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Can a spot on the lung be melanoma if there’s no uptake on scans?

Forums General Melanoma Community Can a spot on the lung be melanoma if there’s no uptake on scans?

  • Post
    rj
    Participant

      Ron has had a 3 mm spot on his lung ever since the original scan in March of 2009.  We were told at the beginning (not by our melanoma specialists) that it was NOT melanoma.  At his follow up appt with the surgeon last week, one of the doctors said it COULD be; hence the watching.  My question is this—-wouldn’t it show uptake on the scans if it were melanoma, and can melanoma just sit without growing for a long time?  If anyone has had similar circumstances, I’d appreciate information.  Thanks–Betsy 

      Ron has had a 3 mm spot on his lung ever since the original scan in March of 2009.  We were told at the beginning (not by our melanoma specialists) that it was NOT melanoma.  At his follow up appt with the surgeon last week, one of the doctors said it COULD be; hence the watching.  My question is this—-wouldn’t it show uptake on the scans if it were melanoma, and can melanoma just sit without growing for a long time?  If anyone has had similar circumstances, I’d appreciate information.  Thanks–Betsy 

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        rj
        Participant

                

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          rj
          Participant

                  

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            Janner
            Participant

              3mm is very small.  PET scans don't have great resolution so can miss small amounts of disease.  PET scans also have a significant false positive AND false negative rate. They are a tool, but they do not diagnose anything for certain.  It is very common to have benign lung nodules.  It seems unlikely to me that a 3mm nodule unchanged since March of 09 is melanoma.  I guess you can't say never, but given how common benign lung nodules are – when something doesn't change in that period of time, I'd be thinking benign.  Doctor's are always having to say "it's possible", but I'd say "not probable" in this instance.

              Best wishes,

              Janner

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              Janner
              Participant

                3mm is very small.  PET scans don't have great resolution so can miss small amounts of disease.  PET scans also have a significant false positive AND false negative rate. They are a tool, but they do not diagnose anything for certain.  It is very common to have benign lung nodules.  It seems unlikely to me that a 3mm nodule unchanged since March of 09 is melanoma.  I guess you can't say never, but given how common benign lung nodules are – when something doesn't change in that period of time, I'd be thinking benign.  Doctor's are always having to say "it's possible", but I'd say "not probable" in this instance.

                Best wishes,

                Janner

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                TAC
                Participant

                  I had spots on my left lung for several years. I also had PET scans about every 4-5 months. There was no change; hence no worry. In 2008, one of the spots showed very slight growth. I had a needle biopsy and it turned out not to be melanoma but adenocarcinoma (lung cancer). I'm a non smoker. Had upper left lobe of lung removed. No further tretament required. It si important to have the spot measured after each PET scan. It is very small and is probably nothing but that's what I thought. Just watch, get regular scans and measure the spot. Best wishes.

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                  TAC
                  Participant

                    I had spots on my left lung for several years. I also had PET scans about every 4-5 months. There was no change; hence no worry. In 2008, one of the spots showed very slight growth. I had a needle biopsy and it turned out not to be melanoma but adenocarcinoma (lung cancer). I'm a non smoker. Had upper left lobe of lung removed. No further tretament required. It si important to have the spot measured after each PET scan. It is very small and is probably nothing but that's what I thought. Just watch, get regular scans and measure the spot. Best wishes.

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                    Jim in Denver
                    Participant

                      Hi Betsey,

                      Very good points by Janner and TAC.  CAT scans are generally the preferred diagnostic imaging tool for the lungs.  They can barely measure 25mm, so the resolution of the scan is an issue, as is the possiblilty of false positives.  No Doctor – Pulmonologist, Oncologist, or general surgeon – can say what the "spot" is unless a biopsy is performed (most Docs would prefer a slightly more medical sounding term of "nodule").  Geterally, a biopsy would be performed only it the nodules is showing growth AND is over 1cm.  This happened to me, by the way.

                      So the best course would be to scan at some regular interval, and not assume that the nodule is melanoma.  Of course, it cannot be said that the nodule is NOT melanoma either without a biopsy and testing, but the odds are very low if there is no growth.  Hope that helps.

                      Best Wishes,

                      Jim

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                      Jim in Denver
                      Participant

                        Hi Betsey,

                        Very good points by Janner and TAC.  CAT scans are generally the preferred diagnostic imaging tool for the lungs.  They can barely measure 25mm, so the resolution of the scan is an issue, as is the possiblilty of false positives.  No Doctor – Pulmonologist, Oncologist, or general surgeon – can say what the "spot" is unless a biopsy is performed (most Docs would prefer a slightly more medical sounding term of "nodule").  Geterally, a biopsy would be performed only it the nodules is showing growth AND is over 1cm.  This happened to me, by the way.

