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

newenglandguy

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

Nodules....
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

In_Memory_of_Paul_Lacy said:

Nodules....
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.

Let me clear a few things
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

newenglandguy said:

Let me clear a few things
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.

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

newenglandguy

nicmarie75 said:

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

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

nicmarie75

newenglandguy said:

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

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

lbinmsp

Hello
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

lbinmsp said:

Hello
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!!!

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

jhsu

Stage IV RCC T2N0M1 with one
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

jhsu said:

Stage IV RCC T2N0M1 with one
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.

How large was your first ling met?
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.

djc2

lung nodules
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!

jhsu

newenglandguy said:

How large was your first ling met?
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.

Nodule size
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

jhsu said:

Nodule size
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

I read the report again, it
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

newenglandguy

lbinmsp said:

Hello
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!!!

Lbinmsp - how was your
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?

Katielynn

Nodules
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

Katielynn said:

Nodules
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.

Katielynn - wishing you the
Katielynn - wishing you the bast with a clear scan!

lbinmsp

newenglandguy said:

Lbinmsp - how was your
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?

It's been a real trip, that's for sure!
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!

garym

Katielynn said:

Nodules
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.

On my knees...
Katielynn,

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

Gary

Septemberzoe

New England guy

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

srbelle1

In_Memory_of_Paul_Lacy said:

Nodules....
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.

Nodules

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

dhs1963

Septemberzoe said:

New England guy

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

Lung nodules....

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.