First things first, my sincere thanks for maintaining this forum in which people with a diagnosis or a suspicion of lung cancer can raise our doubts and expose our fears. I am scared to death.
I have a recent diagnosis of rheumatoid arthritis. I am a 55 year old smoker (one pack per day since I was 17). As part of that diagnosis, I had a chest CT scan in April 2023 which revealed a solitary 8mm nodule in the lower lobe of the left lung, as well as moderate emphysema. As a follow-up, six months later (October 2023) I had a second CT scan. In this second CT scan, the 8 mm nodule had not grown, BUT three new nodules (5 mm each) appeared at the lower right lung.
The rheumatologist, I don't know why, thinks the nodules have nothing to do with my rheumatoid arthritis and could be either lung cancer or a cancer elsewhere with metastases in the lungs, even if he has not even observed the images themselves. His opinion is that I should undergo a biopsy as soon as possible.
My doubts are:
1) What can explain the fact that the 8 mm nodule has not grown in 6 months, and yet three small 5 mm nodules have appeared in the other lung, very close to each other?
2) Could it be lung cancer, or a metastasis in the lung of a cancer in another part of the body?
3) Should I undergo a biopsy, or watch and wait?
Thank you very much for your help.