I have never been diagnosed with lung cancer- but recent CT scan showed Single Pulmonary Nodule- Its very small (5x2mm) and in the middle right lobe - the report says "There is a tubular well-defined noncalcified nodule peripheral third lateral segment right middle lobe" - what does peripheral mean exactly? The doctor said I have to go back in three months, and then another three months possibly over two years to look for any growth or change- I dont understand why they cant check if its cancer now- maybe a PET scan to see if it lights up etc.... if its so small, cant they just take it out rather than wait for it to grow? Can you remove a small nodule like this without having to do a a wedge resection or a lobectomy etc... my doctors office is like a workshop, people in and people out, everything so rushed. They told me this and then ushered me out the door I have so many questions. Are any doctors good with this and take their time to explain things? I am reading all I can online and am very scared.

Mary, you can get a reliable answer to your question at cancergrace.org (GRACE — Global Resource for Advancing Cancer Education). GRACE is led by Dr. Howard "Jack" West, a Seattle oncologist who is an internationally-recognized expert on lung cancer and who gives high priority to promptly answering questions online. A lot of us are "dual citizens" and have the same usernames there as here.

A 5x2mm nodule is quite small, possibly too small to light up on most PET scanners. Some of them go away by themselves, others just sit there and don't change, while others continue to grow and become suspicious for cancer. Unless and until that happens, it's difficult to justify invasive surgery, which has risks of its own. But please recognize that I'm just a patient and guessing at what Dr. West or one of his colleagues might say. Please check out GRACE — I think you'll be impressed.

And welcome to the group! Aloha,

Ned

_________________
Ned is just my nickname, though it would be nice to merge it with the other meaning eventually...

Aloha means "Hello, goodbye, love, compassion, welcome, good wishes." It means belonging to others with a common humanity. It's defined better as a feeling in the heart than by words.

Dx NSCLC adenocarcinoma IIIb Sep 2006, now stage IV. Taxol+Carboplatin+Avastin 4 mo., Avastin 8 mo., Tarceva 16 mo., Alimta 12 mo. (sometimes combined with Cisplatin or Carboplatin), Navelbine since Feb 2010, 10 sessions of WBR in March 2011. See My Cancer Journey: viewtopic.php?p=351369#p351369 — UPDATED 03/05/2011.

Above left: Our golden retriever Rosie, who joined the family on 3/5/08 at the playful age of 2.

Below: Hannah, our golden companion 1994-2007.

Mary, I can't answer any of your questions. But it occurred to me that you could really use a second opinion. Can you get your PCP to send you to a pulmonologist?

You might also want to ask our Dr. West on cangergrace.org about this.

I wish you all the best. Please let us know what you find out.

Lynn

_________________
07/07: Diagnosed stage 4 SCLC. Carboplatin/VP-16, great scans. NED lung/hip, resolving liver.
11/07: Mixed scans. Repeat in 01/08.
01/08: Had seizures same week as scans. New mets: brain/adrenal glands. Active: lung/liver. In ICU overnight. Transferred to Hospice Wing next day.
01-28-08: Home on Hospice. Very critically ill.
01-31-08: Marked improvement. Sought second opinion. Yes, right diagnosis. Chose to not pursue further treatment.
02-05-08: Decided to fight w/Hycamtin.
04/08: Scans: Lung stable. Liver, adrenal gland, brain mets worse. Trying Gemzar.
05-12-08: CyberKnife for 4 of 6 brain mets. (Not WBR candidate-had radiation for non-hodgkin's lymphoma in 1984.)
05-26-08--06-10-08: Meds adjusted for increasing pain.
06-12-08: Fell down. Not injured.
06-19-08: Very wobbly. Brain MRI reveals innumerable lesions scattered throughout.
06-23-08: Hearing loss in right ear due to brain mets.
06-26-08: Not pursuing additional treatment.
07-24-08: Larry passed away at home at 8:10 pm, just the way he wanted. It was a gentle death. God's mercy is infinite.

Hi Mary,

The watch and wait and the scans after 3 months and then 3 months more is the typical protocol for nodules you describe. My hubby has 3 nodules each in a different lobe. He followed this protocol and continues to be monitored annually. Guess what????? No change.

