Lung Nodules

Finding out you have a lung nodule can be upsetting. It is reassuring to know that most nodules are not cancerous—there are a variety of things that can cause a lung nodule, most of which are benign. The important thing is to obtain a definitive diagnosis and have a qualified medical team map out a care plan.

Getting Diagnosed

Lung nodules are typically discovered incidentally, often after a patient has a CT scan* or chest x-ray for another reason. Nodules can also be discovered during lung cancer screening. Patients who are not diagnosed at a comprehensive cancer center or during a cancer screening may not receive specific instructions on what to do next. So here is some quick information:

If you have a lung nodule:

  • Understand that not all nodules are cancer.
    • Most lung nodules are relatively small, non-cancerous masses. These can result from previous infections, inflammation, birth defects, or other causes.
  • Symptoms such as wheezing, coughing or shortness of breath may be present, or you may have no symptoms at all.
  • Discuss your diagnosis with your primary care provider who can be a great source of support.
    • Nodules that are not cancerous can be followed closely by your primary care provider, but it is difficult to know which ones are cancer.
  • Because diagnosis can be tricky, it’s important to go to a comprehensive cancer center where specialized pulmonologists can provide a rapid and accurate diagnosis of a lung nodules, as well as a second opinion.

How a diagnosis is made at Fox Chase:

  • Patients who come to Fox Chase will be cared for by a multidisciplinary team.
  • A CT scan is typically done to determine if the nodule is suspicious. A PET** scan and other studies will be done if needed.
  • The care team will determine if a biopsy is needed to make an accurate diagnosis.
    • A biopsy is done to get tissue to accurately characterize the nodule. Tiny pieces of tissue are sufficient to determine the tumor type and genetics, and to make a diagnosis.
    • Fox Chase uses a new robotic bronchoscopy platform that allows us to reach formerly inaccessible areas of the lung with dexterity, vision, and control. Physicians visualize a 3-D version of the patient’s own lung anatomy throughout the procedure.

What to expect from a lung biopsy:

  • The entire procedure takes a few hours. Patients check in about one hour before their appointment to meet with the anesthesia staff, nurses, and pulmonologist.
  • Anesthesia is administered prior to the procedure. Once the patient is asleep and comfortable, we proceed with bronchoscopy. The nodules and lymph nodes are viewed and very small samples of the nodule tissue are taken. Bronchoscopy itself takes about one hour.
  • The patient is taken to recovery and monitored until they are awake and alert.
  • Fox Chase pathologists analyze the nodule tissue and confirm a diagnosis. Results are typically available in a few days. If the nodule is cancer, analysis of the tissue will help the medical team choose the right therapy.

Patients with a History of Cancer

  • Nodules found in the lung are carefully evaluated to see if they are a consequence of the original cancer or a new manifestation because the treatment choices can be very different.
  • When patients have multiple cancers, it is important to know that we are treating the right cancer. We differentiate lung cancer and cancer metastasizing from other locations, and distinguish which cancers are active and which are not.

Why Choose Fox Chase?

  • The medical teams at Fox Chase frequently see patients with lung nodules and are primed to provide the best care using the latest diagnostic and therapeutic options.
    • We have the robotic navigation platform that combines a small, flexible endoscope with a navigational guide. This GPS-like guidance allows us to visualize and biopsy nodules that are inaccessible by traditional bronchoscopy.
  • Fox Chase can help evaluate and guide anyone who has a lung nodule, whether or not they have a cancer diagnosis. 
  • A multidisciplinary care team is dedicated to take care of each patient. For patients with lung nodules, the team may include a medical oncologist, pulmonologist, and thoracic surgeon, as well as nursing staff and pathologists.
  • Every case is reviewed and discussed by our multidisciplinary tumor board. This approach provides multiple second opinions at the same time to optimize the treatment plan.
  • We help you get evaluated as soon as the next business day.

*CT is computed tomography, also called a CAT scan

**PET is positron emission tomography