NCCN Guidelines for Patients® | Lung Cancer - Non-Small Cell Lung Cancer

17 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 2 Assessing lung nodules Repeat testing to wait. More information on biopsy is in the next section, Confirming cancer . High risk for lung cancer Your risk for lung cancer is high if you are or have been a smoker. If your parents or siblings have had lung cancer, your risk is high. Exposure to asbestos, radon, or uranium also puts you at high risk. <6 mm . CT at 12 months is an option for nodules smaller than 6 mm. If the nodule isn’t bigger or denser, it’s likely not cancer. No more follow-up care is needed. 6–8 mm . Between 6 and 12 months, re-assess nodules between 6 mm and 8 mm in size. If there’s no increase, re-assess between 18 and 24 months. >8 mm . There are three options for nodules larger than 8 mm. One option is CT at 3 months. If cancer is present, an increase in size or density may be seen by this point. A second option is to think about getting PET with CT. When used together, they are called a PET/CT scan. Your whole body or from the base of your skull to your knees can be scanned. Guide 2. Follow-up care for solid nodules Low risk for lung cancer Baseline nodule size What are the options for follow-up care? <6 mm • No routine follow-up care is needed 6–8 mm • CT at 6–12 months ◦◦ If no increase, think about getting CT at 18–24 months >8 mm • Think about getting CT at 3 months • Think about getting PET/CT instead of CT • Think about getting a biopsy instead of CT High risk for lung cancer Baseline nodule size What are the options for follow-up care? <6 mm • CT at 12 months is an option ◦◦ If no increase, no further routine follow-up 6–8 mm • CT at 6–12 months ◦◦ If no increase, CT at 18–24 months >8 mm • Think about getting CT at 3 months • Think about getting PET/CT instead of CT • Think about getting a biopsy instead of CT PET/CT may detect cancer quicker than CTs repeated over a period of time. It may also show signs of cancer spreading in the body. The presence of cancer needs to be confirmed before starting treatment. Read the next section, Confirming cancer . A third option is to think about getting a biopsy. Instead of waiting for a scan, you could be tested for cancer now. However, sometimes a biopsy is not possible. Also, your doctor may think it’s better to wait. More information on biopsy is in the next section, Confirming cancer .

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