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What to know about lung nodules

If an imaging test reveals a nodule in your lungs, you might worry about what that means for you. Could it be cancer?

It's normal to have concerns. But it's important to keep in mind that most lung nodules are not cancer. According to the American Lung Association, they often turn out to be caused by infections. They can also be caused by air pollution and other irritants or by certain health conditions, such as rheumatoid arthritis.

But while it's not the most common, cancer is also a possible cause. That's why people who have lung nodules may need other tests to find out for sure.

What is a lung nodule?

A lung nodule is an abnormal spot on the lungs. Most nodules don't cause symptoms. They're usually found by chance during a CT scan or chest x-ray. Or they might be detected during a low-dose CT screening for lung cancer.

After a lung nodule is discovered, doctors look at several factors when deciding how likely it is to be cancer, including:

  • The size and shape of the nodule. Large lung nodules with a spiky shape have a higher risk of being cancer than do small nodules that are smooth and round.
  • Whether the nodule looks solid. Nodules that look solid are less likely to be cancer than those that do not appear solid.
  • Your smoking history and age. If you're a current or former heavy smoker, over 50, or someone with a history of other cancers, there may be an increased chance your nodule is lung cancer.

Your doctor may look at any previous x-rays or CT scans you've had to see if the nodule was there before or if it has grown. In some cases, a PET scan may be needed to gather more information about a nodule.

Managing lung nodules

Your doctor can help you understand your risk for lung cancer—and what your nodule could mean for you. They will help you weigh the risks and benefits and choose the best approach for your needs.

In many cases, that might involve a watch-and-wait approach. That means monitoring the nodule over time to see if it grows, which could be a sign of cancer. You may need CT scans every three, six or 12 months for a few years. If your nodule doesn't change within that timeframe, you may not need any more tests.

You may need a biopsy if a CT scan shows your nodule is growing or if it shows other signs it might be cancer. A biopsy is a procedure to remove a very small sample of tissue so it can be checked for cancer.

Here are some ways to perform a biopsy:

  • A needle may be inserted in the lungs to remove a small piece of tissue.
  • A bronchoscope (a long, flexible tube) may be passed down the throat and into the lungs to reach the nodule.
  • Surgery may be done to biopsy a nodule that can't be reached with a bronchoscope or a needle.

    • Depending on the results of your biopsy, your doctor may recommend further tests.

    Talk to your doctor

    Let your doctor know about any concerns you have. Even though most lung nodules are benign, it's normal to feel worried about the possibility of cancer. Your doctor can offer support and information about your condition. And further testing can offer answers—and peace of mind.

    Reviewed 5/16/2024

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