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Old 01-20-2007, 02:11 PM   #1
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Question Pulmonary Nodule Questions

I've been lurking here and was wondering if any of you had an opinion about what should be done regarding a nodule found on my chest CT scan. The scan was done last February by my Gastroenterologist because he found I had GERD and erosive esophagitis on an upper endoscopy and I often have very bad GERD attacks with lots of chest pains.

The radiologist wrote on his report that "there is a solitary discrete 4 mm pleural based nodule seen posteriorly in the left upper lobe. If patient is low risk, no further follow-up is necessary; if high risk follow-up CT in 12 months would be suggested."

I have never smoked and have never had cancer so my Primary Care Physician said we didn't need to follow-up. Since I received this news the week after Dana Reeve died from lung cancer, I was very concerned and insisted that she let me see a specialist. She finally gave me a referral (I belong to an HMO) to a pulmonologist who also said it was nothing to worry about because "the statistics nowadays in low risk patients show we don't really have to follow up closely. She then went on to say that having another CT scan would be worse because of the radiation risk it delivers.

As the one year anniversary of this discovery is approaching, I am beginning to obsess about it. Should I ask to see the pulmonologist again and/or demand another CT scan? Or should I just put it aside and try not to worry and cause myself more problems by having an unncessary risky CT scan?

Thank you in advance for any advice. Your thoughts would be appreciated.
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Old 01-25-2007, 05:32 PM   #2
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Unhappy Re: Pulmonary Nodule Questions

I wonder if anyone has any advice for me, please? I was just reading a few other new threads and see a discussion of calcified or non-calcified nodules. Can that be determined by a CT scan or do you need another test to determine that? I also see that some of you have suspicious nodules that are being re-examined via CT scans - did your doctors ever express a concern that doing too many CT scans could cause problems down the road for you? This is what my pulmonologist said and why she wouldn't follow up.

I think I would feel better if I could have another CT scan to see if there has been any change in the past year. what do you think?

Prayers and Best Wishes to all of you are dealing with lung cancer or the scare of it.

Susie
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Old 01-25-2007, 05:40 PM   #3
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Re: Pulmonary Nodule Questions

susie you need to do what you are comfortable with. yes there is exposure that we dont need from ct scans but you have to wiegh the pros and cons. you stand a better chance at treatment the sooner that something is diagnosed. it is becoming more common to see people with very low risk factors getting lung cancer. i would just hate to see you wait if there were really something there. if you were my sister (which i do have a sister susie) i would urge you to have it further checked out.
i guess im more proactive telling people from experience. i found mine when it was stage 4 . i had symptoms for a year before i even went to the doctor(not smart) good luck and keep us posted........blessings,melissa

 
Old 01-26-2007, 05:22 PM   #4
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Re: Pulmonary Nodule Questions

Susie, I also do not think you are wrong to be concerned and feel we must do what we are comfortable doing when it comes to our health. And yes CT's can expose us to unnecessary radiation but sometimes just having peace of mind may be worth it. You say you are a non smoker so low risk but does that doctor stop to consider that while most cancer death rates are coming down the one that is still rising is lung cancer in females? Even non smoking females? They are making a connection between estrogen and lung cancer so that means us females smoking or not have a higher risk and the exposure to smoke could have happened years ago. My mom was a non smoker but she died of lung cancer.
Hope you can find a doctor that is willing to give you peace of mind. JanMarie

 
Old 01-26-2007, 06:24 PM   #5
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Re: Pulmonary Nodule Questions

Dear Melissa and Janmarie,
I really appreciated hearing from both of you! Thank you so much! I know I'm low risk and I know it is still possible to develop a problem even if you've never smoked and I know CT scans give off too much radiation that could come back to haunt me but I really think I need to have another CT scan to see if there has been any change in the past year. I think I really needed to hear that from someone else who has had some experience with this and you both have done that for me. It is very hard to talk with even family and friends - I have a couple of health issues (including an indeterminate lesion on my liver which was seen in October 05 and is being followed by MRI's. I have my 4th one next week. Ughhh!) and although they care, they just don't fully understand.

I know I need to talk with my GP or the pulmonologist. The pulmo made such a convincing argument about the radiation and not wanting to hear that i developed breast cancer at a later date that I meekly agreed to let it go - not that I have however.

