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Like to hear from anyone that had lung nodules - whether is was a sign of metastasis or not

newenglandguy
Posts: 66
Joined: Jun 2011

I had my six month abdominal scan and that was clear, but I also had a Chest Xray and they found a suspicious 5mm spot. Well, a follow-up Chest CT showed two 7mm nodules in the right lung - nothing in the left. As we don't have a previous CT Scan, we don't have anything to compare to. So now it's wait 3 months and take another one. By the way, the two 7 mm nodules didn't even show up on the Chest Xray, and where the 5 mm spot showed on the Xray, nothing was shown on the CT.

I'd be curious to hear from any folks that had lung nodules found, and what was the follow-up to help determine if they thought it was due to RCC metastasis, or turned out to not be an issue. Obviously I'm hoping and praying that they don't show any shape change or growth in size.

In_Memory_of_Paul_Lacy's picture
In_Memory_of_Pa...
Posts: 2
Joined: Nov 2011

Hi New England Guy,

Not sure if I can answer your question but can share my brother's story, as I was his "secretary" for many of the doctor's appointments. When my younger brother was diagnosed on September 21, 2010, his RCC had already spread to his bones as well as his thoracic and lumbar spine. His cancer was immediately diagnosed as Stage IV Metastatic RCC. However, his cancer did not invade the lymph nodes, I remember the specialists at Dana Farber (we are also from New England), were perplexed as to why the cancer appeared to "skip a step" and bypass the lymph nodes but invade everywhere else. Paul had surgery to remove his kidney by Dr. Jerome Richie but other than that there was not much that could be done to combat this aggressive cancer except enter a clinical trial. Paul was given 3-6 months to live and chose to be a part of a clinical trial at Beth Israel (IL2 Treatment). The IL2 was unsuccessful for Paul but as a result more tests were administered to check the cancer status. Approximately six months after the initial diagnosis, nodules were found in both of Paul's lungs. Because my brother's cancer was so aggressive, there was never any talk of removing the cancer from his lungs. That being said, have the doctors confirmed this is the RCC? You were told that these nodules are cancer but not the type? Has IL2 been suggested? Just curious.

newenglandguy
Posts: 66
Joined: Jun 2011

Let me clear a few things up, based on your questions.

1. I'm being told, as we don't have a Chest CT to compare to, this one showing the two 7mm nodes is the baseline. The one in three months will be taking to hopefully show no changes.
2. They aren't saying it it due to the RCC, because they can't be sure they weren't there before. They are saying there are too small to biopsy.
3. Other than the three month follow-up Chest CT, nothing else has been suggested at this time, but I have asked my Urologist to forward the Radiologist report from the latest Chest Xray and subsequent Chest CT to Dana Farber. I've consulted with them after my partial neph in March of this year.

Sorry to hear about your brother's battle, but I really give you credit for responding to my post. I can only assume, by the fact that you replied, that you are a very caring person.

nicmarie75
Posts: 54
Joined: Apr 2010

My mom was diagnosed with RCC and at time of diagnosis she had mets to her lungs.

newenglandguy
Posts: 66
Joined: Jun 2011

Nicmarie75 - can you share details, and what the course of action was?

nicmarie75
Posts: 54
Joined: Apr 2010

They did surgery to remove the kidney and then Chemo for the Lung Lesions.

srbelle1
Posts: 123
Joined: Jul 2013

i don't know if the above poster is still reading posts since the post above was almost 2 years ago.

if she or anyone else has knowledge of kidney cancer "skipping a step" and going to spine with clear nodes and all scans showing no lung nodules, can you please share more?

my husband's kidney cancer sounds very close to this and I have spent hours combing the internet for any answers on this situation.

he is recovering well, gaining energy and improving his appetite daily; the catheter came out last Friday and he finally understands that he needs to increase his water intake. I have been hounding him for years on not drinking water. The guy could play tennis singles in 100+degrees without even a sip of water. 

Now, he gets it and my concern about reddish urine being blood has been relieved; the color was due to dehydration. I was feeling remiss in not seeking medical attention at least two years ago based on dark urine but it was dehydration.

Sarah

NanoSecond's picture
NanoSecond
Posts: 515
Joined: Oct 2012

Yes.  RCC can "skip a step".  But, in fact, there are no "steps".  Mets can appear anywhere and at anytime - regardless of whether or not your lymph nodes were "clear" and normal.  Mine were. 

My 11cm tumor was also totally encapsulated inside my left kidney.  After my nephrectomy I was deemed to be "cancer free" (NED).  But all that meant was that there is no visible evidnence of any spread at that point in time. 

Small, microscopic tumor cells, called CTC's (Circulating Tumor Cells) are still present in our blood streams.  They can seek refuge in out of the way places and then remain dormant for years before developing into metastases.