PET scans do not accurately depict nodules so small. When they are so small they are too small for the doctor to be able to locate for removal. To remove much more than necessary isn't the best direction to go. MANY of these NEVER change.

Try to take many deep breaths and relax as much as possible. And I DO know how very hard that is. My guess is that your outcome will be the same as Fred's, and you don't want to lose part of your lung for no reason at all. And if by chance there is growth, THEN is the time to make decisions. As to your being rushed out the door ~ well, there is NO excuse for that behavior. Make sure the medical staff take their time to explain everything and answer all your questions.

Kasey

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Kasey ~ 8 year survivor ~ Stage IIIb 'inoperable' (yea, right!) lung cancer
9/20/04 Dx lc
9/24/04 Bronchoscopy
10/08/04 CT guided needle biopsy
10/14/04 Dx Pancoast tumor - NSCLC 111a(?) - inoperable - incurable
11/02/04 2nd opinion - Sloan-Kettering - concurs with local dx and tx
11/03/04-12/02/04 Radiation x22 chemo x5 taxol/carboplatin
11/04 - 3rd opinion - FoxChase -turned away
11/04 FOUND LCSC & HOPE
11/04 4th opinion NIH - surgery possible
1/04/05 Successful surgery - RU lobectomy - all margins, nodes, and path reports are NEGATIVE
2/05 chemo x2 taxol/carboplatin
3/05 Esophagus stretched twice
4/06/05 bloodwork, chest x-ray, CT scan, PET scan, NED
5/05 2 more esophagus stretches
7/13/05 bloodwork, chest x-ray, CT scan, PET scan, brain MRI, NED
10/05/05 bloodwork, chest x-ray, PET/CT scan, NED
1/11/06 bloodwork, chest x-ray, PET/CT scan, brain MRI, NED
4/05/06 bloodwork, chest x-ray, PET/CT scan, NED
6/10/06 emergency appendectomy
7/12/06 bloodwork, chest x-ray, PET/CT scan, brain MRI, NED
9/26/06 bloodwork, chest x-ray, PET/CT scan, NED
1/10/07 bloodwork, urinalysis, chest x-ray, CT, PET/CT scan, arm CT, brain MRI, NED
7/11/07 bloodwork, urinalysis, chest x-ray, PET/CT scan, brain MRI, NED
1/9/08 bloodwork, urinalysis, chest x-ray, PET/CT scan, brain MRI, CT w/contrast.....mm 'spot' lower right lobe - watch and wait 3 months
4/8/08 bloodwork, urinalysis, chest x-ray, PET/CT scan, NED
10/14/08 bloodwork, urinaysis, chest x-ray, PET/CT scan, brain MRI, NED
4/15/09 bloodwork, urinalysis, chest x-ray, PET/CT scan, brain MRI, NED
10/13/09 bloodwork, urinalysis, chest x-ray, PET/CT scan, brain MRI, CT/contrast, NED
4/13-4/15/10 bloodwork, urinalysis, chest x-ray, PET/CT scan, brain MRI, CT/contrast, PFT, echocardiogram, EKG, stress test, NED
4/11-4/13/2011 bloodwork, urinalysis, chest x-ray, PET scan, CT scan w/contrast, brain MRI, NED
4/16-4/18/2012 bloodwork, urinalysis, chest x-ray, PET scan, CT scan w/contrast, brain MRI, NED

Thanks to everyone who responded to my post. I have thought about it quite a bit and decided to go to my PCP to get an opinion on a different Pulmonologist. I have an appt. on Monday @ 2PM (mom watching the baby)- I am going to talk to him about everything that I am feeling and show him my CT scan results. He is a very nice "old school" doctor who always takes his time with me and makes me feel better for having spoken to him. I think I will try whomever he recommends b/c the office I am going to now I feel its a treadmill...........and unfortunatley one of those offices more interested in making $$ than patient care. I actually left a message for my Pulmonologist today b/c I had a terrible night last night with what I think are skipped heart beats and feelings of numbness and tingling all down my legs to my feet- I think its the inhaler he gave me (Symbicort)- he never called me back, or at least hasnt yet and its been hours since I called- I am just not going to use it anymore until I speak to my PCP. I need to find a doctor that is a partner in my care- I feel like Im dancing alone here and its not a good feeling at all.