi MY MOM HAS BREAST CANCER SHE DID REMOVE HER THT ONE BREAST FIVE YEARS AGO AND SHE HAD ONE CANCER IN HER LYMPH NODES FROM 18 ONE WERE POSITIVE SO NOW WHT U SUGGEST NOW A DAY MOM NOT FEELING FINE WHT TO DO SHE HAD LOBULAR CARCINOMA

Re: lung nodules

8 Mar 2013 18:53 in response to CRUK Nurse Jean

Thanks Jean. Sorry to be a pain. Does anyone know if more than one nodule is more likely to be mets, especially bilaterally?

Re: lung nodules

12 Mar 2013 14:53 in response to andrea15

Hello,

Unfortunately, I don't know and therefore just cannot say anything concerning your question about nodules on this occasion. Usually, specific investigations and tests are needed to gain more clinical information for the doctors to review.

I hope that you are able to find out more soon.

Best wishes,

Vanda

Re: lung nodules

28 Jun 2013 23:01 in response to CRUK Nurse Vanda

I have had follow up scan which shows no growth of the lung nodules. I am still concerned about mets though I do not know where they could be coming from.

If I had cancer that had spread that far and was quite advanced would I not be feeling unwell by now?

I have been told lung mets would have grown in 4 months. Is this likely to be true?

Re: lung nodules

29 Jun 2013 09:42 in response to andrea15

Hello Andrea15,

I wonder if you might find it helpful to give our nurse specialists a ring to chat through some of the questions you have.

They are available Monday - Friday 0808 800 4040 9am - 5pm

best wishes,

Jenn

Cancer Chat moderator

Re: lung nodules

29 Jun 2013 12:32 in response to Moderator Jenn

I have rung several times but they are not really able to reassure me. I have a chest clinic appointment on Wednesday

Re: lung nodules

29 Jun 2013 18:52 in response to andrea15

It sounds like you may have a few questions/points that you would like your Consultant to clarify for you.

Sometimes it can be helpful to write down any questions you have prior to your appointment so that you don't forget what it is you want to ask when you get into the Dr's office.

I really hope that the appointment with the Dr on wednesday goes well and that they are able to give you some firmer answers to your questions.

Best wishes,

Jenn

Cancer Chat moderator

Re: lung nodules

2 Jul 2013 12:22 in response to andrea15

Hi, Andrea 15,

Thank you for your question. I was very pleased to learn that the recent scan has shown no growth in your lung nodules. This is certainly encouraging.

As you have had these nodules for some months now, if they were cancerous (malignant), I would have expected there to be some changes both in the size of the nodules and your general health. The fact that the nodules have not changed and I get the impression that your health is stable, makes it very unlikely that they are associated with any type of cancer.

I noticed on your thread that you said you had spoken to the nurse team and we had not really been able to reassure you. I think that this sort of thing can be very hard for anyone to cope with and under the circumstances it is difficult to have complete peace of mind. But I do hope that the lung specialist is able to provide you with some information that helps. Also as I said previously, it does seem that cancer is unlikely.

Kind regards,

Jean

Re: lung nodules

4 Jul 2013 08:11 in response to CRUK Nurse Jean

Thank you Jean. Unfortunately I now have some bowel symptoms and have got to have a colonoscopy. My chest clinician thinks the nodules could be mets from bowel cancer. I had a flexible sigmoidoscopy last year which was fine and I had ct colonography 18 months ago also fine, however, the ct was done with Gastoglafin and no bowel cleanse which Im told is the particular hospitals method and I am concerned that ut missed something. Does anyone know anything about the accuracy of this test? I am trying to speak to the consultant who requested ut to ascertain the likelihood of something being missed which may have now spread to my lungs. Generally I feel very well. No fatigue or weight loss. I know Iit can happen but what is the likelihood of me feeling so well when I could have very advanced bowel cancer? p>

Thanks

Re: lung nodules

4 Jul 2013 17:07 in response to andrea15

Hello Andrea15,

I am sorry to learn that you need to have further tests. You certainly have been through a lot.

In the main, studies have suggested that CT colonography (virtual colonoscopy) is an effective way of picking up polyps (non cancerous growths) and bowel cancer.  It is fair to say that no test is 100% reliable, but it is not all that likely that a cancer would be missed.

It seems that you are a little concerned because you did not take medicines to clear your bowel  prior to undergoing the procedure.  Clearing the bowel is important because sometimes with a full bowel the contents may make it more difficult to see things clearly. But bowel preparation can be a little arduous for some people and sometimes people do not take it properly. Because of this in some units they do not use full bowel preparation,

I must admit that because I do not work in diagnostic radiology I only have a limited knowledge of what CT scanners are capable of doing. But there are some techniques that can be used to assess the bowel even when full. Perhaps this is why you did not need to have bowel  preparation. The team at the hospital may be able to confirm this for you.

Occasionally people with advanced cancer can have no symptoms and feel relatively well. But because you have had the lung nodules for several months now, if it was due to cancer usually you would  be less well by now. Therefore I think that there is a good chance that the colonoscopy will be clear.

I hope that you do not have to wait too long to have the colonoscopy.

Kind regards,

Jean

Re: lung nodules

4 Jul 2013 22:03 in response to CRUK Nurse Jean

Thank you so much for the reply Jean.



I spoke to the hospital who just said the Gastoglafin is the usual prep they use which lines the bowel. They said it was unlikely to miss lesions over 6mm. Presumably in order for a bowel tumour to have spread to lungs in 14 months since scan it would have been over 6mm back them? I spoke to the consultant who requested the colonography and he said with that and the flexi sig it would be unlikely they would miss a bowel tumour



I have alternative loose stools and constipation.  Passed some blood but I do have an internal hemmaroid.  Low ferritin of 15.

I also have a 9mm sclerotic lesion in spine and some light stabbing pains in my left pelvis if these are bone mets can anything be done to treat them and improve prognosis?