Funny you should ask that this week.  I have had a similar issue over the last four months, and saw my oncologist yesterday for a follow-up visit.  Based on what my oncologist told me, spots that tiny are not likely to show up on a PET scan, and are hard to find to biopsy, especially in the lung.  Because these types of lesions are common in healthy people and are usually benign, it doesn't make sense to start chemo without a positive diagnosis for cancer.  So what can you do?

When my nodule showed up at the edge of my lung four months ago, the eventual strategy was to wait four months and repeat the tests on the assumption that a cancerous tumor would grow measureably in four months and a benign one would stay stable.  Fortunately, my nodule stayed stable.  My oncologist is pleased and says he isn't worried.  Nevertheless, to be sure, he wants to repeat the scans again in four months.

At this point you have several choices.  Ask for a second opinion at a comprehensive cancer center.  Request a PET scan understanding that it is likely to be inconclusive because the lesions are so tiny.  Or come up with a "watchful waiting" plan with your doctor about when it would be reasonable to scan again.

I promise you that waiting is nerve-wracking (unless you are a calmer person than I am), but your options are limited right now.

The facts I have used to calm myself over the last four months are that most of these types of lesions are benign and that after so many years the chances are increased that the original cancer is gone.  I'm sorry that you are having to go through this worrisome time, and I hope that you eventually get good news that all is OK.

Moi500

2/11/12 7:33pm

Hi Pyyllis,

Thankyou so much for your response it always helps to share thing with people in a similar situation.

I have decided to do what you have done & just wait & see. It is nerveracking but I'm going to stay positive. 3 months seems a little premature & 6 months abit too long. My oncologist basically explained the same things to me regarding size being too small to detect anything definite etc...Are you a BC survivor? If so how many years since your diagnosis, did you have lymph node involvement, chemo?

Phyllis Johnson, Health Guide

2/11/12 8:04pm

Yes, I'm a Stage IIIB inflammatory breast cancer survivor, diagnosed in 1998.  I had 16 positive lymph nodes, so I had AC and Taxol chemo, surgery, and radiation.  I was not eligible for any hormonal treatments.  If I were diagnosed with the same tumor profile today, I would get Herceptin, but it had not been approved for Stage III patients at the time of my diagnosis. 

I hope you get good news when you rescan.  It sounds like you have experience with this with the liver lesions that went away on their own.  I assume your doctor told you to be sure to report any new symptoms if you develop any between now and the next scan.  I am feeling pretty good now after my second scan, and I hope you get similarly good news with your next test.