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Lung nodules < 4mm

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Old 07-20-2007, 03:44 PM   #1
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Lung nodules < 4mm

Often I see people come here frustrated with their doctors taking a wait and see attitude when they see small nodules of less then 4mm in their lungs. Note this is mm not cm as there is a big difference in the two. I asked my friend who is a pulmonary doctor that yes I would trust with my life why the doctors seem to take the wait and see attitude rather then the find out now attitude and here is what his reply was.......

There is now excellent data from Dr. Claudia Henschke in New York that nodules 4 mm or less in size are generally benign, and that waiting twelve months before the next scan is acceptable. In her published papers a nodule 4 mm or less never grew into a cancer in less than one year. However, it is still recommended that all nodules be followed no matter what the size. Here are some generally accepted facts:

1) Nodules less than 1 cm are very hard to biopsy conclusively. So a negative biopsy on a small nodule may not be correct.

2) Any nodule that does not change size over a two year period of time is considered benign by all authorities.

3) The only conclusive way to be certain that a small nodule is benign is to remove it entirely. However, many patients have too many nodules and are too sick to undergo the surgery. That is why doctors wait many times. If patients get frustrated it is because the doctor did not explain these facts well.

I hope this helps some of you sleep a little better tonight. Doctors usually follow standards of care or protocols which can save them from being sued and as you all know too many people are out there eager to sue doctors. So the above info should help you see why they often say wait and recheck and the length of time has to do with the size of the nodule. Too much radiation can lead to lymphoma and leukemia later so they are also trying to avoid that. Make sure you do understand that they are talking mm not cm when they say you have a nodule. ( remember huge difference in 4mm verses 4cm)

The best advice I can give anyone that has just learned they have a nodule is to find a doctor that makes you comfortable, that you can talk to and ask questions. If you are not happy as the doctor does not explain things to you or answer questions find a new one that will. Get 2nd opinions as doctors can make mistakes as they are only human though some of them want to believe the myth that they are indeed gods! I know many doctors very well and believe me there are many in that group that I would not let near me so sometimes you have to " shop around" for the correct doctor for you.

Hope you all have a good weekend. JanMarie

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Old 07-22-2007, 12:36 PM   #2
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Re: Lung nodules < 4mm

I have 4 nodules on my both lungs which is less than 4 mm and they did not change since 2003
But now they find that i got 2.6cm fluid spot on a base of my lungs and Doctor would not do anything except another CT in 3 month (previous Doctor wanted to wait 6 month).
Both Doctors don't believe this is cancer, but how can they be so sure??? Where that fluid came from - they don't know so why not to biopcy this?
I wonder if this is a cancer - will it always grow or it can stay the same size??

I wish you all well and your family members too! I read some stories here and cry... so sorry (((( ))))

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