Help! scan has possible lung spots

Mikeswife321
Mikeswife321 Member Posts: 4
edited March 2014 in Colorectal Cancer #1
My husband is stage 4 and has been NED for a year in February. He had the F-5 combination with Avastin following his colon resectioning prior to that with very good results on all. He was first diagnosed 5/24/05. He was 30 years old. We got the scan results this morning and they said everything looked very good except for two very very small (.5) spots on his lung. His Oncologist is wonderful, very cautious, and he noted that we should not worry and continue on Avastin until his next scan in 3 months. He said it was too small for a biopsy and could even be calcium deposits. Has anyone had an experience similar to this? I hate the "wait and see approach"...I know we all go crazy waiting for test results. But I would feel so much better if I knew it could really be "nothing". When he was first diagnosed we had a false reading on his liver and I pray that is what it is again. I would appreciate any input anyone could provide.

Comments

  • Betsydoglover
    Betsydoglover Member Posts: 1,248 Member
    #2
    Hi -

    Let me briefly share my experience as it is possible your husband's is similar.

    I too am Stage IV with liver met and have been NED for 16+ months now. Last Spring, while still apparently NED a CT scan (done by a different radiologist) mentioned some tiny lung nodules (hadn't been mentioned ever before, including as recently as 1 month before). Freak out time for me! It turns out that they had been present on every CT scan I had prior to that one (6 at that time), but had never been mentioned because no radiologist thought they had any clinical significance.

    It's a long involved tale, but I got a researcher at NIH to evaluate the scans and his opinion was also that they were clinically insignificant and should probably not have even been mentioned in that one report. That said - he told me that you are not totally out of the woods until lung nodules have been stable for 2 years (that gives me 5 more months to go).

    So, now, for my peace of my mind, my regular radiologist comments every time on these "structures" and indicates that in his opinion they are of no significance (and they certainly don't light up on PET).

    Anyway, you can't discount the fact that these may not be new - it is not altogether clear what radiologists, even really good ones, choose to comment on and what they don't. I know it is scary, but you might ask to have the older scans looked at again in an attempt to see if these are really new.

    I'll be thinking of you,
    Betsy
  • shmurciakova
    shmurciakova Member Posts: 906 Member
    #3
    Hi there,
    I am a Stage IV survivor and I had 2 spots appear on my lung back in February of 04 about 8 months after finishing my chemo. The spots, like your husbands were about 4-5mm in size. I was told the same thing, that a biopsy would be difficult and they might not even get the right spot! They have to actually be able to "feel" the nodules with their hand in order to know for sure they are taking the right piece of tissue out and when they are that small it is hit or miss! I was like, well, I am not going to be operated on if they don't even know if it is cancer and they might not even get it out! Geez....so I waited. Of course it was nerve wracking as hell, but what can you do? You could go ahead and find a surgeon who says he can remove them and possibly laproscopically. At any rate, I am sure there will be folks on here who will tell you to get a PET scan, however, in my experience a PET scan is highly inacurate for lesions smaller than 1 cm in size. I had 2 false negative PET scans. One in May of 04 and one in August despite my CT scan showing that the lesions had doubled in size in that period of time. In October, finally the lesions had grown to 1cm and my CEA was elevated AND my PET scan finally came back positive. In October I had the 2 lesions removed surgically and I have not had any more problems since then! YEA....I was 31 when I was diagnosed, so I have a similar situation to your husband. The good thing about watching and waiting is that if anything else is going to show it's ugly head, it gives it time to do so. For example, if there are any other nodules they will appear over a period of time. If some time goes by and nothing else shows up, then that is great and he can have the lung spots removed without fear that any more will show up later. Does that make sense? And of course there is the possiblity that they aren't cancer - in which case they should not grow and his CEA will not rise.
    I hope that helped and gives you some hope. Like I said, I had my lung nodules removed over 2 years ago! Unfortunately I do not know any way around the anxiety that all this can cause other than to just wait and see. I was not on any chemo during the 8 months of waiting that I did, so possibly the Avastin will take care of your husbands "spots" and surgery will not even be necessary. I would say keep exercising, eat a healthy diet and get massages to get your husband through the anxiety!
    Best wishes,
    Susan
  • Mikeswife321
    Mikeswife321 Member Posts: 4
    #4
    Thank you very much for your reply..it helps very much. I will absolutely ask about past scans. That is great advice and the reason I felt compelled to write on the discussion board.

