Lung Cancer / Mesothelioma
As 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 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 CommentsA substantial revision of the staging system was presented at the World Conference on Lung Cancer in Korea this week. This project involved multiple lung cancer experts from all over the world and from a variety of specialties over the last several years, who reviewed the data on approximately 100,000 lung cancer cases, both […]
11 CommentsStaging in lung cancer, as well has two categories, clinical and pathologic. The clinical staging is based on what appears on scans like the CT and PET scan that are now pretty routine parts of the staging workup. Our scans are better than ever before, but some lymph nodes with cancer involvement are not enlarged […]
2 CommentsWe’ve discussed various ways of predicting outcomes with EGFR inhibitors like Tarceva or Iressa using clinical variables like smoking status or BAC subtype, as well as molecular markers like EGFR mutations, or EGFR gene amplification or protein expression. These can all be of value, but we know that the clinical markers are quite inexact, […]
7 Comments One of the central ideas in management of advanced NSCLC is that many two-drug chemo combinations have been compared and show essentially superimposable results, as I described in a prior post.
(click to enlarge)
Perhaps we’re underachieving by using a “one size fits all” approach, getting everyone to a middle ground that falls short of what we might do […]
I’ve been meaning to write on tumor markers detectable in the blood for the management of lung cancer. These are proteins that are produced by some tumors, and the idea is that the levels of the tumor markers in the blood can potentially be used to monitor the status of the disease. For prostate-specific antigen in […]
2 CommentsI’m going to cover the general concepts of management of brain metastases, a subject that is still evolving because of our growing technology, particularly with stereotactic radiosurgery (SRS), commonly referred to as gamma knife. In many cases, our practice has moved a bit ahead of the data. We’ll start with some general issues and […]
9 CommentsThe notorious and always welcomed words after surgery are, “we got it all”, providing great relief to the patients and families who hear the phrase. We know that surgeons can take out all identifiable disease that they see when they do surgery, and that there is no evidence of visible disease on CT scans or on […]
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