Dai Xin and Qin Boyu

In recent years, with the development of medical imaging technology and the improvement of awareness of health examination, more and more people have found out that they have "lung nodules" through lung CT examination. This medical term often makes people panic and even associate it with lung cancer. After discovering lung nodules, many people fall into anxiety due to lack of correct cognition, and even blindly accept overtreatment; There are also some people who miss the best time to intervene because they neglect follow-up. So, when you find a lung nodule, you can't help but ask, "What should I do?" ”

Professor Wang Jinliang of the Department of Oncology of the Fifth Medical Center of the PLA General Hospital told everyone: lung nodules ≠ lung cancer! The vast majority of nodules are benign, but scientific understanding and standardized management are crucial. The management of pulmonary nodules should follow the principle of "early detection, accurate assessment, dynamic observation, and prudent decision-making", so as not to cause excessive anxiety and overtreatment, and not to delay the disease and lead to disease progression.

What is a pulmonary nodule? A lung nodule is a round-like or irregularly shaped lesion with a diameter of ≤3 cm that appears in the lung tissue and is usually detected by imaging tests (such as CT).

According to the size, it can be divided into: small nodules (<10 mm), most of which are benign and require regular follow-up, small nodules (0-0 mm), which need to be judged based on morphological characteristics, and large nodules (>0 mm), which need to be alert for malignant possibility.

According to the density, it can be divided into: solid nodules, uniform high-density shadows, and clear borders; ground-glass nodules, uniform translucent shadows, like frosted glass, do not mask bronchial vascular structures; Mixed nodules, solid with ground-glass components, are at high risk of malignancy.

How do pulmonary nodules come about? Common causes include infection and inflammation, benign lesions, malignancy, environment, and lifestyle habits.

How do you know if a lung nodule is benign or malignant?

Studies have shown that more than 90% of the pulmonary nodules found in physical examination are benign lesions or old lesions, and the diagnosis of lung nodules is benign or malignant, which requires a comprehensive evaluation based on the size, density, and morphology of the nodules seen in CT examination, as well as the patient's age, smoking history, family history, and disease history. On the basis of lung CT examination, when it is difficult to judge the nature of lung nodules, it is sometimes recommended to re-examine the lung CT at intervals of several months to dynamically observe the changes of the nodules, or further PET-CT examination to see the metabolism of the nodules, or even needle biopsy or tracheoscopic biopsy, which can be clarified according to histopathology, and can also refer to the blood tumor marker test to assist in judgment.

What can be done to deal with lung nodules?

First of all, after the discovery of pulmonary nodules, there is no need to be nervous and anxious, because the vast majority of pulmonary nodules are benign and only need follow-up observation. Therefore, if lung nodules are found, go to the hospital to find a specialist doctor, especially now that many hospitals have multidisciplinary joint outpatient clinics for lung cancer and lung nodules, which can give patients the most professional, accurate and suitable diagnosis and treatment suggestions. Based on the results of the evaluation of the pulmonary nodules, combined with the patient's age, physical condition, comorbidities, personal wishes, etc., the doctor will recommend follow-up observation or targeted treatment of the pulmonary nodules.

How can patients with pulmonary nodules adjust psychologically?

When patients know that they have pulmonary nodules, they often experience various psychological and physical discomforts. The most common psychological problem is anxiety, and I often think, "Do I have lung cancer?" "Will the nodule suddenly enlarge?" "Will it be transferred?" I can't wait to have a repeat CT of my lungs in a few days.

In addition, there are also evasive types, who feel that "there are no symptoms anyway, so you don't need to care at all". Even the existence of pulmonary nodules is left behind, and they do not follow up at all. There are also overtreatment types, so I think "I have to cut it out immediately", and I think that surgery can guarantee that there is no problem. In response to these situations, scientific responses are needed. These include: receiving professional guidance, seeking diagnosis and treatment from a specialist, and fully communicating with the doctor to understand the specific risk of nodules; Establish a follow-up plan and mark the time of the review on the calendar to avoid forgetting or worrying excessively; Lifestyle modifications, quitting smoking and staying away from secondhand smoke; Increase antioxidant-rich foods such as dark vegetables, nuts, etc.; Moderate exercise such as brisk walking, swimming, etc., enhances lung function; In terms of psychological support, you can join the patient community to share your experience, and if you have severe anxiety, you can seek psychological counseling.