Should I get a 2nd opinion?

[DebbieinFL]

Just got results of 3rd CT after abnormal Xray taken 9mos ago. Pulmonologist & radiologist suggest a 4th in 2mos. Original & 2nd CT showed 3mm subpleural nodule in right upper lobe anterolaterally. Now 3rd CT shows 5mm subpleural nodule in right upper lobe anterolaterally, lungs otherwise clear without evidence of infiltrate, bronchiectasis or pleural effusion, except for a tiny parenchymal scarring in left lower lobe posterolaterally. No Hilar or mediastinal mass or adenopathy. I'm 51, 5ft8in, 148lb, physically active, never smoked, take only premarin, Allegra D, Nasonex and Astylin for non-allergic rhinitis. No health concerns other than occasional tiredness. What would you do if you were me?

[HeinrikMD]

Hi,

Your concerns are valid. The increase in size may indicate an actual increase in the size of the nodule or it may be a limitation of the CT scan. The CT scan takes images by making cut sections or slices across the chest. Imagine slicing a tomato, if you only make one slice at random and repeat the procedure on another tomato of exactly the same size, the size of the cut surface would likely vary. Whether or not it represents an actual increase in size, the more important question is whether or not you would be willing to undergo an operation. If you are, and you seem fit to undergo one, taking a sample (whether via needle or via surgery itself) would be a reasonable. Discuss these options with your doctor. One problem here is since it is quite small, hitting it with a needle may not be easy, so you may need to have more invasive procedures.
Why was the scan requested in the first place? Screening for lung cancer is not recommended. The reason is that early detection of small subcentimeter nodules doesn’t seem to improve outcomes. This is because patients still get cancers that cannot be removed despite the screening (hence, even if we assume that you have lung cancer and have the nodule removed, it won’t guarantee that within a few months another nodule will not appear that cannot be removed by surgery).  

[DebbieinFL]

Thanks. I will research other doctors. Having my annual mammogram/sonogram this week so I will be praying over that test too.

[RJ233]

Debbie, personally, I would find another dr. For what reason are they waiting for an abnormality to grow? The whole purpose of examinations and procedures to find those things is to correct it before it grows. What is their problem? It is your body they are playing around with. I would get those records and find another dr with good credentials. I was in a similar situation some yrs back and the surgeon treated me like it was a joke because the spot was big as the eraser on a pencil. That is more than big enough for me. I found another dr. The first one wanted me to wait 6 months to be rechecked. The second one told me right away he needed to get it out, which is exactly what I wanted. If it is foreign, then they should not question removing it if they find it. They already know it shouldn't be there or they wouldn't have you coming back. It is not something to play around with. Hope you find another dr that is truly concerned and does the right thing. Let me know how things go. RJ