That is why it is so important to conduct those regular CT scans going forward.

srbelle1
Posts: 123
Joined: Jul 2013

oh, no doubt about this disease turning up again and again; it was intriguing to read "skipping steps" about it not being in the lungs.

we were told by the oncologist that the goal at this point was not "cancer cure" but long intervals and CT scans will be done every 3 months.

my question, and I think it has been answered, is whether it metastasized in some type of order; for my husband, a 5-10 year interval would be welcome and we will learn the grade soon. Dreading this.... 

Cancer has entered our home again, a most unwelcome visitor.

thanks for the responses

sarah

lbinmsp's picture
lbinmsp
Posts: 266
Joined: Jun 2006

I had lung nodules too. Initially there were a couple in my left lung - very tiny - so the doctors decided to wait and watch (they were too small to biopsy). Six months later - a couple gone, a new one popped up. Six months later none in my left lung, but a few in the right. One of my doctors said that more people than we know have lung nodules on and off that do nothing except come and go - even many of us RCC folks. I was at the 5 year post nephrectomy mark when the nodules in the right lung grew and they decided a biopsy was in order. There were three, the largest of which was about 1.5 cm. It did turn out to RCC again but only required a lower lobectomy. It was a surprisingly easy surgery and recovery.

I was glad the doctors were diligent in their continued 'watch' mode - because when the nodules finally did decide to grow, they were on top of it and it was caught early.

Good luck to you!!!

foxhd's picture
foxhd
Posts: 1872
Joined: Oct 2011

I had none after surgery in March. Now told have 8-10 with maybe 2 in liver and some? along aorta. Keep watching.

newenglandguy
Posts: 66
Joined: Jun 2011

Lbinmsp - how was your original RCC diagnosis made and what's been your journey? Have you done pelvis, abdominal and ling CT scans since original diagnosis?

lbinmsp's picture
lbinmsp
Posts: 266
Joined: Jun 2006

My original RCC was found, as most are, accidentally, while looking for a cause of the lower back pain I'd had for over a year along with extreme fatigue. Had an MRI which showed the tumor, then followed by CT scans, PET scans, ultrasound and boat-load of blood work. Had an open radical in 2001 which showed a Grade 2, T1, N0, M0. I had chest, abdomen and pelvic CT's plus blood work every 3 months for the first year, then every 6 months for the next three years. Throughout that time there would be tiny little lung nodules (which I understand is pretty standard in most people even without cancer) - they'd come go, disappear, new ones pop up. At my 5 year mark a couple of them 'grew up' - biopsy showed RCC. This was an easy fix - surgery - and then back to followups every 3 months again! I had finally graduated to once a year when another recurrance poppped up.

I am a huge proponent of close and diligent followup! Without that, I probably wouldn't by typing this response. I read the posts here and I know how scary each followup visit is - it's like you stop breathing until you get the results. Then it's CELEBRATION TIME! I always pray that each person here gets the 'all clear' with each visit!

Bottom line is this - get your followups done - then start breathing and LIVING to the max!

jhsu's picture
jhsu
Posts: 78
Joined: Sep 2009

Stage IV RCC T2N0M1 with one nodule met to left lung, biopsy confirmed. Open radical left kidney nephrectomy in May 2008. And surgical removed the left lung nodule a month later.

CT found a 0.9cm nodule in right lung in June 2009, assuming RCC and put on watch. A year later it grew to 1.1cm and VATS (Video-Assisted Thoracoscopic Surgery) wedged it out, confirmed RCC after.

newenglandguy
Posts: 66
Joined: Jun 2011

Hi Jshu - what was the Furhman grade of your kidney tumor, and how large was the first lung nodule? You say it was biopsies, so I am wondering how big they have to be before they biopsy them.

jhsu's picture
jhsu
Posts: 78
Joined: Sep 2009

Hi Newenglandguy,

They did not grade my RCC. It was a clear cell type and judge from the speed it grew felt like a low grade. The first lung nodule was 1.2cm. It was a challenge for both the technician and me to get that needle hit the target using real-time CT guided image on the screen mainly because of its size and a moving target. The key is that you have to hold the breadth during. Also, remember that the CT resolution is about 0.5cm. I remember we tries at least 3 shuts before he called it a bulls eye.

Jon

jhsu's picture
jhsu
Posts: 78
Joined: Sep 2009

I read the report again, it was grade 3. And the nodule diameter was 1cm measured after the surgery. So, the tolerance of CT was 0.2cm in this case.

Jon

djc2
Posts: 17
Joined: Nov 2011

Not sure if this will help, but...about three years ago I had a urinary tract CT scan looking for kidney stones. It picked up a couple of very small lung nodules in my lower right lung. This was followed up with lung CT scans at 6 mo, 6mo and 1 year. Each time the results were a little different. Some nodules disappeared, some new ones surfaced. After two years my pulmonary doctor said there was nothing indicating lung cancer to be concluded from the results. Less than 6 months later, after a urinary bleeding episode and subsequent CT scan, I received my diagnosis of probable Renal Cell Carcinoma. I began reading up and, discovering one path of RCC metastasis is to the lungs, called my pulmonary doctor to ask if there was any possible connection. He answered in the negative, probably due to the timing.