Best wishes to both of you!
Peace!
Susie
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Old 01-27-2007, 05:15 PM   #6
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Re: Pulmonary Nodule Questions

Susie,

Do listen to what your inner voice tells you to do and not to what others tell you. My oldest sister is a breast cancer survivor and she joined dragon boat team that was made up of Breast cancer survivors. I can not tell you how many of those poor women would go to the doctor and say I have been having headaches, stomaches aches what ever and beg the doctors to do tests and instead had doctors knowing darn well they had had breast cancer write it off to it is nothing, it is all in your head etc and refuse to do the tests. For most by the time they found a doctor that would listen it was too late as it was the cancer had returned and as a result they died. They knew something was wrong as I think many of us do if we stop and listen to our bodies and that inner voice.

The stress of just not knowing day in and day out maybe just as bad as the radiation from a follow up CT as there is a connection to stress and so many diseases. Take care and I pray you get some answers so that you can move ahead on your life. JanMarie

 
Old 01-29-2007, 10:45 AM   #7
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Re: Pulmonary Nodule Questions

Hi Susie,

I totally second what Janmarie and others say, you are living in your body and need to know what's going on with it.
I was ill for years and was diagnosed with chronic fatigue syndrome and the medics tried to tell me I had depression. Yes I was depressed because I knew something was wrong with me, and the Doctors in England refused to run tests to find out what, despite my asking for investigations on an almost monthly basis as to why I felt so rotten, they were happy with their diagnosis saying I had CFS and depression.

I emigrated and went to a new Doctor in a new country about my knees which were getting stiff and painful. The new Doctor looked at me and listened to my chest did some tests a CT and others, guess what I have stage IV cancer metastasised into my lung, kidney and vertebra too late for any treatment.
- No I don't have CFS - No I don't have clinical depression. This cancer did not suddenly appear overnight it has been growing for years and could have been found and perhaps cleared it the doctors in UK had listened to me, I knew something was not right with my body.

I sincerely believe that if I was still in England, I would not know about the cancer even now, as the Doctors would never have run the tests.

So Susie please get yourself checked out, it could save your life, and if there is nothing there to worry about, you will be able to move forward with your life. Be strong.

Good luck and God bless
Cee

 
Old 01-29-2007, 05:49 PM   #8
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Re: Pulmonary Nodule Questions

Cee,
I am so very sorry for what you have been through. Thank you so much for sharing your story and caring enough to reply to me. No one should have to go through what you did. I will keep you in my prayers as you deal with your illness.

JanMarie - your kind thoughts and advice are also much appreciated

Peace!
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Old 01-30-2007, 06:08 AM   #9
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Re: Pulmonary Nodule Questions

Susie-
I am going through something similiar to you. I just had a CT scan done for other reasons but they found a spot on my lung and liver. I was a smoker for over 20 yrs and quit and now this. I talked to my Dr and he advised CT again in 6 months, I worried about exposure.

I agreed the risk of exposure out weight the possibility of a tumor. And so I am going for another scan in July. Do what is right for you!! If you do not trust your Dr get another opinion. It is scary all the what if's and hoping you are doing all you can.

I do not have any answers but I sure can understand how you feel!!! Keep positive!!!

 
Old 01-31-2007, 04:08 PM   #10
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Re: Pulmonary Nodule Questions

Reyne,

Thanks for your post! We actually have lots in common - I also have an "indeterminate lesion" on my liver which was discovered thru a CT scan for a possible thickened appendix in October 05. I then had an MRI to check it out and it was still a mystery to what it was. Siince then I had 2 other MRI's in Feb and July 06 which shed very little light on what it was. Actually each radiology report referred to it as something different: a hemangioma, an adenoma and a focal nodular hyperplasia (fnh). Ironically I just had an MRI today at a new hospital and am waiting anxiously to see/hear the results.

To be able to change hospitals I had to change my primary care doctor in September 06 and get a referral to a new GI doc ( I also have erosive esophgitis, GERD and IBS). I belong to an HMO and need a referral for all specialists. I see my PCP next Friday and hope to now discuss the lung nodule and see if I can see someone different who will refer me for a CT scan. This will be one year now and I really want and need to know if it is stable or has changed.

