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A small spot on a lung scan can raise big questions: Is it cancer? Will it need a biopsy? Could surgery be part of the plan?
These small spots, called lung nodules, are very common and most lung nodules are not cancerous. The goal of lung cancer screening is to identify cancerous nodules in early stages of disease to take advantage of the most effective treatments and the best survival rates.
LUNGevity connected with Jonathan Villena-Vargas, MD, an accomplished cardiothoracic surgeon at Weill Cornell Medicine in New York City, to answer important questions about what lung nodules are, how doctors evaluate them, and what patients can expect if surgery is recommended.
LUNGevity Foundation: What is a lung nodule? Does a lung nodule mean cancer?
Dr. Villena-Vargas: A lung nodule is a small spot seen in the lung on a CT scan or chest X-ray. Most lung nodules are not cancer. They can be caused by old infections, inflammation, scar tissue, or other benign conditions.
LF: How do doctors decide whether to monitor, biopsy, or remove a nodule?
DVV: We look at several things, including the size, shape, growth over time, whether it is solid or “ground-glass”, and the patient’s age and smoking history. Small, low-risk nodules can often be followed with repeat CT scans. Nodules that are growing or look more suspicious may need a PET scan, biopsy, or surgical removal. It is critical to know that up to 20% of people diagnosed with lung cancer are not smokers.
LF: What does surgery to remove a lung nodule involve?
DVV: Most lung nodules can now be removed using minimally invasive surgery, either robotic surgery or VATS, through a few small incisions. Depending on the size and location, we may remove a small wedge of lung, a segment, or occasionally an entire lobe. Many patients are able to leave the hospital within a few days.
LF: Who should be screened for lung cancer, and what should someone do if they're told they have a nodule?
DVV: The American Cancer Society recommends yearly low-dose CT screening for people ages 50 to 80 who currently smoke or previously smoked and have at least a 20 pack-year smoking history. If someone is told they have a lung nodule, they should not assume it is cancer. The important thing is to make sure it is reviewed and that there is a clear plan for follow-up.
LF: Anything else to add?
DVV: Lung nodules are very common, especially now that more people undergo CT scans and lung cancer screening. The goal is to identify the small number that are cancerous early enough to potentially cure them, while avoiding unnecessary procedures for nodules that are benign.
Want to learn more? Visit our website:
- Should I get screened for lung cancer?
- What are lung nodules?
- Surgery as a treatment option for lung cancer.
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If you have additional questions or concerns about lung cancer screening, lung nodules, or treatments for lung cancer, please call LUNGevity at (312) 407-6100 or email us at [email protected]. We are here to support you.