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Tuesday, May 21, 2013
Is this lung cancer? Please help!
I am 33 y.o., 5`3"; 115 lbs. Non smoker, but exposed to second hand smoke growing up. Recent mitral valve prolapse and 5 mm non calcified lung nodule. Have had 3 scans with no change, just recently had 4th and waiting on results. Symptoms come and go for about a year now. Chest pain, shortness of breath. Recently have been getting back, shoulder, arm pain. Sometimes I get a pain in my lower stomach. I have had my gallbladder removed. I also get dull ache pains in my legs. Mainly most of my pain in the arm and leg is the left side. Nodule is also located in left lung. PCP says probably muscular skeletal or stress which I am under a great deal of stress. Is it possible that I could have lung cancer and the nodule not showing change? Why is my back suddenly hurting. I do have a 16 month old baby that I pick up a lot. I have a high tolerance of pain. My PCP and pulmonary doc just tell me I am not the typical lung cancer patient and that they don`t think it is lung cancer. It has been about 5 or 6 months since my last scan. They also said if it was lung cancer the nodule more than likely would`ve showed some type of change by now, which I don`t believe. Why monitor it for 2 years? I am just really frustrated and freaking out. I dont want to get a second opinion because I dont want to have to go through all of these tests again. Can anyone help me out? Oh and I also clear my throat a lot, which causing me to cough. It is not constant. I live in the midwest so sinuses aren`t the greatest. My pulm doc also said after my 3rd scan that the nodule `could be` old pneumonia? I ended up in the ER again today and they dismissed me saying well it probably is just fibromyalgia. But again no def answer. I did find out from my 4th scan that the non calcified nodule is now calcified. Not sure if the size has changed they didnt have that information. Not even sure if that is a good thing. I have been clearing my throat more which in turn makes me cough. Not coughing up anything really just a lot of drainage. I have these pains in my shoulders, and back that are almost unbearable. They again told me the nodule wouldnt be causing the symptoms which I know. They did not do any blood work and didnt want to subject me to more radiation with another CT scan. Told me to again follow up with my family doc and pulmonary doc. They said if this has been going on for a year its probably nothing major. Well the back and shoulder pains just started. My pulm doc said the nodule was too small to do a biopsy. So if it is cancerous...will I ever know or will it be too late? I am really just confused and frustrated and not know what to do. Can you help me understand this some? The finding of my last CT scan are : No definite pulmoary embolus is noted. No mediastinal or hilar adenopathy identified. within the left upper lobe, there is a calcified granuloma along with a small amount of atelectasis versus scarring. No focal infiltrates are noted. no discrete infiltrate is noted regional to the lingula. no effusions are noted. There is a small infiltrate in the left mid and lower lung zone laterlly adjacent to the lingula. There is otherwise no pleural effusion, consolidation, or pneumothroax. Small density in the left lower lung zone, early infiltrate not excluded. Follow up recommended. ???? what is that? Thanks
Thank you for your question. Lung nodules can be a source of tremendous anxiety for most patients. There are several factors that we as physicians take into consideration when assessing one's risk for lung cancer. These risk factors include the size and appearance of the lung nodule, length of time that it has been present, growth rate, age of the patient and smoking history to name a few. Your age , lack of smoking history and stability of the lung nodule make the risk for malignancy much lower. However, lung nodules are often followed for at least two years. If there is no change, the likelihood of malignancy is very low (but not zero). It is also appropriate for your physicians to follow any infiltrates or shadows on your CAT scan to make sure that they resolve. As to your other symptoms, it is unlikely that a nodule of this size would cause such symptoms but their etiology should still be investigated by your primary care physician.
Patrick Nana-Sinkam, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University