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Lung Cancer

Lung nodules

03/18/2008

Question:

After a CT scan I was told that I have 8 nodules on my lungs the largest is 7mmx5mm. I am very upset about this and was told that I had to wait three months to take another CT scan. I was also told that if the nodules are calcified then there was no cancer. How do you test the nodules to see if they are cancerous. I have never smoked and do have lung cancer in my family. I was told that the cancer may be coming from somewhere else in my body. I am on Ativan. Is there anything I can do now. Three months is a long ways off. Thank you in advance.

Answer:

I completely understand why you are upset.

Multiple nodules in the lungs could be from infection or spread (metastases) of cancer from another site. Not sure why your CT was done in the first place, were you having cough, fever or any other symptoms?

The best way to diagnose a nodule or mass in the lung is by getting a biopsy (usually with a needle or with bronchoscope). Unless these nodules are bigger than 1cm it is hard to get a tissue diagnosis as they are too small to find during biopsy. In these cases we prefer to watch and repeat CT every 3-6months. If it is tumor it would grow and may be amenable to biopsy, if it is infection it may just disappear, if it is old infection with fungus it may not change size, shape or character. (I know most patients get worried when we tell them that this may be cancer but we need to watch in 3 months. However, as I explained we cannot biopsy such small nodes and best management plan is to wait and watch).

Ativan should not cause any problem. Smoking is a risk factor for lung cancer and in your case as a non-smoker you are at a lower risk but we cannot be 100% sure till we do the biopsy or find out that they have disappeared on the follow up CT (not cancer).

If your physician said that there is a chance that this could be cancer from other part of the body, s/he may have ordered the appropriate screening tests depending on your risks and age.

Please let us know if you have any further questions.

Thanks.

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Response by:

Shaheen  Islam, MD, MPH Shaheen Islam, MD, MPH
Clinical Associate Professor
Pulmonary, Allergy, Critical Care & Sleep
Hematology
College of Medicine
The Ohio State University