If you were told you have a lung nodule, you may be wondering if this means you have lung cancer. The good news is that most lung nodules are not cancerous. If an isolated nodule turns out to be cancerous, it is often successfully treated because it was identified early. Let’s look at what lung nodules are and what to expect if one is detected on a chest X-ray or CT scan.
What Causes Lung Nodules?
A lung (pulmonary) nodule is a small abnormal growth in the lung, commonly found while being evaluated for other medical conditions using a chest X-ray or CT scan.
Lung nodules are commonly formed due to past infections and inflammation. Prolonged exposure to airborne irritants and autoimmune conditions, such as rheumatoid arthritis and sarcoidosis, are good examples. A nodule appears as a white spot in imaging and may appear solid or semi-transparent. A doctor may refer to this spot as a “shadow.” In some cases, only one nodule is found, while in others, multiple nodules are present. Sizes vary, and a nodule is defined to be less than 30mm in diameter.
The majority of lung nodules are benign, but occasionally, they can indicate early-stage lung cancer.
Nodules in High-Risk Patients Can Be Found with Lung Cancer Screening
Smoking is a significant risk factor for the development of lung nodules. The reason behind this is that smoke is an irritant to lung tissue. For those who qualify, lung cancer screening is another method for identifying lung nodules. A low-dose CT scan is performed as the screening process for individuals who meet the following criteria:
- Between the ages of 50 and 80, AND
- Have a “20 pack-year” history of smoking or more, AND
- Currently smoke or have quit smoking within the past 15 years
A “pack-year” is defined by the CDC as smoking a pack of cigarettes daily for a year. By this calculation, it means a “ten pack-year” could be from a person who has smoked one pack of cigarettes per day for ten years or from someone who has smoked two packs per day for five years.
Once lung nodules are identified, your doctor will investigate whether the nodules are cancerous or not.
Insurance plans, including Medicare, often cover the cost of screening for eligible individuals. The goal is to identify lung cancer early and cure more patients.
How Do Doctors Determine Whether a Nodule is Cancerous?
Fortunately, about 95% of lung nodules are benign and are nothing to worry about. Nevertheless, your doctor must officially determine if the detected nodule is cancerous. Your doctor will evaluate the nodule or nodules by:
- Assessing your risk factors for lung cancer. The following factors can increase the likelihood of a nodule being cancerous:
- Being over age 50
- Having larger nodules
- Having a smoking history or a family history of lung cancer
- The size of your nodule may not warrant immediate action. In such cases, your doctor might opt for active surveillance to monitor the nodule’s growth over time. However, if the nodule is more than 8 mm, lung cancer needs to be ruled out.
- Conducting a biopsy may be necessary. A biopsy is the only definite method for diagnosing whether a nodule is cancerous. Your specific situation will determine whether you’ll undergo a biopsy.
- Sometimes more scans are needed, such as a CT scan, if not done, or a PET scan if needed.
Once a biopsy is done, a pathologist will analyze the tissue removed from a lung nodule in a laboratory. The pathologist will determine if the biopsy sample shows infection, inflammation, scar tissue, or cancer. If cancer or precancerous cells are found, they will determine the type of lung cancer it is.
At What Point Should a Lung Nodule Be Treated?
Small, non-cancerous lung nodules can be monitored with follow-up imaging without treatment. Your doctor will let you know when monitoring is no longer necessary or when further investigation is needed.
Lung nodules generally do not impact breathing function. If you have a known lung nodule being monitored, it is important to seek medical attention if you:
- Notice a change in your cough, especially if it involves blood
- Develop new or worsening shortness of breath, chest pain, fever, or chills
- Experience a significant, unplanned drop in body weight
- Would like more information about your nodule and options
It is also important to remember that the appearance of lung cancer symptoms does not necessarily mean you have a cancerous nodule. When a biopsy does not show cancer, but the nodule is very suspicious or causes symptoms, your doctor may recommend surgery to remove the nodule. The decision to pursue surgery must be made with great care, and it will ultimately depend on the specific characteristics of the nodule.
Lung Cancer Treatments and Personalized Care at Virginia Oncology Associates
If your nodule is identified as lung cancer, your next step will be consulting with a medical oncologist. This is a doctor who treats cancer. Most nodules that become cancer are diagnosed at an early stage, which is often manageable with surgery and/or radiation therapy. A personalized treatment plan will be created for you.
Virginia Oncology Associates (VOA) provides the latest lung cancer treatments on the Peninsula, Southside, Western Tidewater, and Northeast North Carolina. If you were diagnosed with lung cancer, find the VOA Cancer Center convenient for you and schedule an appointment with one of our lung cancer doctors.
Virginia Oncology Associates is located in Norfolk, Virginia Beach, Hampton, Newport News, Williamsburg, Chesapeake, Suffolk (Harbour View and Obici), and Elizabeth City, NC.
