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Lung Cancer

Can I have lung cancer?

08/31/2009

Question:

I am 40yrs old and a heavy smoker. I just recently had several tests to confirm that I have COPD and I am in the early stages of emphysema. I have had a CT and an X-Ray and was confirmed with having several nodules on both of my lungs. Thay are about 5 to 6mm each. I having a time with breathing and my chest always feels soo heavy. I cough constantly and my upper back hurts alot too. I have another CT scheduled on the 26th and then an appt. with my Pulmonary Doctor on the 2nd of Sept. He said that he can`t say for sure that they are malignant, but he wants to do follow-up CT`s every 3 months. My CT today, they could not use the dye because I had an allergic reaction last time. This CT w/o contrast showed that it was difficult to see the size changes. It also showed a calcified nodule, right renal lesion measuring 3cm diameter & left renal lesion measured 1.5cm diameter. Should I have my Pulmonary doctor do a PET scan? I am very concerned and having been researching the internet about lung cancer. Could it be that I do have lung cancer? Please reply, very scared.

Answer:

With the heavy smoking history, you are at a high risk for lung cancer. However, given the fact that you have multiple lesions and also are having respiratory symptoms it is possible that these lesions are just infectious. Because the lesions are small about 5-6mm, they cannot be biopsied at this time. The best approach at this time would be to stop smoking and repeat a CT scan in 3 months. If the lesions are getting bigger then biopsy can be done. However, if they remain the same then we will need to periodic CT scans every 3-6 months for a period of two years as most cancers double in size during that time period. If they are infectious, as I suspect then they may just disappear, and we will be home free. At this time the PET scan would not be an appropriate test as infectious can be positive on PET scan and we will not be able to tell whether this was infection or cancer. Periodic follow-up with your pulmonologist would be the best approach. With regards to the kidney lesions, an abdominal ultrasound may be a better option to further characterize them rather than a PET. If on ultrasound they appear suspicious then PET can be considered. Once again, I would stress on the benefits of quitting smoking. You will notice significant improvement of breathing symptoms. Hope this helps. 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