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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 49380
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Customer: replied 6 months ago.
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Please quote your health query.My dad, aged 73, just had a CT scan due to indigestion.
All was clear with stomach etc but they found a small dark spot on one lung.
He does not have a chest infection.What does this mean?
Is this the same as a lung nodule and therefore only 5% chance of cancer?
Customer: replied 6 months ago.
Sorry something weird pasted in at the top

Any asymptomatic lung nodule (termed incidental finding of no clinical significance) which is less than 1 cm can be left alone.

Customer: replied 6 months ago.
I don't know the size. They just said a small dark spot. Is that the same as a nodule?
They asked if he had a chest infection, which he doesn't and said he needs a rescue to rule out cancer.

As discussed a small dark spot (nodule) has an extremely low incidence (nearing zero) of cancer.

Customer: replied 6 months ago.
Then why did they mention cancer and ask for another scan?

This is just for precaution/reconfirmation.

Customer: replied 6 months ago.
I am confused as websites talk of nodules showing up white on scans.So is the dark spot that was seen a nodule??
Customer: replied 6 months ago.
Is a dark spot s nodule?
Customer: replied 6 months ago.
Are they the same thing?

Yes, they are the same thing.

Customer: replied 6 months ago.
Is it a bad sign that he has no chest infection to explain this dark spot?
Customer: replied 5 months ago.
Also. I just saw this, so how can the chance of it being cancerous be close to zero?About 40 percent of pulmonary nodules turn out to be cancerous. Half of all patients treated for a cancerous pulmonary nodule live at least five years past the diagnosis. But if the nodule is one centimeter across or smaller, survival after five years rises to 80 percent. That's why early detection is critical.
https://www.urmc.rochester.edu/urmc.www.rochester.edu › encyclopedia › content
Pulmonary Nodules - Health Encyclopedia - University of Rochester ...

This is the latest 2019 review;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784443/

The cross-references are in the brackets.

Strongly associated with the probability of malignancy, nodule size represents a cornerstone in nodule assessment in all recommended algorithms.[1,2,3,4] Based on observations in high-risk patients from lung cancer screening trials,[10,84] a cut diameter below 6 mm is proposed by most recent guidelines as an indicator of acceptably low cancer risk (<1%).[1,4] The same cutoff applies for both solitary and multiple solid nodules as well as for solitary subsolid nodules.[1,4] A second clinically relevant cutoff diameter is >8 mm. Using data from the NELSON trial, a high lung cancer probability of 9.7% can be estimated for solid nodules ≥8 mm compared to an intermediate probability of about 1% in those smaller than 8 mm (and larger than 5 mm).[2,84]

This is the latest guideline;

https://pubs.rsna.org/doi/10.1148/radiol.2017161659

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Customer: replied 5 months ago.
Thank you for the links.
I hope it's nothing. Just worried as they want a rescan but your links say no need so I wonder if it looked suspicious

You may ask a rescan at 3 months. A biopsy is not needed.

A positive rating would be highly appreciated.

Customer: replied 5 months ago.
Then isn't it worrying that they say he needs a rescan now?The CT was for indigestion so they checked liver, stomach, pancreas, kidneys. They were all clear.
The small dark shadow on the lung was found incidentally.
And has been "urgently referred" to the chest doctor - that is why I am worried.
My dad has no symptoms.

Doctors work on high caution and that helps the patients too. He is not urgently referred for being cancer but to rule out the chance of cancer which is less than 2-3%.

Your anxiety is not beneficial for you, your father or the family.

A logical thing is to get it further evaluated which is being done and in all probability come normal.

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Customer: replied 5 months ago.
you don't think the urgent referral is because the dark spot looked suspicious?
All the doctor said was that it was a small dark spot and that it needed to be looked at to rule out cancer.
No other info.

As we discussed this is being further investigated just for precaution and the chance of cancer is extremely low.

Dr. Arun Phophalia and 4 other Medical Specialists are ready to help you
Customer: replied 5 months ago.
Thank you.
I hope so.

You are very welcome.

Customer: replied 5 months ago.
Can you please tell me if lung issues can cause sickness/indigestion by causing more acid?
I just read it on a forum and am worried that lung issues may have been the cause of my dad's indigestion.
Thank you.

Lung issue is highly unlikely to cause indigestion.

Customer: replied 5 months ago.
He has an appointment now at the oncology department.
Is this a bad sign or are all lung shadows looked at in oncology?He also said he has burning pain low down in the middle of his chest.
Would this be from indigestion or can it be a sign of lung cancer?
Customer: replied 5 months ago.
If you can answer me here, I can then open another thread to credit you.

All the lung shadows are assessed by the oncology department.

The burning pain low down in the middle of the chest is not likely to be related to lung nodule. It is likely to be due to acid reflux.

Customer: replied 5 months ago.
Thank you for your reply.So it doesn't mean it is suspicious as they referred to oncology?
Why not refer to a chest specialist?
Customer: replied 5 months ago.
Also, the shadow is at the bottom of the left lung. Does this make it less likely to be cancer than a shadow at the top?

This is according to the guideline.

Chest specialists too can review it and some hospitals still do it.

Customer: replied 5 months ago.
Okay. So I should not assume they think it is suspicious just because of the oncology referral?

It is just getting a second opinion.

Customer: replied 5 months ago.
But some people say that an oncology referral mean suspected cancer.
That it would be a thoracic referral if it did no look suspicious.