My doctor did a lung cancer screening CT scan and found a mass - now what?

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Oct 30, 2017 | Mark S. Allen, M.D. | @MarkAllenMD | Comments (2)

Since I am a smoker, a pack a day for the past 30 years, my family doctor did a screening CT scan and they found a mass on my lung.  Now what do I do?

First of all, relax.  Although lung cancer is a very deadly disease you may have been relatively lucky since it was found in an early stage.  Unfortunately, most people with lung cancer are not diagnosed until late in the course of the disease.  This is because there are very few symptoms of lung cancer until it is too late.  Your doctor correctly obtained a screening CT scan, so yours was found early and it is curable.

The first step in the evaluation and management of lung cancer is to stage the cancer.  This will help the physicians recommend the correct treatment and give you an estimate of the cure rate.  Staging usually involves a history and physical exam, and PET scan. These tests may lead to others, but hopefully you have a stage I cancer, which means the cancer is confined to the lung and does not involve any lymph nodes.  Once the staging is complete, your doctors will assess your fitness for surgery, usually with pulmonary function testing and an electrocardiogram.  You need to stop smoking immediately as well, for patients that are smoking up to the day of surgery have a marked increase in the complications after surgery.

Once your evaluation is completed, you’ll see a surgeon who will likely recommend a minimally invasive procedure that will remove the mass in the lung along with some surrounding lymph nodes.  This can be done with a very low chance of complications and almost no chance of death.  The hospitalization is usually around 4 days and you can resume normal activities (NOT smoking) in about 2 weeks.

If it is a stage I lung cancer, you don’t need any other treatment.  No chemotherapy or radiation therapy are necessary.  You would have surveillance CT scans at 6 months and then yearly thereafter to look for any recurrence or another cancer.

There is quite a bit of variability in the care of lung cancer patients, so it is recommended that you go to a center that sees a large volume of patients with this problem.  They would be up to date on the newest diagnostic and therapeutic techniques, thus giving you the best outcome.

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