11/20/2025
# A perfect storm: and a “positive colon cancer” test
When I, like you, hear phrases like “spots on the lungs,” “lesions on the liver,” and “a positive test for colon cancer,” with my cancer history and cancer found in other family members makes it is easy to assume the worst: late-stage, widely spread cancer. In reality, each of these findings can have **more than one cause**, and sometimes they occur in a way that feels like a perfect storm rather than a clear, straightforward diagnosis.
This article will explain what each of these findings on their own, can mean, and why they **don’t always necessarily equal metastasized cancer**, and why only a careful step by step medical work-up can sort out coincidence from consequence.
# # 1. “Spots on the lungs”: what that actually means
On imaging (often CT scans or X-rays), “spots” on the lungs, usually called **nodules** or **obstructions**. They are actually common, especially as people age or if they have a history of infections, pneumonia, or environmental exposures.
More typical causes of lung spots include:
* **Old infections** (healed fungal infections, pneumonia scars)
* **Benign tumors** (hamartomas, other noncancerous growths)
* **Inflammation** (autoimmune lung disease, sarcoidosis)
* **Vascular changes** (small blood vessel abnormalities)
* **Metastatic cancer** – only one of the many possibilities, not the only one
Radiologists assess spots based on size, shape, borders, calcification patterns, and growth over time. Many nodules are found incidentally and **never turn into anything dangerous**, which is why guidelines specifically emphasize the need for follow-up imaging rather than an immediate cancer panic.
Key point:
You need to look at a lung spot as a **finding**, not a diagnosis. It raises a question; it does not answer anything.
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# # 2. “Spots on the liver”: more reasons than just metastasis
Similar to the lungs, “spots on the liver” (lesions, masses, or focal abnormalities on ultrasound, CT, or MRI) are actually quite common – and more often than not **benign**.
Here is list of Non-cancer causes for liver spots:
* **Hemangiomas** (benign blood vessel clusters; very common)
* **Focal nodular hyperplasia (FNH)** – benign overgrowth of liver tissue
* **Hepatic cysts** – fluid-filled sacs, often harmless
* **Fatty infiltration** or focal fat sparing in the setting of fatty liver disease
* **Regenerative nodules** in chronic liver disease
* **Simple Infections or abscesses**
Yes, cancer is on most lists – both **primary liver cancer** and **metastases from other sites (including the colon)** – but, let's be clear, it is **not necessarily the automatic explanation**.
Imaging features are important (contrast patterns, shape, number, and distribution of the spots) and should be paired with blood tests and a biopsy. All these steps are used to definitively separate benign from malignant causes.
Key point:
Just like with the lung spots, liver spots represent a **pattern on an image**, never an immediate cancer verdict.
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# # 3. A “positive colon cancer test”: what was actually positive?
“A Positive colon cancer test” can mean so many different things:
It should be followed with:
* A **positive f***l occult blood test (FOBT)** or **FIT** (stool test for hidden blood)
* A **positive stool DNA test** (like Cologuard)
* A **suspicious polyp or mass seen on colonoscopy or xray**
* A **biopsy proving cancer** in the colon
The most important distinction here:
* **Screening tests, even (FOBT, FIT, stool DNA)** can be what are called **false positive** or positive for reasons other than the primary one:
* Hemorrhoids
* Polyps that are not cancer
* Inflammatory bowel disease
* Non-cancer bleeding higher up in the digestive tract
* What you need to take from this is that **Only a biopsy** can confirm actual colon cancer.
If a screening test is positive, the standard next step before any assumptions should be made is a **diagnostic colonoscopy** to look directly at the lining of the colon and take biopsies of any suspicious areas.
Key point:
A positive screening test simply means “something needs to be checked,” **definitely not** that “you have cancer everywhere.”
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# # 4. When all three show up together: coincidence or consequence?
Now we get to the core question:
> Lung spots + liver spots + a positive colon cancer test – is this just a series of consequences, or an unlucky cluster of unrelated coincidences?
There are three broad different possibilities here:
# # # Scenario 1: True metastatic colon cancer (everything is connected)
In this scenario:
* The colon lesion is an actual **biopsy-proven cancer**.
* These Cancer cells have spread via blood or lymphatic channels to:
* The **liver** (most common first site of colon cancer metastasis)
* The **lungs** (another common site for spread)
In that case, the spots in the liver and lungs are consequences of the colon tumor. The findings line up in a, textbook example, and staging scans plus biopsies are needed to confirm the connection.
This is the scenario that everyone fears – of course it is serious – but **it is far from the only explanation**.
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# # # Scenario 2: Mixed picture – some findings are related, some are not
This is actually more common than most people realize.
Examples:
* The colon lesion is proven to be cancer or an advanced polyp, **but** the lung nodules are from an old infection that left scars and the liver lesion is there, but a benign hemangioma.
* The colon test is positive due to an adenoma or (precancerous polyp) that is easily removed, and as for the liver spots, they turn out to be benign cysts and as for the lung spots, they are small and stable over time.
* A person may have a long-standing fatty liver disease causing irregularities on imaging, **plus** a new colon polyp, **plus** tiny lung nodules from a past infection.
