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Locked for answering on Sun 16, Mar 2008 12:57am by Dr Dennis S, MD

lung nodules - What are the chances they are cancer?


    
Asked by user (Male ) on Sat 15, Mar 2008 09:07am

i had a ct 3 months ago and they found a nodule 2cm in size. they repeated ct 3 months later and found i have 9 new nodules ranging from 2-5cm in size. what are the chances they are cancer? I am going for a broncoscope in 3 days.

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Answer by Dr Heinrik M, MD  on Sat 15, Mar 2008 07:51pm:

Hi, The progression seems to be atypical for lung cancer. The usual behavior would be a change in size of the primary, perhaps a lymph node along the predicted drainage of the nodule. The development of multiple nodules over the course of 3 months sounds more like a slow-growing infection or an immune-mediated disease. It may also be due to a substance you are exposed to in the workplace. Do you have any other symptoms? Fever? Difficulty breathing? Problems with bones and joints? My condolences about your father. There are no clear identified patterns of lung cancer with a hereditary basis. Much of the information is confounded by smoking (whose effect is difficult to isolate). Was you father a smoker? If you have a family history of multiple cancers (not just lung cancer), that may make screening for genetic predisposition to cancer. Another thing to consider is the age of the patient when the diagnosis was made. The bronchoscope is a good step. However, if it turns out to be non-diagnostic, it may become necessary to sample one of the nodules to make a definitive diagnosis. The diagnosis of cancer can only be made through such sampling methods (through bronchoscopy, needle biopsy).

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Comment by American MD on Wed 22, Apr 2009 04:15pm: There are a few problems with this answer: 1) There IS a link to hereditary development of lung cancer - specifically in people who have never smoked and develop lung cancer. 2) I would be concerned that multiple nodules could indicate metastatic lesions in the lung from a primary cancer. Thank you. (From an American Board Certified MD)

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