Overview
● What is a lung nodule?
A lung nodule, also called a pulmonary nodule, is a small “spot,” “shadow” or “coin lesion” on the lung found during an imaging scan of the chest. It can be round or irregular, isolated or multiple.
● How common are lung nodules?
Lung nodules are pretty common. The American Thoracic Society reports that as many as half of the adults who get a chest X-ray or CT scan have lung nodules, especially those over the age of 50.
● How big is a lung nodule?
Your pulmonologist can inform you of the size of the nodule according to your CT scan. Nodules are typically less than or equal to 3 cm. If greater than 3 cm, doctors call it a mass, and it usually has a higher chance of being cancerous.
● Does size matter?
Doctors consider size one of the main factors in diagnosing a nodule. Most of the time, the smaller the size, the lower the risk of cancer.
● Can lung nodules be cancerous?
About 95% of lung nodules are non-cancerous (benign) and do not require treatment. Only 5% of lung nodules are cancerous (malignant). If a nodule is malignant, it is most often early cancer which is easier to cure.
Causes
● What causes lung nodules?
Non-cancerous lung nodules can be caused by a variety of things, including chronic inflammation, infection, old lesions, abnormal growth, precancerous lesions, etc. Cancerous nodules, which, as the name suggests, are caused by cancer, make up only 5% of lung nodules.
● Does smoking cause lung nodules?
Smoking is a major risk factor for lung cancer. People with a history of smoking, especially excessive smoking, have a much higher risk of developing cancerous lung nodules.
Risk factors
● What are the risk factors for lung nodules?
Most lung nodules are non-cancerous. However, certain risk factors increase the chances that a nodule is cancerous, which include: over 3 cm in size, partially solid, spiculation sign, over 60 years old, history of smoking, family history of lung cancer, etc.
Symptoms
● Can lung nodules cause any symptoms?
Lung nodules are small and usually do not cause any symptoms. If pressing against the airway, a nodule may cause breathing problems such as cough, wheezing, or shortness of breath. Symptoms like chest/back pain, coughing up blood and unexplained weight loss are rare but maybe early signs of cancer.
Diagnosis
● What specialist to consult for lung-nodule diagnosis?
Many types of doctors are involved in the diagnosis and treatment of lung nodules. After finding a nodule, you will meet with a pulmonologist, who is a lung specialist and can evaluate it to determine whether it’s of concern. You can also consult with a thoracic surgeon, a radiologist (imaging specialist), and sometimes an oncologist (cancer specialist) if necessary.
● How are lung nodules diagnosed?
Once found, your doctor will analyze the characteristics such as size, shape, density, and certain risk factors to make a diagnosis. If it’s small or the risk is low, doctors usually recommend follow-up CT scans in 3, 6, or 12 months to see if it grows or changes. If it’s large and/or suspicious, further tests are likely recommended. Commonly used tests include lab tests, bronchoscopy, biopsy, and PET scans.
Treatment
● How are lung nodules managed or treated?
A small lung nodule usually requires no treatment. Doctors typically recommend monitoring it through repeat chest CT scans over time to see if it grows. If a nodule is causing symptoms, is at high risk, or is cancerous, surgery may be necessary to remove it.
● How are lung nodules surgically removed?
There are two major types of lung nodule surgery: minimally invasive surgery and thoracotomy (open-chest surgery). The former is more often used, including video-assisted thoracic surgery (VATS) and robot-assisted thoracoscopic surgery (RATS). The surgeon may remove a small piece of the tumor to an entire lung. Which surgery you have depends on the characteristics of the nodule and your physical condition.
● Why is it important to monitor lung nodules?
Most lung nodules are benign. However, if a nodule is cancerous, the earlier it is detected and treated, the better the chance of being cured. Follow-up monitoring is necessary to ensure early detection of lung cancer.
Prevention
● Can lung nodules be prevented?
There is no sure way to prevent lung nodules, but there are many ways to reduce your risk of cancerous nodules and improve lung health. Smoking is a major risk factor, and the best way to reduce your risk is to stay away from tobacco. Other methods include getting fresh air, living a healthy lifestyle (eating a healthy diet, engaging in regular exercise, and managing stress), and avoiding exposure to pollutants and harmful chemicals. If you have a history of smoking or other risk factors, talk to your doctor about screening recommendations and how to reduce your risk.
Outlook
● What is the outlook of lung nodules?
Most lung nodules are non-cancerous and usually require no treatment. They should have no effect on your quality of life. In some cases, a nodule may be early cancer. As being detected early, it’s easier to cure when surgery is performed.
Summary
Lung nodules are fairly common and are often found incidentally when performing some other imaging scans. They usually cause no symptoms. Most lung nodules are not cancerous and don’t need treatment. Follow-up imaging tests are often recommended to see if a nodule grows over time. If a nodule is cancerous, it’s more likely an early-stage cancer and is easier to be removed surgically.