After the PET scan I knew like 95% sure the mass in my lung and the lymph nodes were cancer since they "lit up". Then the biopsy does the final confirmation and determines the exact type of cancer. Each step of the way from first lung x-ray to CT scan to PET scan to biopsy tells you more and more that it is cancer and helps prepare you for the next step and I had very good doctors that helped too. They had a lot of experience with cancer and seemed to be able to know the best way to inform the patient. For me that was a direct approach - just tell me. It doesn't help anything to not know about it and I don't do denial. Now I finished chemo and radiation and am 10 months into immunotherapy. I have great support from my son and a friend which helps a lot. I know I will probably die from this - but not today! So I will live today.