Q: A physical examination 4 and a half years ago revealed mixed ground-glass degeneration of 8 mm in length and diameter in the basal segment of the left lower lung. Every six months or so, I come for review at the same hospital. Until now. The expert told him that there were no major changes, but they could not rule out the possibility of micro-invasive adenocarcinoma. Recently, a 5mm nodule was discovered on the other side. Will this situation change?
A: That’s it. Generally speaking, we usually encounter multiple cancers clinically. At the same time, there are quite a lot of polygenics. In your case, I don't think it's a metastasis, it should be multiple attacks at the same time. What’s the next step?
My suggestion is that you observe closely, mainly observe the mixed nature on the left, as the mixed nature is more dangerous. So I hope you can observe it closely and deal with it in time if there are any changes.
Q: I have been coughing and wheezing. After I went to the hospital, I was told it was asthma and I was prescribed some sprays. I have been using them for a week, and basically there is no problem. Still using it. The doctor said to check again after a month. At that time, I wanted to see if there was inflammation. The doctor did a CT and found pulmonary nodules. What I want to ask is, will asthma cause lung nodules and how to treat it?
A: Asthma will not cause pulmonary nodules. The pulmonary nodules are his own and have grown separately. Of course, as to what the nodule is, many of our imaging treatments cannot tell you whether you should perform surgery or observe it. Therefore, it is recommended that you take the imaging data to the hospital to see the doctor to see if you need to continue observation or surgical treatment.
Q: A chest CT was performed in February 2016, and the ground glass nodule in the apical segment of the right upper lobe was 4 mm. The reexamination in November 2019 showed that it was 7 mm, and it was still ground glass. It has grown 3mm in the past 4 years. Is it considered a significant increase? Do you need surgery?
A: If it is indeed a pure ground glass change, it has grown 3mm in 4 years, which is not a significant increase. The risk is not that great, and it is around 7mm. So if you look at what we said in our guide, in a situation like yours, the advice for you is to continue to observe. Maybe after 4 years, it has not grown to 1 centimeter. During these 4 years, your quality of life is very high, and there is no need for surgery.
Q: It has been one month since the surgery for pulmonary nodules. The postoperative pathology is adenocarcinoma in situ. How long does it take for reexamination? What tests are needed?
A: That’s right. We generally talk about adenocarcinoma in situ, and we also say that it is very early, and its prognosis is very good, and the 5-year survival rate is very high. Generally speaking, we review it every six months or so every six months. Because it is a little different from the guideline in China. It is recommended in foreign countries to review it every year or so. We review it every six months. Generally speaking, the current routine clinical examination is to review a plain chest CT scan and a blood oncology indicator. If you have special symptoms and discomfort, you can add some more targeted examination items, including head CT, abdominal ultrasound, etc. Generally, do not go overboard with examinations.
Q: There are multiple nodules in both lungs. A 1 cm nodule in the left lung has been operated on. The pathology report is carcinoma in situ. Observation is recommended for the others. May I ask what kind of CT mode is used for subsequent CT review?
A: The CT mode commonly used in clinical practice is plain scan. Some people can even do low-dose plain scan CT. Once every six months is enough. There is no need to be overly nervous.
Q: Breast cancer was discovered 10 years ago and had a removal operation. A chest CT was done in 2014 and it was found that there were small nodules and spots in the lungs. I have been undergoing re-examination. Last week, the nodule size became about one centimeter during a re-examination.
A: If your nodule is obviously increasing, because you have not described it, I don’t know whether the lesion is a pure ground glass change or a composite or mixed one. Infiltrating lesions. But when it is 1.3 centimeters, it needs to be taken seriously. It is a relatively large lesion. I hope you can take it to the hospital and let an experienced doctor help you identify it. If you need to take it seriously, you should still need surgery.