                        So the best course would be to scan at some regular interval, and not assume that the nodule is melanoma.  Of course, it cannot be said that the nodule is NOT melanoma either without a biopsy and testing, but the odds are very low if there is no growth.  Hope that helps.

                        Best Wishes,

                        Jim

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                        lhaley
                        Participant

                          Betsy,

                          Over a year ago the PET scan lit up a node in my right chest area. When the tumor board looked back it had been there on several scans. They decided it was a false positive.  On my last scan it showed metabolic disease.  A biopsy was done and sure enough it was melanoma.  At the same time I could feel a lump on my arm. It did not show up on the scan. The fna showed to be melanoma.  Another scan done right before the surgery and this time it lit up.  It just wasn't large enough for the PET just 2 months earlier. 

                          I hope your husbands proves to be nothing. One of the many horrible things about this disease is the hurry up and wait feeling.  Just keep watching and hopefully it will prove to be nothing.

                          Linda

                          Stage IV NED 1 month

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                          lhaley
                          Participant

                            Betsy,

                            Over a year ago the PET scan lit up a node in my right chest area. When the tumor board looked back it had been there on several scans. They decided it was a false positive.  On my last scan it showed metabolic disease.  A biopsy was done and sure enough it was melanoma.  At the same time I could feel a lump on my arm. It did not show up on the scan. The fna showed to be melanoma.  Another scan done right before the surgery and this time it lit up.  It just wasn't large enough for the PET just 2 months earlier. 

                            I hope your husbands proves to be nothing. One of the many horrible things about this disease is the hurry up and wait feeling.  Just keep watching and hopefully it will prove to be nothing.

                            Linda

                            Stage IV NED 1 month

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                            djpayn
                            Participant

                              Betsy,

                               

                              I have had a 6mm nodule in my right lung since my very first PET in july of 2008. at one point in mid- 2009 i was told this 6mm spot had grown to 6cm (in just 3 months with no uptake).  after meeting with a cardio-thorasic surgeon and scheduling a surgery date, i requested a chest CT – just to be sure. no biopsy was done due to placement of this spot and an artery – anyways…. CT showed that the spot was NOT growing. it was still 6mm – the reason i was given for the error was "breathing during PET vs. holding breath during CT".

                              nothing else has ever been done with my lungs and i am just fine. the spot is still there, unchanged, and everytime i get a scan i am told that it "could be" melanoma. however, i feel that because melanoma typically advances rapidly, that i just have a spot in my lungs. i worry about mel everyday, but dont allow myself to obsess about my lungs.

                              i hope you are able to get the answers you seek… and find peace in the "waiting" part of watch and wait.

                               

                              DJpayn, IIIc, NED

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                              djpayn
                              Participant

                                Betsy,

                                 

                                I have had a 6mm nodule in my right lung since my very first PET in july of 2008. at one point in mid- 2009 i was told this 6mm spot had grown to 6cm (in just 3 months with no uptake).  after meeting with a cardio-thorasic surgeon and scheduling a surgery date, i requested a chest CT – just to be sure. no biopsy was done due to placement of this spot and an artery – anyways…. CT showed that the spot was NOT growing. it was still 6mm – the reason i was given for the error was "breathing during PET vs. holding breath during CT".

                                nothing else has ever been done with my lungs and i am just fine. the spot is still there, unchanged, and everytime i get a scan i am told that it "could be" melanoma. however, i feel that because melanoma typically advances rapidly, that i just have a spot in my lungs. i worry about mel everyday, but dont allow myself to obsess about my lungs.

                                i hope you are able to get the answers you seek… and find peace in the "waiting" part of watch and wait.

                                 

                                DJpayn, IIIc, NED

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                                  rj
                                  Participant

                                     Thanks for your answers.  I haven't been overly worried but it helps to hear from others.  We're not waiting…we're LIVING.  Ron has been NED for 1 1/2 years now.  We're so thankful, but also saddened that so many here are in other circumstances. 

                                    Ron (IIIC) and Betsy

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                                    rj
                                    Participant

                                       Thanks for your answers.  I haven't been overly worried but it helps to hear from others.  We're not waiting…we're LIVING.  Ron has been NED for 1 1/2 years now.  We're so thankful, but also saddened that so many here are in other circumstances. 

                                      Ron (IIIC) and Betsy

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