Lung Nodules Don't Necessarily Mean Cancer

Lung nodules are clusters of cells found during an x-ray or CT scan that appear as more dense or white spots in the lungs. They might surprise you because lung nodules generally do not cause symptoms, and most are not cancerous. In fact, fewer than five percent of nodules turn out to be cancer. More often, nodules are the result of old infections, scar tissue or exposure to lung irritants.

When a nodule is discovered, the next step is determined after reviewing all available clinical information including an analysis of your risk factors for cancer as well as the size, shape and location of the nodule. The physician will also factor in your overall health. This may lead to undergoing a repeat CT scan to see whether the nodule grows over time, or other advanced imaging or testing studies.

Benign nodules tend to be small, round, slow growing and appear solid in scans while indicators for cancerous nodules include larger size, fast growing, bumpy and hazy or non-solid. However, appearance alone does not make a diagnosis. If a repeat scan shows that a nodule has grown, your doctor might also want to see a positron emission tomography (PET) scan, which gives additional information about the nature of the lung nodule and drives the need for biopsy.

If nodules have concerning features, your doctor will perform a biopsy in one of the following ways to test for cancer:

• Bronchoscope: a thin tube is passed down your throat and into the airways of your lung to reach the nodule. A small tweezer on the end can be used to get a sample.
• Image-Guided: If the nodule is in the outer part of the lung, a thin hollow needle is inserted through the skin of the chest wall (with the guidance of a CT scan) and into the nodule to get a sample.
• Surgery: If there is a higher chance that the nodule is cancer or if it can’t be reached with a needle or bronchoscope, surgery might be done to remove it and some surrounding lung tissue.

Once the biopsy is complete, a pathologist will review it and establish a diagnosis. If there is no cancer present, nodules will be monitored with regular CT scans to reveal when or if there are any changes. If cancer is found, a stage is determined, and a treatment plan formulated.

You can also be screened for lung cancer using low-dose CT scan if you meet criteria for being high-risk:

• Age 50 to 80 AND
• Smoked 15 cigarettes or more each day AND
• Smoked cigarettes for at least 20 years

Our lungs are always working hard bringing oxygen into our bodies and bloodstreams. Here are some things you can do to help promote healthy lungs:

• Avoid smoking
• Exercise
• Maintain annual check ups
• Deep breathing
• Maintain good air quality at home
• Inform you doctor is you are experiencing shortness of breath or chest pain

James Fenton, M.D., C.P.H.Q., is a board-certified, fellowship-trained thoracic surgeon with MyMichigan Health and a member of MyMichigan’s comprehensive cancer care team. As a thoracic surgeon, Dr. Fenton is dedicated to advanced and minimally invasive surgical management of a wide spectrum of thoracic conditions including disease of the lung, diaphragm, esophagus and the chest wall. He is dedicated to utilizing advanced surgical techniques, including robotic-assisted surgery, to improve quality outcomes and patient experience.

Resources:

www.cancer.org - Lung Nodules

www.lung.org - Lung Nodules Explained

www.lung.org - 10 Tips for Healthy Lungs