Lung Cancer growth? & Paraneoplastic Syndrome?

Hello,  I have a question I hope you might be able to answer. If you have one pulmonary nodule in the left lung, then 6 months later you have one pulmonary nodule show up in the right lung (so one in each lung) could cancer happen that way, or do you have to have multple nodules in one lung before it spreads to the next lung? Could you have nodules that aren't showing up on CT yet. Can you have a nodule that has grown stop while another one grows or will they all still grow? What if there is a suspicion of Cerebellar Degeneration Paraneoplastic syndrome (with many deficits) how does that work? Can you havenon-cancerous as well a cancerous nodules? Can you have a benign nodule then it turns cancerous? Sure would like your opinion. I would apreciate it very much. Thankyou Lisa

[Kamal S Saini, MD, MRCP (UK), DM]

Hi Lisa,
Lung cancer may indeed spread to the opposite side without first spreading to surrounding areas in the first lung.
Some small nodules may not be picked up be CT scanning.
There may be some nodules which grow faster than others.
Cerebellar Degeneration Paraneoplastic syndrome is a condition where a cancer located at a site distant from the cerebellum (for example lung cancer), causes degeneration of the cerebellum.
A nodule is a radiologically detected image and may be caused be cancer as well as benign conditions.
A benign nodule turning cancerous is theoritically possible, but rare.
Hope that helps!