Lung nodules are common, but there are different courses of screening, observation and treatment based on the size and rate of growth. Watch pulmonologist Brian Gelbman, MD, discuss the various options and details involved in treating lung nodules.
If a patient should have a CAT scan for screening against lung cancer it's common that we would find a lung nodule. In fact if you screen everyone 50% of patients will have a nodule of some kind. The next step generally depends on the size of the nodule and the patients risk factors.
Frequently if we wanted to determine if a nodule could be cancer what we look for is to see if this nodule is growing over time. This means the patient will need another follow up CAT scan at a set interval. It can be three months it can be six months it can be one year, and at that interval we'll be looking to see if the nodule is changing in size.
For nodules that are highly suspicious, they may be referred for a PET scan to see if there's any abnormal activity in that nodule. Alternatively for our most suspicious nodules a patient may be referred directly to a biopsy of the nodule. Biopsies can be performed either by a CAT scan guided procedure, or someone lies on a CAT scan table and a needle is inserted through the chest directly into the nodule or it can be biopsy through the bronchoscopy where cameras placed through the airway and out through the lungs to biopsy the nodule.
Only biopsies can determine whether nodules are or are not cancer. Ultimately if a nodule is found to be cancer, there are many different treatment options that may be available. In general this can include surgery, radiation or chemotherapy. Patients will speak to their doctor, and may need a referral either a surgeon who specializes in thoracic surgery, a medical oncologist or a radiation oncologist.
Brian Gelbman, MD is assistant attending physician at New York Presbyterian Hospital and is board certified in internal, pulmonary and critical care medicine by the American Board of Internal Medicine.
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