Is a pulmonary nodule a precursor to lung cancer? Popularization of science Firstly, we need to clarify that in medical terminology used by radiologists, "nodule" is not a disease but a phenomenon. For example, tuberculosis can present as nodular, and benign and malignant tumors can also present as nodular. It can be understood that lung nodules are just a phenomenon presented in the lungs, rather than a lung disease.
What are the causes of lung nodules？
○Prolonged exposure to smoke, fog, and other dusty environments is a common cause of lung nodules.
People breathe all the time, and the smoke and dust particles in the air will pass through the nose and trachea to reach the lungs. In response to foreign substances, the body's immune cells will enter a state of combat to clear the dust. During this process, nodules will form on the surface of the lungs.
○Bacterial and viral infections can also cause lung nodules.
The lungs are prone to developing chronic inflammation when infected by bacteria and pathogens such as Mycobacterium tuberculosis and Cryptococcus. After the body's immune cells fight off the inflammation, fibrous scar tissue nodules may remain in the lungs.
In fact, most nodules are remnants of healed diseases, and only 5% of lung nodules may be malignant tumors. [2]
Therefore, lung nodules ≠ lung cancer.
However, lung nodules do have the potential to develop into lung cancer.
Although the vast majority of nodules are benign, lung cancer is indeed a highly prevalent malignant tumor in China. According to the data from the "2022 Cancer Incidence and Mortality in China" published by the National Cancer Center Journal, lung cancer was the most common cancer in China in 2022 (1,060,600 cases), with 733,300 deaths. [3]
From this perspective, we cannot be complacent in monitoring and managing pulmonary nodules, as well as reducing the risk of developing lung malignancies. Below is a summary table of the characteristics of pulmonary nodules that may progress to lung cancer. You can save it for future reference.
Feature Classification | Low-Risk Features | Medium-to-High Risk Features | Lung Cancer Risk Level |
Size | <6mm | ≥8mm (especially>10mm) | Risk increases with size ↑ ↑ H303> |
Morphology | Smooth edges | Lobulated, spiculated, Pleural indentation | High-risk features ↑ ↑ ↑ |
Density | Solid nodules | Partially solid nodules (especially with solid component >5mm) or Pure ground-glass nodules | Partially solid nodules pose the highest risk ↑ ↑ ↑ |
Growth rate | No change in 2 years | Volume doubling time<400 days (especially <200 days) | Rapid growth risk ↑ ↑ ↑ |
Location | Random distribution | Upper lobe nodules
(especially for smokers) | Risk slightly elevated ↑ |
Patient factors
|
Other imaging features | Calcification (central/lamellar) | Cavitary sign, Distortion of bronchial air filling sign | High-risk features ↑ ↑ |
It is worth noting that after discovering lung nodules, seeking medical attention promptly is the first thing to do. Doctors will assess the risk based on their characteristics and develop follow-up or intervention strategies to prevent malignant lesions in lung nodules. At the same time, we ourselves should maintain lung health and adopt lifestyles that reduce the risk of lung cancer, thereby avoiding potential risks posed by lung nodules from the root.
3 major methods to prevent malignant lesions of pulmonary nodules Popularization of science When the immune cells of the human body have weak fighting ability and cannot fully resist viral infections, pulmonary nodules remain in a state of local stimulation for a long time, gradually grow and develop, and are prone to forming tumors.
From the causes of lung nodule formation, it can be seen that enhancing human immunity is a crucial aspect. Led by Professor Zhang Minghui, an immunology expert from Tsinghua University, the Lehe New Medicine team advocates the following three methods to comprehensively improve immunity: ➢ Vegetarian diet. Japanese microbiology professor Hiroshi Maeda found that when there is an excess of "reactive oxygen species" in the human body, it can directly damage human genes, causing cell mutations and ultimately leading to cancer. Plants, however, can produce a large amount of antioxidant substances to eliminate reactive oxygen species. Therefore, adhering to an organic, whole-grain vegetarian (vegetarian) diet on a daily basis can effectively enhance human immunity. ➢ Traditional Chinese Medicine (TCM) yang-boosting therapy. The Yellow Emperor's Classic of Internal Medicine states, "When righteous qi is preserved within, pathogenic factors cannot invade." TCM believes that weakness of the internal organs and deficiency of qi and blood are the internal causes of cancer. Using TCM methods to strengthen the body's vital energy and enhance yang can fundamentally improve immunity.
➢Modernmedical technology
Immunocyte therapy is a rapid method to enhance humanimmune function. When a person's immune system is weakened and their immune cells are unable to fight viruses, external support can be sought. For example, using vNKT cell immunotherapy, healthy donor immune cells are cultured, expanded, and then infused back into the person with insufficient immunity to quickly kill viruses andrapidly enhance human immune function.
Click to view Professor Zhang Minghui's explanation on methods to enhance immune function
Popularization of science Of course, once your pulmonary nodules develop into lung cancer, don't panic excessively. Seek timely diagnosis and treatment. For early-stage lung cancer, after surgery, the 5-year survival rate is 80%-90%[4], and for middle and late-stage lung cancer, concurrent chemoradiotherapy + immunotherapy /followed by targeted maintenance therapy can lead to long-term survival with the tumor or even clinical cure. Early detection and treatment, regular follow-up, maintaining a good attitude, eating a balanced diet, exercising regularly, and achieving an ultra-long survival period are not impossible.
Declaration: The content of this article is written based on authoritative sources and personal opinions. The literature sources and figures have been indicated at the end of the article. Please be aware of this.
Reference Sources:
[1]Farjah F, Monsell SE, Greenlee RT, Gould MK, Smith-Bindman R, Banegas MP, Schoen K, Ramaprasan A, Buist DSM. Patient and Nodule Characteristics Associated With a Lung Cancer Diagnosis Among Individuals With Incidentally Detected Lung Nodules. Chest. 2023 Mar;163(3):719-730. doi: 10.1016/j.chest.2022.09.030. Epub 2022 Sep 30. PMID: 36191633; PMCID: PMC10154904.
[2]Steiling K, Kathuria H, Echieh CP, Ost DE, Rivera MP, Begnaud A, Celedón JC, Charlot M, Dietrick F, Duma N, Fong KM, Ford JG, Gould MK, Holguin F, Pérez-Stable EJ, Tanner NT, Thomson CC, Wiener RS, Wisnivesky J. Research Priorities for Interventions to Address Health Disparities in Lung Nodule Management: An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med. 2023 Mar 15;207(6):e31-e46. doi: 10.1164/rccm.202212-2216ST. PMID: 36920066; PMCID: PMC10037482.
[3]Bingfeng Han, Rongshou Zheng , Hongmei Zeng … & He J. (2022). Cancer incidence and mortality in China, 202［R］2. Chinese Journal of Cancer Research, 34(1), 1-12.
[4]Vaporciyan AA, Kies MS, Stevens CW, et al. Therapy for NSCLC. In: Kufe DW, Pollock RE, Weichselbaum RR, et al., editors. Holland-Frei Cancer Medicine. 6th edition. Hamilton (ON): BC Decker; 2003. Available from: https://www.ncbi.nlm.nih.gov/books/NBK13752/
Reviewed by: Lehe New Medical Department
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