I wish you well and hope your scan in July gives you some answers and hopefully they are good answers. What did they call your liver spot? There is a great thread on the "liver disorders" thread about adenoma vs fnh which you might find helpful.

Take care!
Susie
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Old 02-02-2007, 11:10 AM   #11
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Re: Pulmonary Nodule Questions

Hi..... a chest x-ray uses way less radiation... the nodule was very tiny last year and might not have shown up on an x-ray, but mine did, at only 5mm. Now that the doctors know where yours IS, they should be able to locate it on an x-ray. If yours has grown enough in the last year to cause the doctor to feel concerned I'm pretty sure it would show up on an x-ray, and THEN they'd order you a new CT Scan I'd think. I don't blame you for wanting to know what the nodule is doing. Hope you can get a new scan soon..........Tiz.
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Old 02-26-2007, 05:47 PM   #12
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Re: Pulmonary Nodule Questions

Hello!

Just thought I'd post an update to my story...

I saw my GP on February 9 and he did give me a referral to see a different pulmonologist about my 4mm pleural based nodule. He did not think it was necessary but since I insisted he finally relented. He didn't think it was necessary because in his opinion the radiologist who read my CT scan is very conservative and if he thought there was any question that it was a problem nodule the radiologist would have suggested follow-up. My GP went on to say that technology is too good today and picks up spots in everyone.

Well, I went to see the pulmonologist and heard the same songs again! "It is probably nothing", "you never smoked so you shouldn't worry", there is more risk to having another Ct scan than not" Hard as it was, I stood my ground and insisted that I needed to have this follow-up CT to put my mind at rest. I just need to know that there hs not been any change in the past year. He finally wrote up the order for a CT but not for another 3 months - MAY 24. He said it has to be pre-certified by my insurance company and he wants me to think it over in case I am being too emotional since it is the one year anniversary of finding it.
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Old 02-28-2007, 08:51 PM   #13
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Re: Pulmonary Nodule Questions

Susie,
I just read your posting and just let your GP know that even though you do NOT smoke you are not exempt from getting lung cancer. My husband's GP said well, your lung x-ray is clear so at least we know you don't have lung cancer. (keep in mind this was in April 05 and in June 05 diagnosed with full blown extensive SCLC) Now please, with me saying that I am not saying you have lung cancer! Hopefully all will be clean with your CT Scan and you can enjoy life without constantly worry.
Take care and keep us posted.
Kim

 
Old 03-02-2007, 09:47 AM   #14
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Re: Pulmonary Nodule Questions

Kim,

Thank you for your concern! And I am so sorry about your husband's diagnosis. I will keep him and you in my prayers.

Ironically I was told that I had this nodule the day after "non-smoking" Dana Reeves died last year and of course there was a flurry of stories in the paper, on TV and in magazines about non-smoking women and lung cancer so you can imagine the tailspin I was in wondering and worrying about my situation and listening to my GP and the Pulmonologist tell me "oh you have nothing to worry about". I am still concerned and definitely plan to have that CT scan in May provided my insurance company approves it. I can't believe the medical profession somedays! It is so tiring to have to battle all the time for your own well-being. I also have an indeterminate lesion on my liver which was discovered in October 05 and is being followed by MRI's. The reports from the first 3 MRI"S called it something different each time: i,e a possible hemagioma, an adenoma or maybe a focal nodule hyperplasia. So it seems like I will continue to fill up my appointment book with scans and doctor appointments....

Take Care!
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Old 03-12-2007, 08:42 PM   #15
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Re: Pulmonary Nodule Questions

Hi Susie,
I am in a similar situation as you, however my doctors have no problem giving me CTscans. One was discovered last year after the deaths of my Mom and Dad from lung cancer. I wasnt expecting them to find anything, but just wanted them to check as a precaution. Much to my surprise they found nodules. That was last May. Since then I have had a PET scan which was negative and another CTscan showing improvement. I have one more scheduled for Wednesday and if all is well I'm going to tell them enough! I applaud you for being persistant. We have to be our own advocates because many doctors today drop the ball. I hope your results are good ones. I know its tough to have to wait until May. I hate the waiting part most of all. I'll keep you in my thoughts.

Becky

 
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