Lung Nodule Treatment

Finding out that you have a lung nodule is likely unanticipated and can be a stressful event. We're here to help; our team will provide you expert consultation on what this means and help develop a treatment plan that is right for you.

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What is a nodule?

A nodule is a “spot” seen in the lung on an x-ray or CT (also called CAT) scan. Sometimes there is one nodule and sometimes there may be many.

In most situations, the spot is found when a chest x-ray or CT scan is done for other reasons.

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What causes pulmonary nodules?

Many things can cause a nodule and most nodules are not cancer. Just like your skin can have old scars, freckles and discolorations, the inside of the lungs can have a variety of things that cause spots. Nodules may include scars from prior infection or inflammation or non-cancerous tumors. Nodules may also be cancer.

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Does a nodule in my lung mean I have cancer?

No - most nodules are not cancer, though a few nodules will turn out to be cancer.

If the nodule has been present and unchanged for more than two-three years, cancer is very unlikely (less than 1% chance).

If the nodule is newly discovered, you may need a lung specialist (pulmonologist) to assess the risk of cancer in the nodule.

Your EvergreenHealth pulmonologist will work with a team to determine the nodule's risk for cancer. The team includes radiologists, chest surgeons, cancer specialists, respiratory therapists, nurses and a dedicated nurse navigator.

They will consider a lot of information to help determine the risk of cancer. This includes, but is not limited to:

• The size, shape, location, and density of the nodule
• Your age
• Whether you smoke or used to smoke
• Your history of cancer
• Exposure to asbestos
• Your family history
• Where you have lived and traveled

Based on this information, the team can estimate whether there is a low, medium, or high risk of lung cancer in a nodule.

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What is next?

If the nodule has been known about and not changed in two-three years, then often nothing else needs to be done. In this situation, the nodule is not cancer.

If the nodule is newly discovered, EvergreenHealth’s Pulmonary Care Center Lung Nodule Clinic can help. In larger nodules that are higher risk for cancer, our goal is to see you and complete your evaluation as quickly, safely and thoughtfully as possible.

If the risk of cancer is low, you may need a few follow-up low-dose CT scans to make sure the nodule does not change. Depending on the size and features of the nodule, it might need to be followed for one-to-three years.

If the risk of cancer is intermediate or high, your pulmonologist may recommend a PET scan, lung function testing, and/or biopsy.

• PET scans are special scanners where a dye is injected through an IV and tells us if there are metabolically active cells in your lung and other parts of your body, which helps determine if there is cancer.
• Lung function testing is done to assess the impact of smoking on your lungs and assesses the safety of several options for biopsy or even surgery.
• A biopsy can be performed several different ways. Each involves a physician obtaining a piece of the nodule, lymph node or body fluid so that a pathologist can look at it with a microscope and determine what it is. Most biopsies are outpatient procedures and you return home the same day.

To make an appointment with the Lung Nodule Clinic, call EvergreenHealth Pulmonary Care at 425.899.6972.