Here, only one part of the picture is actually “cancer,” the rest re basically background noise from a lifetime of wear, tear, and healing.
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# # # Scenario 3: A true “perfect storm” of unrelated issues
When you consider that Modern imaging is extremely sensitive. Once you start scanning:
* You find old scars, cysts, nodules, and anomalies that have possibly been there for years.
* You pick up colon obstructions or mild inflammation.
* A screening test is a false positive from something minor, such as a small bleed from hemorrhoids.
From the patient’s perspective, at first glance, it feels like all hell breaks loose at once:
* “Spots” on the lungs
* “Spots” on the liver
* A “positive” colon result
But you need to remember that medically, each finding could be unrelated and each could have a benign or reasonable explanation of a manageable condition.
This is just a real “perfect storm”: **multiple ambiguous findings appearing at the same time, before anyone has the full information and can make an informed explanation.** It by its very nature creates a situation that causes maximum anxiety long before there is a clear well informed diagnosis.
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# # 5. Why appearances alone cannot answer the question
The human brain is genetically wired to connect unrelated dots, after a real or imagined conclusion has been reached. We see three scary findings, connect them (after we google it!) and assume one catastrophic story, lacking any solid proof. Fortunately, Medicine does not work that way.
Sorting out coincidence vs consequence requires:
* **Clarifying questions for what exactly was positive in the colon**
* Was there a biopsy?
* What did pathology show (polyp, early cancer, advanced cancer)?
* **What are the Characteristics of each lung spot**
* Size, number, shape, calcification, PET activity, growth on repeat scans
* **What are the Characteristic of each liver spot**
* MRI with contrast, ultrasound, CT pattern, and if possible, a biopsy
* **Looking at it over time**
* Have these lesions changed over months/years, or are they stable?
Only when you combine all the **imaging patterns, pathology, lab tests, and time** can an oncologist make an informed decision whether this is widespread cancer, partly related disease, or just a cluster of mostly benign findings.
My hope for you is that it is just coincidence!
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# # 6. Beware of the emotional trap: worst-case scenario thinking
From a Google search standpoint, this topic naturally draws readers who are terrified they (or someone they love) are in a catastrophic situation.
Here is the hard truth:
* Yes, sometimes it is stage IV cancer.
* But, sometimes it is early-stage cancer along with unrelated benign spots.
* Always remember that sometimes it is not cancer at all, just a lot of coincidental findings that just appear to be the worst case scenario.
What usually drives suffering a sound medical determination is made is often **uncertainty**:
* Waiting for biopsy results
* Waiting for repeat imaging
* Hearing the word “spots” with no explanation
* Hearing “positive test” without context
It is clear that proper communication from all clinicians – with the perspective and understanding that **findings are questions, not verdicts!**
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# # 7. What you or anyone in this situation must realistically expect
If you have lung spots, liver spots, and a positive colon test, you can expect:
1. **A detailed colon evaluation**
Which should include:
* Complete colonoscopy if not already done
* Biopsies of suspicious areas
* Clear pathology report (cancer / precancer / benign)
2. **More focused imaging of liver and lungs**
* CT, MRI, or PET-CT focused on characterizing each lesion
* Radiologist comparison with any previous scans
3. **Possible biopsies**
* If a lesion looks suspicious and would change treatment decisions if a biopsy is done, it may be recommended by your health professional. But may not happen if the radiologist determines it is in a spot they cannot reach with a syringe.
4. **Staging and treatment planning when cancer has been officially confirmed**
* If this truly is colon cancer with metastases, an oncology team will decide what stage the disease has reached and outline youur options (surgery, chemotherapy, targeted therapy, liver-directed treatments, etc.), they will be guided by current evidence and your overall health.
5. **Follow-up if lesions appear benign or indeterminate**
* If spots are small or look benign, doctors may plan **an interval for follow-up scans** to ensure they are not growing or changing.
Unfortunately, none of this is usually fast or comfortable. But it is the only way that doctors can separate **coincidence from consequence** and avoid overtreatment and dangerous delay.
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# # 8. Conclusion: A perfect storm is just a situation, not a reason for an unfounded sentence
Lung spots, liver spots, and a “positive colon cancer” test together create a storm of fear and uncertainty. The brutal reality is that:
* Sometimes the storm is signaling a large, unwanted yet connected beginning to a cancer story.
* Sometimes it is just a mix of serious and benign issues all at once.
* Sometimes it is purely a coincidence of unrelated findings that fortunately only look connected on paper or Google.
Without biopsy results, detailed imaging reports, and professional interpretation, **Absolutely nobody can honestly say what it really is**.
If you or someone you care about is in this situation right now:
* Push your clinicians for **clear explanations**:
* “What exactly was positive?”
* “What is on the pathology report?”
* “What are the possible causes of these spots?”
* “What are the next steps, and what are we trying to rule in or out at each step?”
* Speak up and ask for copies of any reports so you can see for yourself, the language used, and if you feel it necessary, seek a **second opinion** from another specialist.
A perfect storm of findings does not automatically equal a perfect storm of outcomes. The real story only emerges after each piece is properly investigated – and even then, not until that work is done, any kind of conclusion, confident or otherwise, (good or bad) is guesswork just.