I am no expert but my experience with small pulmonary nodules suggests to me the ever-improving technology of CT scans has outpaced the doctors' ability to interpret the information unambiguously, particularly as it applies to small nodules. Still, it seams prudent to follow up and see if anything definitive does materialize.

Good luck!

Katielynn
Posts: 61
Joined: Apr 2011

I was found to have some nodules when I had a chest CT in Nov. 2010. I was told that almost every adult that gets a chest CT will show some lung nodules. I had a follow up CT done in May 2011. There were no changes. I was told I could go another year before my next, but my primary doc has ordered a chest, abdomen and pelvic CT and I'm going tomorrow. Talk about no time to worry...My urologist didn't want to see me for a year!!!!!!!! TOTALLY unacceptable. Thank God I have a PC I've been seeing over 15 yrs. He's really taken over for me. So, I get the scan tomorrow. Praying to my Dear God all goes well.

newenglandguy
Posts: 66
Joined: Jun 2011

Katielynn - wishing you the bast with a clear scan!

garym's picture
garym
Posts: 1651
Joined: Nov 2009

Katielynn,

Good luck today, saying a prayer for you and everyone fighting this battle.

Gary

Septemberzoe
Posts: 43
Joined: Sep 2013

Hi new england guy,

i know this is a longshot a since this post is from long ago but I am in a similar situation And just wondered how things turned out with the lung nodules

dhs1963's picture
dhs1963
Posts: 368
Joined: May 2012

If you have lung nodules, it means something is showing up on your lungs that are not expected.  A PET scan wil tel you if it is metabolically active.  The nodule could be scaring from an earlier infection, an active infection, inhaling a pebble, or a met.

If it is metabolically active, then they should do a biopsy before treating, as you do not want to treat scar tissue as if it were cancer.

FWIW, I had a solitary nodule last december.  It was a met, but we did not know that until it was taken out.  Biopsy showed abnormal cells, but could not tell if it was a new primary or a met. 

Septemberzoe
Posts: 43
Joined: Sep 2013

I have a 2mm nodule in right lung and 3mm nodule in left lower lung...have never had a chest ct before this one so nothing to compare with...dr said to rescan in 3 months and compare.saiid size was too small for biopsy or reliable PET scan results...praying for them to go away or show no change

dhs1963's picture
dhs1963
Posts: 368
Joined: May 2012

A 2 mm nodule is small.  If it is cancerous, they will know soon enough.  It is hard to live with, I know, but that is the reality of our lives now.

Y

Galrim's picture
Galrim
Posts: 270
Joined: Apr 2013

Just to underline what has been posted a million times before: PET scans for RCC are only useful in roughly 3/10 cases.

/G

danbren2's picture
danbren2
Posts: 171
Joined: May 2013

Septemberzoe,

     I was officialy diagnosed in July 2011 and had right kidney removed August 2011.  January of 2013 I started coughing up blood and was rushed to the hosiptal and then flown to Georgetown Hospital.  My scans up to that time had been clear.  I was placed on life support for about a week so the bleeding could be controlled, which finally thank God it was.  It was said not to be cancer related just a bad lung infection.  March 2013 I started coughing blood again, just not near as bad.  Back to Georgetown Hospital I was sent again. The decision was made to remove lower lobe of right lung.  The surgery was done March 16, 2013 and the results were positive for mets from the kidney cancer.  I am now doing well, can't even feel a difference with missing part of my lung.  Went back to work in April full time, June scan was clear and my next scan is scheduled for Oct. 11 and I am praying for that one to also be clear.

     I have had horrible problems with anxiety, and this is where I come to help deal.  The people on here are the best, and they are the ones that have helped me make it through!  They have taught me to not look at yesterday, live today to the fullest, and do not worry about tomorrow! I am here today and very happy to be!  Hope and pray everything goes well for you!

                                                             Love and prayers for good health!

                                                             Brenda

Galrim's picture
Galrim
Posts: 270
Joined: Apr 2013

Just a word of encouragement to you Brenda. As RCC mets go, surgically removeable lung mets are the most favorable to get if one were forced to pick. There is a good chance that it will give long time durable response. Your onc most likely already told you this, but repeating it doesnt hurt I guess :-)

/G

twinthings's picture
twinthings
Posts: 385
Joined: Jun 2013

Brenda, it seems each time I read one of your posts, I am inspired by your attitude and bravery.  I will be lifting you in prayer as you undergo your next set of scans, on the 11th.

Hugs to you,

Sindy

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