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Lung Cancer

5 mm noncalcified nodule in right lung base

04/23/2009

Question:

Hi because of pain in my right side (flank-back-front down to my pelvic region) I recently had a CT that showed a 5 mm noncalcified nodule in right lung base, a 4 mm cortical hypodensity in lower pole of the right kidney, a 4 mm hypodensity in the posterior hepatic lobe (liver), 19 mm cysts on my right ovary. There are pelvic phleboliths as well. I am a heavy smoker. I had a CT done in 2004 and none of the above was present at that time. I have an appt with a lung doc in 2 days. The recommendation was to follow up in 3 months w/ another CT. I am very scared and I do not want to wait. Should I be concerned with these results? I have read that lung cancer when it spreads stays in the same side. Thank you.

Answer:

For a noncalcified lung nodule in a smoker, repeat CT in 3 months is appropriate. At 5 mm, it is often too small to biopsy. Moreover, waiting 3 months to see if it grows is safe. Should you be concerned? Of course. A heavy smoker should always be concerned about numerous health risks, including cancer, cardiovascular disease, emphysema, etc. Lung cancer spreads in a variety of manners. Commonly, it first spreads to nearly lymph nodes. Then to distant sites. But early metastatic spread is possible. If the nodule grows, biopsy is indicated.

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Response by:

Michael F Reed, MD Michael F Reed, MD
Assistant Professor of Surgery
College of Medicine
University of Cincinnati