How big must a tumour be before decision is taken to treat it.

[ferntreegully]

Left lung lower lobe lesion has grown slowly over a few years and has been classified as a cancerous tumour because of how it presents on scansI have surveillance CT scans with contrast every six months or so.

I ask this in light of having most of my right lung surgically treated with the removal of two tumours initially and another three months later also right lung.

I assume that if the left lung tumour is treated then it would not be surgery as I now have co morbitities.

I am also aware that if radiotherapy was used that the treatment itself would damage to a certain extent my one remains lung.

Hence my question: is there a guideline to ascertain the size of lesion/nodule/tumour becomes to start treatment.

None of my lung tumours were accessible by biopsy but post op testing confirmed malignancy. This left lung nodule cannot be biopsied either as I am told a large blood vessel is involved

Thank you.

[Silver14]

I had upper right lobectomy, then 15 months later a small tumor that was being watched was deemed to be needing treatment, same as you wasn't medically fit for surgery so I had stereotactic radiotherapy 8 rounds of it, I sailed through treatment no side effects at all, it's the waiting that's the worse thing, then after treatment have to wait 3 months for a scan to see if it has worked, happy to say all was good, I'm currently waiting for results of a routine scan Sending you so much luck .

[ferntreegully in reply to Silver14]

Thank you Silver14 for your kind response.

[RoyCastleHelpline Partner Ask the Nurse Roy Castle]

Hi Ferntreegully

Sorry to hear of your situation and understandable anxiety in regard to this. There are guidelines from the British Thoracic Society on lung nodules and there is a Brock model for risk assessment, this link is a summary of the guidelines but can be quite complex as they have to factor in also location of nodule if accessible, which you have said yours is unfortunately not as it is near a blood vessel: radiologyassistant.nl/chest...

Lung nodules below 10mm are usually too small to biopsy and the guidelines are continued CT surveillance.

You may or may not be interested to read another summary of lung nodule guidelines from this article from the British Thoracic Society: thorax.bmj.com/content/70/S...

It can be quite tricky to know whether to start treatment with someone if there is no confirmed diagnosis from the lung nodule as equally this could be benign, if you have discussed treatment options with them already and are not satisfied, you are entitled to a second opinion, I have placed some links below on how to access this:

cancerresearchuk.org/about-...

You are welcome to contact our ask the nurse helpline if you would like to discuss anything on 0800 358 7200 Monday to Thursday 0900-1700 and Friday 0900-1600, alternatively you can email us at [e-mail]

Kind regards

Ask the nurse support team

The Roy Castle Lung Cancer Foundation

[ferntreegully in reply to RoyCastleHelpline]

Thank you for all the helpful information