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The things that make us more concerned about a lung nodule are the size, the shape, sometimes the location of the lung nodule itself, and also the patient. Their age, their smoking history, their family history, their other medical problems. All of those things can help us be either more or less concerned as to whether this is related to a cancer. If the team does decide that there is a reasonable concern for cancer, there are several ways we can go about proceeding with a definitive diagnosis. PET scans are oftentimes helpful. They’re not diagnostic, but they can help point us in the right direction, if something is what we call “hot” on a PET scan. Another thing that will oftentimes help is a biopsy, and there are several ways to biopsy lung nodules, some from the outside, some from the inside, with a bronchoscopic procedure. Other times there’s enough of a concern, or there’s been a growth of a nodule over time or something that makes everyone in the multidisciplinary team feel a little more concerned about that specific lung nodule. And at times in that scenario, we’ll go directly to surgery, or if biopsy is considered especially high risk, sometimes we’ll go directly to radiation as well. It really is individualized based on that patient and that lung nodule.
