Lung Cancer / Mesothelioma
Intuitively, you’d think that people who are doing worse while getting treated for lung cancer are not going to do as well as people who have improvement in their symptoms after treatment starts. But how much do patient symptoms count in our current medical system for deciding whether a treatment is working or not, […]
0 CommentsA cancer has to grow faster than the tissue around it to become a tumor. Progressive growth is therefore a central feature of a cancer and a critical factor in distinguishing cancerous nodules from benign ones. There is a characteristic “volume doubling time” (VDT), the interval it takes for a nodule to double in volume. […]
11 CommentsAs you might suspect, there are features of different spolitary pulmonary nodules (SPNs) that makes us more or less suspicious for cancer. The first is the size of the nodule. Looking at multiple series of SPNs, the likelihood of cancer among nodules that measured under 5 mm is generally in the 0-1% range. Nodules […]
0 CommentsAs is fitting for Lung Cancer Awareness Month, we should become more aware of the concept of the solitary pulmonary nodule, or SPN, which is how lung cancer appears in the small proportion of (relatively) luckier people who have their lung cancer detected incidentally or in screening. Technically, it’s defined as a spherically-shaped lesion that measures up […]
8 CommentsWe know PET scans can provide additional metabolic information that can be more sensitive and specific for cancer than chest x-rays and even CT scans in the initial staging of lung cancer (see prior post on introduction to PET scans). PET scans are now nearly universally employed in the initial workup, at least of […]
3 CommentsAmong the key issues in following patients with a history of treated lung cancer is the pattern of recurrence. We need to have a sense of when the risk is highest and where people are more likely to demonstrate new evidence of disease. Fortunately, there are several studies that can help us with these […]
4 CommentsPET scans are an important way to discriminate between metabolically active nodules, suggestive of cancer but sometimes representing inflammation or infection, and non-PET-avid lesions that are felt much likely to represent cancer. They are also a cornerstone of “clinical” staging by imaging and patient exam (vs. “pathologic” staging by surgery to clarify where cancer […]
3 CommentsAmong the many variables that can potentially be helpful in predicting outcomes after surgery are some imaging results. One of these is cavitation, or hollowing out of the inside of some part of the tumor. Although most clinicians think of this as a feature of squamous cancers, it can also be seen with adenocarcinomas […]
2 CommentsPurists have considered mediastinoscopy, which is invasive staging of the mediastinum through a small incision just at the base of the neck to get down behind the sternum, or breastbone, to be the “gold standard” for determining whether lymph nodes in the mediastinum, or middle of the chest, is involved with a cancer. The […]
8 CommentsThe topic of lung cancer screening is a very charged one, with most people, patients and physicians alike, having a strong opinion, either for or against. This is also an area in which there can be suspicion that any argument against screening is due to a financial calculation in which saving people from lung […]
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