Lung Tumors: Do You Need Surgery?

Lung tumor

Hello, doctor.
I underwent a health check on June 10, 2002, and a chest X-ray revealed a circular shadow in the lower left lung (approximately 5 cm in diameter).
I then went to the thoracic department at a regional hospital for further examination.
A CT scan confirmed that it was a growth in the lung, but due to its location, an endoscopy could not be performed.
Blood tests for hemoglobin and platelets were normal.
The CT scan did not show any nodules.
The doctor asked me to retrieve the first chest X-ray data, and I provided the X-ray from December 1989.
The shadows in both X-rays appeared to be the same size, but the doctor still recommended surgical removal.
My overall health is currently normal, and I would like to ask Dr.
Zhou if surgery is necessary.
P.S.
I have no history of smoking.

Kiki Du, 30~39 year old female. Ask Date: 2002/06/27

Dr. Zhou Ziguang reply Pulmonology

There are many common causes of a solitary pulmonary nodule, including cancer, tuberculosis, cryptococcal infection, and post-tuberculosis sequelae, among others.
According to the information provided, if the size has indeed remained unchanged over a year and a half (from December 2000 to June 2002), the likelihood of malignancy decreases.
Therefore, in the absence of symptoms, close monitoring with chest X-rays (approximately every two months) can be considered.
However, if a definitive answer is desired, a surgical biopsy may be necessary to obtain a conclusive diagnosis.

Reply Date: 2002/06/27

More Info

When it comes to lung tumors, the decision to undergo surgery is often a complex one that depends on various factors, including the characteristics of the tumor, the patient's overall health, and the potential risks and benefits of the procedure. Based on the information you've provided, it seems that you have a round shadow in your left lung, approximately 5 cm in diameter, which has been stable over time according to your X-ray results.
The fact that the shadow has remained the same size over a significant period is a positive sign, as it may suggest that the tumor is not aggressively growing. However, the recommendation from your physician to consider surgical removal is likely based on several considerations:
1. Tumor Characteristics: The size of the tumor (5 cm) is a critical factor. Tumors of this size can potentially be malignant, and even if they appear stable, there is a risk that they could be cancerous. Surgical removal allows for a definitive diagnosis through pathological examination of the tissue.

2. Location of the Tumor: The location of the tumor can also influence the decision. If the tumor is in a part of the lung that is difficult to monitor or biopsy, surgery may be the best option to ensure that it is addressed appropriately.

3. Potential for Malignancy: While your blood tests (hemoglobin and platelets) are normal, which is reassuring, imaging studies alone cannot definitively rule out cancer. The presence of a lung mass warrants further investigation, and surgery is often the most effective way to obtain a tissue sample for histological analysis.

4. Patient's Overall Health: Your overall health and absence of smoking history are positive factors that may make you a good candidate for surgery. If you are otherwise healthy, the risks associated with surgery may be outweighed by the benefits of removing a potentially harmful tumor.

5. Monitoring Options: In some cases, if a tumor is stable and there are no concerning features, a physician might recommend a watchful waiting approach with regular imaging studies. However, this is typically more common for smaller tumors or those with benign characteristics.

In conclusion, while the decision to proceed with surgery is ultimately yours, it is essential to weigh the potential risks of leaving the tumor untreated against the risks associated with surgery. If you have concerns about the necessity of the surgery, consider seeking a second opinion from another thoracic surgeon or oncologist. They can provide additional insights based on your specific case and help you make an informed decision.
Additionally, if you choose to proceed with surgery, it is crucial to discuss with your healthcare team the type of surgery that will be performed (e.g., wedge resection, lobectomy) and what to expect during recovery. Remember, early intervention can often lead to better outcomes, especially in cases where malignancy is a concern.

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