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Early Detection

Program: Minimally Invasive Thoracic Surgery for Lung Cancer
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Andrew Schorr:

All right.  Let’s go over that for a minute.  As we do this program it was very recently that there was new National Cancer Institute study data that came out that really showed how important it is for people who smoked for a long time, whether or not they stopped, whether current smokers or former smokers, that that CT scan, while there’s always a concern, is it going to show things that aren’t significant. That the CT scan, as in the case of Mr. Davis, that that early detection could make all the difference.  So do you support that idea of if they’ve been a smoker or former smoker like Mr. Davis that that’s an important exam?

Dr. de Hoyos:

I think we have better evidence now that a CT scan is going to play a bigger role in early detection of lung cancer.  This has been a question that has been debated over more than two decades, who are the patients that actually benefit from a CT scan.  On the other hand, there are many patients with small pulmonary nodules that end up being benign and not necessarily tumors.  So we have to consider when we send a patient for a CT scan how we are going to proceed, because many patients will end up having lung cancer or pulmonary nodules and we have to select those that will actually benefit from the surgery so the patient that will benefit from the surgery are those patients that have pulmonary nodules that look like cancer because, on the other hand, we don’t want to subject patients with benign problems to an operative procedure with the risks involved.

Andrew Schorr:

Right.  We should make that point.  There are risks, and so this whole CT scanning and really identifying what is in fact a cancer and then intervening early and even with minimally invasive approaches it’s not an insignificant procedure.  So all that’s being worked out but a lot of new news. 

Now, the other news that’s come out, Doctor, is the question still remained the traditional approach was a big incision and a thoracotomy and splitting the ribs to get in there, and now, as I know at Northwestern, 80 percent of the time you do the video-assisted minimally-invasive surgery.  The question was, was it as good for lobectomy, which Mr. Davis had, removing part of a lobe of his lung.  What’s the latest data?  What does that say?

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