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Lung Nodules - Cancer or Not? Here is the info for all to see.

I have spend considerable time on the internet reviewing different studies and reports on Lung Nodules after a smoker CT scan showed a 8mm nodule  back on Feb 15 2017. The nodule was not calcifired and solid, surrounded by a ground glass attentuation and was slightly irregular in shape and located in my right upper lobe. Subsequently, I had a PETSCAN that showed I have a significant uptake in my hilar lymph node measuring 4 SUV MAX and 1.4 cm size and my uptake on the lung nodule was  SUV MAX 1.4. I had a follow up CT 45 days later that showed the nodule remained stable as it shrunk to 6mm and the surrounding ground glass attentuation was less.  Then I had an Ebus biopsy of the hilar lymph node that was determined not cancerous and granuloma was found. Then another CT 4 months later and no change from my last scan.  So here is what I learned so far.

1)Spiculated or Irregular lung nodules are far more concerning then smooth shaped solid nodules. For example the odds of a 6-9mm nodule being cancer if smooth is less then 1%, vs 25% if spiculated.
2) Calcified nodules are far less concerning, then non calcified. In fact nearly all calcified nodules are not cancerous.
3)Nodules found in the upper lobes are more concerning then those found in the middle or lower lobes.
4) Petscans are good at eliminating concern if the nodule is bigger then 1cm (less then 1cm the petscan is not accurate) if the SUV max is less then 1. Petscans are not good at proving cancer since they readings of SUVMAX 2.5 or higher (2.5 =positive result) is frequently not cancer and rather infectious in nature;about half the time anyway.
5)The Nelson study (the best study on lung nodules in medical history) proved that growth rates of 5-9mm (If your lung nodule is smaller then that dont worry and follow up in a year, if its >1cm its time for a wedge biopsy via VATS) . is the best predictor of cancer vs benign. Volume doubling time measured  every 3 to 6 months over 2 years will determine your course of action. If.  its stable for 2 years , your nodule is 99% sure to be benign. If it grows slowly it is 70% chance cancer.  Volume (mm3) is not the same as size (mm) and a better measurement tool. A 6mm nodule that grows to 8mm in size had more then doubled in volume for example and fewer mistakes by the reader comparing one scan witht he next.
6) !00% ground glass nodules (transparent) are slower growing and need to be reviewed beyond 2 years.
7) 50% of smokers have nodules in their lungs. Only 2% of them are or ever will be cancerous. So dont panic but be smart and follow up in timely increments and not forget about it..
8) Lastly, if your a long time smoker like me. Quit, work out an hour a day every day, eat right.. no red meat or heated carbs like bread, organic foods, add ginger root and propolis to your diet.
I wish I had this info at my fingertips when I was going through this. Hope it helps others.
1 Responses
Avatar universal
Sorry for typos. Also before a wedge biopsy you should have a PET Scan if the nodule is >1cm.
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