After discovering lung nodules, how do we assess the risk and do we need to “eradicate the problem”?

Huazi has a friend whose elders were found to have lung nodules during a physical examination, and the whole family racked their brains for treatment. Some people said that lung nodules are prone to cancer, and they must be "eradicated" by surgery. But others said that a drastic thoracotomy would cause too much harm to the body, and if it was benign, the pain would be in vain.

A friend talked to Huazi about lung nodules and asked him what he thought. Huazi told his friend that ten years ago, the medical view on lung nodules was to remove them as soon as they were found, but now the treatment concept for lung nodules is not so radical and overtreatment should be avoided.

1. Classification of pulmonary nodules In imaging examinations, there are two ways to refer to objects with abnormal structures in the lungs. One way is called a mass, which refers to an object with a larger volume and a diameter of more than 3 cm; the other way is called a nodule, which refers to an object with a diameter of less than 3 cm; objects smaller than 1 cm can also be called small nodules.

In imaging examinations, pulmonary nodules can be single or multiple, with round or quasi-round high-density shadows. If the shadow density is high enough to cover the blood vessels and bronchial images running through it, it is called a solid nodule. When the shadow is not enough to cover the blood vessels and bronchial images, it is called a subsolid nodule. For example, the ground-glass nodules in the lungs that are often mentioned now are a type of subsolid nodule.

2. How to identify the danger of lung nodules Generally speaking, 90% of lung nodules are benign. If a nodule is surgically removed immediately after it is discovered, it will not only cause unnecessary pain to the patient, but also waste a lot of medical resources. Therefore, it is crucial to identify the danger of nodules.

1. Look at the size: Generally speaking, ground-glass nodules with a diameter of less than 1 cm are more likely to be inflammatory and are not usually considered to be tumors.

2. Check whether the structure is solid: If the nodule has no solid structure, it is very likely to be inflammatory. Even if the diameter of the nodule reaches 2cm, as long as it is not a solid nodule, the risk is not high.

3. Look at the number: If the number of nodules is between 1 and 4, the risk of primary lung cancer will increase. If the number of nodules is greater than 5, the risk of lung cancer will decrease, because usually only infection can cause multiple nodules.

4. Look at the growth rate: During regular check-ups, the growth rate of benign nodules is very slow, while the growth rate of malignant nodules is very fast.

5. Look at the appearance: if the nodule has clear edges and no burrs, it is mostly a benign nodule; if it is a malignant nodule, the edge is usually irregular and has protruding small burrs.

3. What to pay attention to after discovering lung nodules After discovering lung nodules, don't panic, because imaging examination is a probabilistic judgment, not an exact diagnosis. To truly confirm the diagnosis, it is necessary to use puncture, bronchoscopy and other means to remove the standard for pathological examination to confirm the diagnosis. If the nodule is not dangerous, antibiotics can be used for treatment under the guidance of a doctor. Some patients' ground-glass nodules in the lungs can disappear or shrink after antibiotic treatment.

If the diameter of the nodule is less than 6mm, a low-dose spiral CT scan should be performed annually; if the diameter of the nodule is between 6mm and 8mm, a low-dose spiral CT scan should be performed every six months. If the nodule does not change within 2 years, the scan can be suspended to reduce the adverse effects of CT radiation on the body. If the diameter of the nodule exceeds 1cm, a biopsy is recommended as soon as possible to obtain pathological results.

In summary, don't panic if you find lung nodules. Most lung nodules are benign and will not turn into cancer. Follow the doctor's instructions and intervene and examine the nodules under the doctor's guidance. We must develop good living habits, don't smoke, stay away from secondhand smoke and car exhaust, and wear masks when going out in foggy weather. Exercise more, eat more vegetables and fruits, and improve your immunity, which can prevent cancer. I am pharmacist Huazi, welcome to follow me and share more health knowledge.