Lung Nodules

What is a lung nodule?

A lung nodule is a small "spot" in the lungs, seen when imaging tests are done. You can have one or several of them. Most lung nodules are benign, meaning they are not cancer. But sometimes they can be cancer.

A lung nodule is found when a person has an X-ray or CT scan of the chest. It looks like a white spot or shadow on the lung.

What causes a lung nodule?

Many things can cause a lung nodule. Some of the more common causes are:

• Scar tissue

• A current or past infection

• Irritants in the air

• Autoimmune diseases, such as rheumatoid arthritis

In some cases, a lung nodule can be cancer. But it's not common.

Who is at risk for a cancerous lung nodule?

Certain things can raise your risk for a lung nodule being cancer. These include:

• A larger nodule

• Being a smoker or having smoked tobacco products in the past

• Having a family history of lung cancer

• Being older in age

• Having exposure to asbestos

What are the symptoms of a lung nodule?

Lung nodules usually don’t cause symptoms. If you have symptoms, they are often linked to the cause of the nodule, such as an infection. It may be cancer if a nodule causes pain, weight loss, or coughing up blood.

How is a lung nodule diagnosed?

Most lung nodules are found when a person has a chest X-ray or CT scan done for an unrelated reason. After finding a lung nodule, your healthcare provider will want to make sure it's not cancer. Your provider will ask about your personal and family health history. They will want to know if you are a current or past smoker and if you have any other health problems.

Your provider will also do a physical exam that includes listening to your lungs. They may also order tests, such as blood work, to help determine the cause of the lung nodule. More imaging tests may be recommended. One test for nodules is a PET scan. This test measures the metabolic activity in the nodule. More active nodules are more likely to be cancer.

How is a lung nodule treated?

In most cases, your healthcare provider will advise active surveillance. This means watching to see if the nodule changes or gets bigger. To do so, you will have regular CT scans. These may be done every few months or yearly. How often you have this imaging test depends on many things. These include:

• How likely it is that the nodule may be cancer

• How big the nodule is

• Where it's located

• What your personal preferences are

If the nodule doesn’t change or grow over time, your healthcare provider will likely stop the CT scans after a year or two. No further treatment will then be needed.

If the nodule does change or grow over time, your healthcare provider may advise more tests. These are done to check if the nodule is cancer. They may include:

• Blood tests

• PET scan

• Biopsy. This is when a small piece of tissue is tested in a lab. This can be done using pictures to guide a small needle through the skin. Or it can be done by a doctor using a scope to look in your lungs and take a biopsy from the inside.

• Surgery to remove the nodule

Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.

What are possible complications of a lung nodule?

A lung nodule often doesn’t cause any problems, unless it grows bigger or is cancer. Complications are often related to treatment. For example, if you have surgery to remove the lung nodule, you may be at risk of bleeding or an infection.

How can I help prevent a lung nodule?

Many things can cause a lung nodule, so you may not always be able to prevent one. But the best way to prevent a lung nodule is not to smoke. If you do smoke, take steps to quit. Talk with your healthcare provider. They may connect you with a support group or recommend medicines to help you quit.

When should I call my healthcare provider?

Call your healthcare provider right away if you have:

• Symptoms that don’t get better or get worse

• New symptoms

Key points about lung nodules

• A lung nodule is a small spot seen on imaging tests.

• Many things can cause a lung nodule, such as scar tissue or a past infection. Sometimes a lung nodule can be cancer.

• Lung nodules usually don’t cause symptoms.

• Most lung nodules are found when a person has a chest X-ray or CT scan done for an unrelated reason.

• Treatment often includes regular CT scans to check if the nodule is getting bigger. This is called active surveillance.

• If the nodule grows over time, your healthcare provider may advise other tests, such as a PET scan or biopsy. These can check if the nodule is cancer.

• Not smoking can help prevent lung nodules.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.