You said that in the last PET they showed activity. Could you please post what SUV value they equate with each nodule. This number is very telling. You are one of many, as you can see, that has pulmonary nodules develop some period after treatment. With this disease notorious of spinning mets to the lungs, people have to be careful. Pulmonary guys call it ALL out, your oncology team is more accustomed to seeing these kinds of things, and knows that there is a difference between a lung extension of the disease and nodules.

Another common finding in those of us that have this happen are hot nodes in the mediastium near your heart and lungs. These are almost always lung lobe inflammation related to silent aspiration (accompanied by surrounding nodes trying to clean things up and getting hot on the scans.) This always raises your blood pressure and sounds dire, and most of the time is not. In me it has been a chronic find as the aspiration is a chronic worsening issue over the years, and aspiration pneumonia has put me in the hospital more than once. There are few that want to biopsy these things since they are in the middle of lots of huge blood vessels. It can be done by only a couple of people in the US that I would personally be comfortable with personally doing it. It is done by CT guided needle and if it nicks something it shouldn't in the process, it is an immediate crack your chest to stop the bleeding. Not a procedure for the faint of heart or someone outside of a major institution that has done lots of them. A woman doc at MSKCC is considered the best in the US for doing these if the are absolutely necessary.

That is precisely why those in the know watch and wait on some of these things. Experience is the difference between a major CCC and a smaller institution that sees them less often. Having said that, it always scares the crap out of me, but I am getting more used to things going bump in the night..... after ten years of it.