Growth of Lung Nodule

[Jenmo]

I was diagnosed in 2002 with stage III colon cancer and underwent surgery/chemo. Last December (2005) a very small 2-3mm solitary lung nodule was found during a CT scan.  We have been following the nodule with serial CT scans. Over a 9th month period the nodule has grown to 6-7mm. The nodule is classified as "indeterminate".  Even with the growth it has been recommended that the only thing we do at this time is to re-scan again in 3 months. Apparently this is due to the small size of the nodule. Given my cancer history - does this sound reasonable? Should I consider a biopsy or resection? I am 44 and in otherwise good health.  Thanks.

[National Jewish]

As a general rule, a single, non-calcified nodule less than 2 centimeters (cm) in diameter in a non-smoker will not be cancer.  However, the likelihood of a nodule of any size being cancer increases with age, having had cancer in the past, or smoking.  Also, keep in mind that at one time every nodule was less than 2 cm in diameter.

Doubling time is another way of telling if a nodule is or is not cancer.  A spherical nodule doubles in volume when its diameter increases by a factor of 1.25.  Thus an increase in diameter from 2.0 cm to 2.5 cm means that the nodule has doubled in volume.  There is an overlap of the doubling times of nodules that are and are not cancer.  Generally doubling in less than 11 days or more than 18 months happens with non-cancerous nodules.  With nodules as small as yours the estimation of doubling is less accurate.

The likelihood of a cure is highest when the nodule is small.  You should definitely consider resection of this nodule.  However this may not be necessary if there are other factors that have led your doctors to conclude that the nodule is probably not cancer.

[Barbarella]

My husband who does not have cancer, but was a 4 pack a day smoker for 40 yrs had a nodule on his lung.  The Lung Specialist took a biopsy and it was benign.  After that he had to have CT scans done every six month for the next three yrs.  The size of the nodule stayed the same.  If I were you I would insist on a biopsy this way you know for sure and don't have to guess and worry about the "what if".

Good luck to you!

[ATHENA1963]

Hello, I just received a call from my mom saying that a chest xray she had last week revealed a very tiny nodule on her right lung.  Naturally I am floored and worried thoughts are going through my mind.  My mom is a 13 year breast cancer survivor, 25 years brain tumor survivor.  She just had a chest xray 6 months ago and this nodule was not there.  Now the physician says they will re-xray her in March.  I am just curious is this normal procedure?  Couldn't it just be a bad xray?  I would think they would want to take a second one right away.  She was told not to worry, it was probably nothing, but I am naturally worried sick.  If you could give me some ideas on how this is handled by other physicians I would be eternally grateful.

Thanks