Lung cancer remains one of the most serious diseases we, as pulmonary physicians, must face. When patients present with findings on chest x-ray or CT scan that are potentially a cancer, all efforts are initially directed to making an accurate tissue diagnosis. Tests such as fiberoptic bronchoscopy, thin needle aspiration, and endobronchial ultrasound may all be used to establish the diagnosis of lung cancer.
The work for the patient does not stop at making a tissue diagnosis. What we have learned over time about lung cancer is that assessing the spread of the disease in each patient helps to avoid unnecessary treatments, determine which treatments should be most effective, and what we may expect in terms of survival. These lessons learned did not come without significant observation and trials.
Total surgical removal of lung cancer is now the only known cure. Unfortunately, many patients present with disease which is not amenable to surgical cure. To be certain that a patient is, or is not, a surgical candidate requires a process called staging. Staging often requires radiologic and biopsy data to help determine the spread of the disease, and without these efforts the best treatment for lung cancer cannot be determined. Lung cancer presents a difficult problem for the patient and family, and the need for numerous tests is often hard to understand and the results are not always the ones hoped for.
Staging of lung cancer is important and should be done for all patients.