The Role of the Surgeon in Diagnosing and Treating Lung Cancer

Techniques such as flexible fiberoptic bronchoscopy and sputum cytology remain the basic tools for lung cancer diagnosis.Advances in radiology have led to the introduction of low dose helical computed tomography for screening for lung cancer, which is effective in identifying small lung nodules not evident on plain chest radiographs. Such nodules are not amenable to bronchoscopic biopsy, percutaneous aspiration for cytology, or further characterization by PET scanning. As a result, the identification of a small peripheral nodule often requires the input of surgeons for diagnostic assistance.Thoracoscopic biopsy techniques, sometimes directed by fluoroscopic identification of radiopaque markers placed under CT guidance, offer the ability to diagnose and treat some such early stage cancers.The benefit and cost-effectiveness of this technique are currently under investigation.