Cancer Found During a Scan for Something Else

This page is for people who learned about a possible cancer from a scan done for another reason. It covers what the report means, how to handle the wait, and the choices you may face.

Most people expect a cancer diagnosis to follow a symptom. This one does not. You went in for kidney stones, a lasting cough, a fall, a pre-operative check, or a scan of a completely different organ. Then the report mentions something nobody was looking for.

Often the report reaches you through a patient portal. It may be written in technical language for another clinician, and it may use words you do not know.

Report wording such as "cannot exclude malignancy," "clinical correlation advised," or "indeterminate" can be alarming. Do not guess what it means for you. Ask your care team to explain the exact words used about your finding.

Four things are worth writing down:

• The organ
• The size
• The words used about its edges
• Whether the report compares it to any earlier scan

The gap between reading the report and speaking to someone is the hardest part. Two things may help.

Get a date. Not reassurance, a date. One message asking "is this urgent, and when will it be reviewed?" turns an open-ended wait into a bounded one.

Ask about old scans. If you have had imaging of the same area before, ask whether it can be compared with the new one.

If you develop new or worsening symptoms while you wait, call your care team right away.

Your care team may recommend watching the finding with repeat tests, doing more tests, or taking a tissue sample (a biopsy). NCI notes that follow-up tests and procedures have their own risks, and that some cancers found by screening would never have caused symptoms. The right choice depends on your finding, so ask your care team. Four questions can make the choice easier to handle:

• What is the estimated chance this is significant?
• What would change our plan?
• What specifically would make us act?
• When does this end?

People in this situation are often told they were lucky. Sometimes it is not knowable. NCI's screening guidance is blunt that some detected cancers "would have gone away on their own or never caused any symptoms". There is no way to tell, for one person, whether treating a particular one extended life. That uncertainty is uncomfortable, and it is more honest than certainty in either direction. What it argues for is a specific conversation about your specific finding, rather than a general one about early detection.

The reason you were scanned still exists. Once an incidental finding takes over, the back pain, the headaches or the breathlessness that prompted the imaging routinely stop being discussed. Keep them on the agenda at every appointment. Ask explicitly what the plan is for the original complaint.

You are under no obligation to announce an uncertain finding. Many people tell one or two people and wait until the picture is clear. Bringing one person to the appointment to write things down can help.

• American College of Radiology — Incidental Findings
• USPSTF — Lung Cancer Screening recommendation (harms and incidental findings)
• NCI — Communication in Cancer Care (Patient Version)