tests

bone scans
If cancer has not spread outside the lung, the surgeon might decide to do more surgery than if it has spread to the bones. That is because once cancer has started setting up camp elsewhere, chemotherapy is the best treatment. If it is still confined to the lung, surgery is the best treatment and sometimes the only treatment if the spot is small enough and the cancer is not an aggressive sort. When I had surgery done, I had to sign papers allowing the surgeon to take up to one lung if he deemed it necessary on the operating table. I found out AFTER I woke up, that he only took one lobe. A biopsy would probably still be necessary if the cancer had spread so they know what kind of chemo to do, but there would not need to be as much surgery if the primary treatment was going to be chemo.

Different kinds of cancer have different doubling rates. Some double every 7 days (very rare type of esophageal cancer), some double every 27 days (aggressive breast cancer for example) some double every 210 days (non-agressive breast cancer for example). They really can differ. I have been told that lung cancer is not all that fast at doubling, but I don't know the exact doubling rate for the different kinds of lung cancer. It is common with lung cancer to do two CAT scans about 3 months apart to make sure a spot is growing. Many things can make spots on the lung and not all are cancers. They like to make pretty sure before they suggest surgery.

Second opinions are very common. Even when I really trusted my surgeon, I was a bit worried about what he was suggesting. I didn't know anything about lung cancer, or for that matter, about lungs in general. I mean, I knew you use them to breathe. But the doctor said he would be removing my right middle lobe if the biopsy showed I had lung cancer. I didn't even know that there were two lobes on the left and three on the right or that my right lung would still work if the middle was removed. So I found an "Ask the Expert" spot on the internet (University of Maryland I think) and asked them about what was the "gold standard" treatment for my kind of cancer. Sure enough, my surgeon was following the correct guidelines and giving me good advice. If you want a face-to-face meeting with another expert, you can make an appointment and meet with them. I would suggest talking to the local Lung Association or American Cancer Society on what center could give you the most up-to-date opinion possible. Usually those kind of experts are at teaching university hospitals. You don't want just another surgeon. You want a lung expert for a second opinion. You may find out that your surgeon is doing just what he or she should be doing. Or you may find out that there are other possibilities at a different site. Either way, if you are concerned, getting a second opinion may help. Your tests, scans, reports, whatever, are yours, not the doctor's or the hospital's. You send all the information collected so far to the expert and have your meeting. If you want to know about chemotherapy, you will proably have to wait for the biopsy results to come in. That is because different kinds of lung cancer need different kinds of therapies. Again, it is very common to get a second opinion just to be sure you are getting the best treatment for your kind of cancer. Almost any hospital can give chemotherapy, but some experts are better at putting the available drugs together in the best way for you. I have known many folks that see the general oncologist in town for varying kinds of cancer. Several of them checked his recommendations with an expert from a teaching university hospital that specialized in their particular kind of cancer. They still went back to the general oncologist after meeting with the expert. But they slept better knowing they were doing all that could be done for their particular problem.

Good luck!

C. Abbott