7mm noncalcified nodule in my lung

[hoxiesteven]

Hi, I have a non calcified nodule,7mm in one of my lung .It showed up during a ct scan . I had the scan because I had an elevated afp test. It was 2000 and one week later it was 2333. There was no indication I had a mass in my liver but one lobe was swollen.The ct scan results said I had a possible malignency and followup was needed. My question is..when should I see a cancer doc?   thanks

[HeinrikMD]

Hi,

The CT scan with more slices would be able to detect any changes more accurately and over a shorter period of time. The difficulty is that the usual practice would be based on the older models, and hence incorporation of the new technology makes the meaning of such interval changes of less than a millimeter vague whether or not this would constitute a significant change or otherwise. If the nodule is less than a centimeter, then interval monitoring would likely be advised over a 3 to 6 month period, this sounds reasonable. If it is proven to be cancer and there is a plan to have it removed, then planning before surgery may be helpful if you have the CT scan with better resolution.  

[hoxiesteven]

I have cirrhosis caused by HCv .  also portal hypertension .I had a varesies burst and had banding done while I was in the hospital. At that time the test for AFP was done and it came back at 2000. A test a week later came back at 2333. I also have heart disease and need bypass surgery but because of my liver they would only do it in a life or death situation. To look at me you would think I am the picture of health but my scans and tests show otherwise..I am dealing with the VA and am leery of their treatment. I live in northern Maine and am 300 miles from the hospital.Also I heard they use an 8 slice ct as opposed to a 16 slice machine. Is ther a big difference?  Thank you for your time. I had beaten the hcv after years of treatment and now this.

[HeinrikMD]

Hi,

The nodule in the lung may not be related to the AFP. The AFP is indeed diagnostic of a liver cancer. The CT was requested probably in search of a mass near the heart. The evaluation would call for a search for a germ cell cancer. I am guessing you are male from your internet handle and your testicles should be examined. In the absence of a mass in the testicle, the area around the heart may have the mass. The CT however, may not be able to delineate the areas around the heart very well, an MRI may be the more definitive imaging  tool. As to the question when to see an oncologist, that would depend on the practice in your area. Some places may call in the oncologist after a definitive diagnosis (usually required a biopsy), but other places may seek an opinion when there is a high suspicion of cancer.
Why was the AFP done in the first place? Was it because of pain in the liver area?