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What Do "multiple Lung Nodules,bilaterally" Mean?

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Posted on Tue, 1 Apr 2014
Question: My friend was just diagnosed with prostate cancer. Psa is 12. XXXXXXX score 9(4+5). Bone scan clear. Ct scan shows multiple lung nodules, bilaterally. Started on Lupron injection. He has a history of (1970's) a pulmonary chlorine burn. He worked at a water treatment plant. He owns and operates a sawmill, so does heavy lifting and strenuous work. This routinely requires him to take breaks and catch his breath, especially in hot humid weather (also breaths in sawdust). What is the likelihood that these nodules are metastatic prostate cancer? Wouldn't the psa normally be much higher if cancer had metasticized? Also, would the chlorine burn typically result in multiple nodules? He is having no more breathing difficulties now than he normally has had since the burn. Thank you
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Answered by Dr. Krishna Kiran Kannepalli (2 hours later)
Brief Answer: A biopsy of the lung nodules might help Detailed Answer: Hui. Thanks for the query. Previous x-rays, if available, might help. If these are new nodules, they are likely due to cancer. In case of doubt, a CT guided core biopsy of one of the nodules will help in differentiating between the two. One more important point is, with a PSA level of 12 and a high Gleason's score of 9, there is a possibility that it might be a small cell cancer rather than adenocarcinoma. A pathology review of the prostate biopsy might help. Leuprolide will not work if it is a small cell cancer.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Krishna Kiran Kannepalli

Oncologist, Surgical

Practicing since :2004

Answered : 59 Questions

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What Do "multiple Lung Nodules,bilaterally" Mean?

Brief Answer: A biopsy of the lung nodules might help Detailed Answer: Hui. Thanks for the query. Previous x-rays, if available, might help. If these are new nodules, they are likely due to cancer. In case of doubt, a CT guided core biopsy of one of the nodules will help in differentiating between the two. One more important point is, with a PSA level of 12 and a high Gleason's score of 9, there is a possibility that it might be a small cell cancer rather than adenocarcinoma. A pathology review of the prostate biopsy might help. Leuprolide will not work if it is a small cell cancer.