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2194148 tn?1397323475

Is this what I think it is, and why did the doctors wait a year?

Last year, they took a CAT scan of my chest, and they found a "nodule" in my lung.  They said that with nodules, they just "watch" them for a year and see if it has changed at all.  They asked me if I had smoked in the past, and I told them yes, I had smoked for 37 years!  Every day, about 1/2 to 1 pack per day.  I also told them I have exercised enduced asthma, and it never got worse.  But there is one other thing that I have had for years, and they look at me like I'm speaking in a foreign language when I tell them what happens!  I'm  hoping you can help.
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Avatar universal
In October, 2015, a nodule was discovered in my left lung during a routine chest x-ray.  My family doctor's Physician Assistant (PA) ordered a PET Scan, which showed no "lighting up" and the PA said we would watch it.  Fade to March, 2018, and I asked the PA during the regular physical exam if maybe we shouldn't check it again--she had forgotten about it.  The subsequent CT revealed that the nodule had grown in size (doubled but was only 1.4 centimeters to begin with), but nodules don't normally grown.  She sent me to a Pulmonary Specialist who ordered a PET scan prior to my visit with him, and at my appointment, he revealed that I had lung cancer and immediately scheduled me with a Cardio-Thoracic surgeon who performed a lobectomy of my upper left lung lobe.  So, if I were you, I would have any nodule in the lungs checked regularly.   By the way,  I smoked for 25+ years and had not smoked for several years at the time the cancer was discovered.
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See, this kind of stuff scares me.  They did call and say that it hasn't done anything and there weren't any more nodules and it was benign.  But instead of just  "watching it" forever, why don't they just take the thing out?  I asked that, and they said they just don't do it that way.
Lung surgery is a significant step to take and shouldn't be done (in my opinion) unless justified. There are other causes for nodules than lung cancer and surgery for a benign nodule just isn't worth the risk. CT imaging has come a long way in terms of diagnostic ability, and though not completely risk-free in and of itself due to radiation exposure from having one, it is much safer than having virtually any kind of surgery.
Avatar universal
Did you receive a copy of the radiologist's report, and if so did it include a Lung-RADS category for the nodule in question?
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No, I never even heard of a RADS category!  But fortunately the doctor called and said the nodule has done nothing and and there were no other nodules, and it was benign.  So they have to keep checking it every year.  Thank you, though.
If the nodule doesn't increase in size and displays certain characteristics on imaging that is the usual course of action. I for instance have had several in that category, and if something suspicious is seen a repeat scan is typically scheduled for three months after the initial finding.
Thank you so much, you are a wealth of information.
Since you smoked for 37 years, see if your primary care physician will refer you to get annual low-dose CT (LDCT) screenings. That is what I have been doing for the past five years or so, much lower radiation exposure compared to a full-on CT and no intravenous contrast is used.  That a good way to routinely monitor your lung health and if something suspicious shows up you'll have caught it early. The last one I had was covered 100% under health insurance, prior to that they used to be offered through self-pay or with a co-pay at a cost of $50 - $200 (including radiologist report), and these have  been performed at a major medical center.
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