Recently the diagnosis of a primary lung cancer was made in an older patient in our offi ce. This, unfortunately, is not an uncommon event. The work- up determined that he had no evidence of tumor spread and he was considered for a potentially curative surgery. The thoracic surgeon I chose is thoughtful and following his assessment wanted some further studies, specifi cally a cardiac catherization. At the time of this writing I do not have the results of the study, but that is not the point of this article. When patients are considered for potentially curative surgery for a Stage 1 lung cancer we want them to survive.

Many of these patients are older or have what are called co-morbidities, i.e. other serious medical conditions, which could infl uence their survival. Occasionally, we get some push back from patients or family members about the need for further testing before a surgery. This was not the case for this patient or family, but even if nothing is said, you sometimes get the feeling that there is some question about whether or not these tests are really necessary or are we just padding the bill. The statistics show that serious underlying medical problems (co-morbidities) are the leading cause of death for 2.5 years after a surgery to cure a lung cancer. This statistic is even more pronounced in the older patient. We want you to survive no matter how old you may be, so knowing about your co-morbidities and their severity is important