A lung nodule is a round spot on the lung made of dense tissue. They usually show up when a patient is having an X-ray or CT scan for a different reason and appear as white spots on the image. It’s normal to feel surprised or concerned if you hear you have a lung nodule. It is estimated that 25% of the U.S. population has a lung nodule. The vast majority of these end up being benign.
Most small nodules don’t cause problems, but they can change over time. That’s why it’s important to work with a care team that specializes in pulmonary issues who can properly diagnose you, monitor your nodule over time and get you any care that may be needed.
At Fred Hutch Cancer Center, we care for patients with lung nodules and lung issues through our Lung Cancer Early Detection and Prevention Clinic. In addition to preventing, screening for and monitoring patients at risk for lung disease, our pulmonologists (lung specialists) offer comprehensive care for patients who have been diagnosed with a lung disease or lung cancer.
Lung Care Tailored to You
You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. Fred Hutch is one of the few cancer centers in the nation that has a dedicated pulmonology service. You'll have access to the latest treatment options, clinical trials and supportive care services.
Pulmonary Nodule Causes and Symptoms
Lung nodules can develop for different reasons. Often, they are caused by scar tissue, air pollution or another irritant you inhaled. They can also be caused by a past or current infection or, rarely, by cancer. Sometimes, the cause is unknown.
When it comes to symptoms, most people have none because their lung nodules are very small. But if they are large when discovered or if they grow, it may be a sign of an underlying issue, and they can cause problems. Common symptoms include coughing, coughing up blood and shortness of breath.
Why Choose Fred Hutch for Lung Care
The Lung Cancer Early Detection and Prevention Clinic (LCEDP) is Fred Hutch’s specialized clinic for evaluating patients with lung issues, including lung nodules. The clinic uses a multidisciplinary approach, with recommendations tailored to you by lung cancer experts, including pulmonologists, thoracic radiologists, thoracic surgeons, thoracic medical oncologists, interventional radiologists and radiation oncologists.
Diagnosis, Treatment and Surveillance
After a lung nodule is discovered, your physician will recommend the next best steps. If the nodule is suspicious for cancer or you have certain risk factors, you might need to have additional tests, like further imaging or a biopsy.
CT scans are helpful in understanding the size of the nodule and more about what’s happening. For example, if the nodule is smaller than 0.6 centimeters, it is likely to be benign (noncancerous).
If the scan shows it is larger or you have certain risk factors for lung cancer, such as you smoke or used to smoke in the past, your physician may want to schedule a biopsy. A lung biopsy involves taking a tissue sample from the lung and sending it to a lab for testing.
Staging and Treatment for Cancerous Lung Nodules
Testing results can confirm the size, type and location of the lung nodule and if it may have spread. Based on this information, if it is diagnosed as lung cancer, it can be assigned a stage.
Early stage, small nodules are often treated surgically. Cancerous lung nodules that are discovered in later stages may be treated using a combination of surgery, radiation, chemotherapy, immunotherapy and targeted therapy. If the nodule turns out to be cancer, your care team will refer you to a Fred Hutch pulmonary oncology expert for further care.
Surveillance of Noncancerous Pulmonary Nodules
If tests show that a nodule is not cancerous, it usually won’t grow. But that doesn’t mean it can’t grow. Because of this, for certain patients who may be at higher risk, we create a surveillance plan, sometimes requiring surveillance for at least 5 years.