[Medical Q&A] What should I do if lung nodules are found during the first examination?

Planner: Chinese Medical Association

Reviewer: Zhou Xin, Chief Physician, First People's Hospital, Shanghai Jiao Tong University School of Medicine

Many people’s physical examination reports will show "lung nodules". After discovering lung nodules, don’t panic. You need to take a series of steps to evaluate the nature of the nodules and determine the best treatment plan.

Generally speaking, the diameter of a lung nodule is ≤3 cm. Since the lesion is small, the possibility of a malignant nodule is relatively low. After the first discovery of a lung nodule, with the help of a doctor, the nature of the nodule should be confirmed as much as possible, because these factors are related to later treatment and follow-up. For nodules with a diameter of less than 8 mm, it is usually recommended to undergo regular (usually 6 months) CT reexaminations to observe the growth of the nodules; medium nodules of 8 to 20 mm may require more frequent reexaminations, such as reexaminations every 3 to 6 months. During the follow-up, the doctor will decide whether to perform a biopsy or surgical treatment based on the changes in the nodules; large nodules with a diameter of more than 20 mm require immediate further examination and treatment. Most benign nodules do not require immediate treatment, but regular imaging examinations are required to observe changes in the nodules. If it is clear that the nodule is caused by infection or other diseases, the primary disease needs to be treated. If it is confirmed to be a malignant nodule, it can be surgically removed. Patients who cannot be surgically removed need adjuvant treatment measures such as radiotherapy, chemotherapy, and targeted therapy. Of course, necessary psychological support and psychological counseling, as well as health education guidance for lung nodules are also important. It should be noted that people at high risk (such as long-term heavy smoking, family history of lung cancer, etc.) should be more cautious during follow-up.