lung tumor

44 yr old female.  Diagnosed with a 4mm tumor in right lung, also evidence of scar tissue.  Shortness of breath, fatigue, back and shoulder pain and headaches\. Peristent cough for 6 months.
Current CT shows enlarged bilateral axillary lymph nodes ("small") , and pretracheal and precarinal lymph nodes. Low attentuation area in the left kidney,
I started out with CT scan that showed the tumor with no symptoms.  The symptoms started about 6 months ago and seem to be getting worse.  I have a Pulmonologists and the attitude seems to be let's just wait and see......
I don't want to over react but I am not sure if this is the best advice. Any opinions?

[National Jewish Health]

A 4mm nodule is in the "very small" category and would almost never cause a cough and never would be responsible for shortness of breath and your other symptoms.  It is ordinarily appropriate to wait and see on a nodule this small.

The lymphadenopathy may or may not be related to your symptoms but a wait and see approach may not be appropriate for these lymph nodes.  In any event, your doctors should seek a cause for those symptoms and, once this is determined, it may cast the lymph node enlargement in a different light.

You might also ask your doctor if any of the nodes might be relatively accessible for biopsy.  As an aside, it would be unusual for the disease sarcoidosis to present with this node enlargement without also having enlargement of the so-called hilar lymph nodes, the nodes adjacent to the large pulmonary blood vessels.