Diagnosis of Lung Cancer

Generally, patients can be categorized as either operable or inoperable. For patients whose tumors are operable, staging is followed by surgery. Patients who are considered inoperable because of distant metastases such as liver or bone metastases are typically given chemotherapy alone.

There is a third group of patients who fall somewhere in the middle. These patients with locally advanced cancer can sometimes be treated successfully with aggressive radiotherapy combined with chemotherapy. Surgery either before or after chemoradiotherapy can also be helpful in selected patients.

Improvements in PET scanning have made this test a valuable tool for both diagnosis and staging. PET scans can help us choose which patients are candidates for surgery. These scans can also pick up metastases that wouldnt necessarily show on a CT scan. For example, a single nodule in the lung that may be inaccessible for biopsy may be positive on a PET scan, offering more definitive evidence of malignancy. The resolution of PET scans also will show lymph node involvement of 7 mm or larger that is not seen on a CT scan. So PET scans have added an additional step to the staging process, but they have increased accuracy.