    Thank you for your encouraging words and you will be in my thoughts as well.
  • Mikeswife321
    Mikeswife321 Member Posts: 4
    #5
    shmurciakova said:

    Hi there,
    I am a Stage IV survivor and I had 2 spots appear on my lung back in February of 04 about 8 months after finishing my chemo. The spots, like your husbands were about 4-5mm in size. I was told the same thing, that a biopsy would be difficult and they might not even get the right spot! They have to actually be able to "feel" the nodules with their hand in order to know for sure they are taking the right piece of tissue out and when they are that small it is hit or miss! I was like, well, I am not going to be operated on if they don't even know if it is cancer and they might not even get it out! Geez....so I waited. Of course it was nerve wracking as hell, but what can you do? You could go ahead and find a surgeon who says he can remove them and possibly laproscopically. At any rate, I am sure there will be folks on here who will tell you to get a PET scan, however, in my experience a PET scan is highly inacurate for lesions smaller than 1 cm in size. I had 2 false negative PET scans. One in May of 04 and one in August despite my CT scan showing that the lesions had doubled in size in that period of time. In October, finally the lesions had grown to 1cm and my CEA was elevated AND my PET scan finally came back positive. In October I had the 2 lesions removed surgically and I have not had any more problems since then! YEA....I was 31 when I was diagnosed, so I have a similar situation to your husband. The good thing about watching and waiting is that if anything else is going to show it's ugly head, it gives it time to do so. For example, if there are any other nodules they will appear over a period of time. If some time goes by and nothing else shows up, then that is great and he can have the lung spots removed without fear that any more will show up later. Does that make sense? And of course there is the possiblity that they aren't cancer - in which case they should not grow and his CEA will not rise.
    I hope that helped and gives you some hope. Like I said, I had my lung nodules removed over 2 years ago! Unfortunately I do not know any way around the anxiety that all this can cause other than to just wait and see. I was not on any chemo during the 8 months of waiting that I did, so possibly the Avastin will take care of your husbands "spots" and surgery will not even be necessary. I would say keep exercising, eat a healthy diet and get massages to get your husband through the anxiety!
    Best wishes,
    Susan

    I know that we will wait, and pray, and hope that things continue to go as well as they have. Although we would definitely not push for a biopsy or surgery and you are right, the Avastin has worked very well for him and hopefully it can knock it out. This disease certainly teaches you to be patient, and I am not long on patience....but I am learning. It helps to get educated and to talk to people in a similar situation. Thank you for taking the time to make me feel better by sharing your story.

    All my best,

    Michelle
  • libris
    libris Member Posts: 23
    #6
    After a cat scan looking for possible bone mets my radiation oncologist casually mentioned a couple of spots on my lungs. When I questioned him rather anxiously about them he told me that if you scan 10 random people off the street 8 of them will show some lung spots and that they would only worry if there was any change in 6 months. I actually found this oddly comforting and hope that you will too.
  • taraHK
    taraHK Member Posts: 1,952 Member
    #7
    I have recently been through something similar. A routine PET scan noted a very small lung nodule (<1cm). It didn't "light up" on PET. Waited 3 months. Three months later, same size, but it 'lit up' on PET. But several doctors (I did the rounds!) still thought it might not be a met (funny shape, not growing). Waited another 2 months. Still no increase in size but decided it needed to come out in order to determine what is was (biopsy wasn't possible, other than surgical excision -- and I had a history of lung mets). In my case, it was a met. However, in the meant time, I learned a lot about lung nodules. As others have said, apparently a large percentage of the population is running around with 'nodules' or other benign 'spots' in their lungs. PET is generally not reliable until the lesion gets to about 1 cm. Even then, 'infections' can light up on PET - or other inflammations. Needle biopsy for lung can tricky (and some docs don't like to do it, for fear of spread). It wasn't possible for me, either time. Bronchoscopy is an option but often doesn't yield the cells you need, and the lesion has to be v. close to a [?bronchial opening]. I agree with others -- watchful waiting is probably the way to go. As you note, that is very hard!!!!! Wishing you all the best -- and certainly wishing that those spots are nothing. They probably are nothing.
  • CAMaura
    CAMaura Member Posts: 719 Member
    #8
    Hi there, I'm right there as well...my first lung scan showed a nodule, but it is too small to boipsy as well. Mine wasn't calcified, but my onc wants to wait until February for a three month check. The days move SLOWLY. I did have another blood test, though, and my CEA is still super low so I am hopeful (my CEA seems to act in a consistent manner). Maybe you can ask for a blood test during the this waiting period? I know the 'not knowing' is hard...I am right there.
    Wishing you and your husband all the best - Maura
  • CAMaura
    CAMaura Member Posts: 719 Member
    #9
    CAMaura said:

    Hi there, I'm right there as well...my first lung scan showed a nodule, but it is too small to boipsy as well. Mine wasn't calcified, but my onc wants to wait until February for a three month check. The days move SLOWLY. I did have another blood test, though, and my CEA is still super low so I am hopeful (my CEA seems to act in a consistent manner). Maybe you can ask for a blood test during the this waiting period? I know the 'not knowing' is hard...I am right there.
    Wishing you and your husband all the best - Maura

    With this possible scare, I am thinking about an even better nutritional/exercise plan for my immune system. I figure that it can't hurt! I reread Dr. Quillin's book yet another time and it is amazing how we can pick up on new things and need reminders... I have added different mushroom extracts and other herbs and am trying to vary (and increase) my workouts even more. Anyway, just thought I would mention it...it helps me to be part of the process.
    All the best and take care - Maura
  • nudgie
    nudgie Member Posts: 1,478 Member
    #10
    Beack in 2000 or 2001 I had some lung/breathing tests done by my Lung Doc and he found small nodules 7mm in size and indicated he wanted me to get a CT Scan done on yearly basis to watch and see. The last High Resolution CT Scan I had was in Sept 07 and it continues to be the same size. This was all before I was DX in 7/06 with Stage II Colon Cancer. I gave my Onc Doc a copy (CD) of my last CT Scan for his review also. He indicated that he would like to continue to watch and will make sure that when I get my CT Scans every 3 or 6 months that it would cover fromt he neck to the pelvis.

    I hope this helps. Has your husband seen a "lung" doctor? If not, maybe he should.
  • Kanort
    Kanort Member Posts: 1,272 Member
    #11
    Hi,

    I hope you have felt some comfort in knowing that these spots are probably not anything to be concerned about.

    I had several small spots show on my first CT scan and my oncologist wanted to have the largest one biopsied. It turned out to be a hamartoma, which is something benign. The others are being watched and they have been stable for almost a couple of years.

    Please keep us posted on your husband's progress.

    Hugs,

    Kay
  • Mikeswife321
    Mikeswife321 Member Posts: 4
    #12
    Kanort said:

    Hi,

    I hope you have felt some comfort in knowing that these spots are probably not anything to be concerned about.

    I had several small spots show on my first CT scan and my oncologist wanted to have the largest one biopsied. It turned out to be a hamartoma, which is something benign. The others are being watched and they have been stable for almost a couple of years.

    Please keep us posted on your husband's progress.

    Hugs,

    Kay

    Yes, I feel very much relieved by all the responses posted. It is very comforting to my husband to be able to show him all of the reply's. His radiologist wants him to have an MRI and he may end of doing that. But the oncologist suggested just waiting the 3 months until the next scan. Whatever he decides, the wait will be much easier armed with the information I received from this post. Thank you!!
  • pink05
    pink05 Member Posts: 550
    #13
    Hi,

    I think you have gotten some excellent advice. Each of my father's scans have showed small lung nodules that are believed to be what they call granulomas. My father worked in a foundry when he was younger, breathing in lots of dust, asbestos, and other crap so I wouldn't be surprised if that is what the granulomas are from. Did your husband ever get exposed to any environmental pollutants, or has he had any lung infections in the past? If so, maybe that could be why these spots are showing up. It is true. Many people with no history of cancer have some type of unexplained spots on their lungs. Also, was there a different radiologist reading the scans this time? It seems like sometimes the scans could be subjective and one radiologist may perceive something differently than another one. You and your husband are in my prayers.

    God bless,

    -Lee-

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