### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am a 40 year old female, drinker of alcohol, smoker of cigarettes and have a poor diet. Just noticed a lump/nodule (about the size of a silver dollar) on my lower back about 1 1/2 inches to the right of my spine (L3-L4) area. It is completely painless. I have no family history of any kind of cancer, however, I am still concerned. Obviously, I am fully aware that I should see a physician to get it checked out, but I do not have insurance and am currently unemployed. I will have it looked at as soon as I can afford to, but in the meantime...should I be overly concerned since it is painless? Please give me the best advice you can with the limited information I have provided. I am a professional engineer and hold a master s in business, therefore, I understand that you will only be able to provide me with a list of possibilities. Thank you so much for your time.

### output:

Hi! Good morning. I am Chat Doctor answering your query. Even though it requires a physician examination and related investigations like an FNAC to reach at a definitive diagnosis, from your history it seems to be a benign lump like a deposition of fat. However, alcohol and smoking habit along with poor dietary habit also compels me to think of chronic infections like tuberculosis resulting in a cold abscess showing up at the area specified. Further management would depend on the physical examination and related investigations like an FNAC. I would also take this opportunity to dissuade you from alcohol and smoking and would encourage you to have proper diet instead for a healthy life. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor.