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Staging Basics

Staging Basics

December 14, 2021
Sanjay Juneja, MD
Sanjay Juneja, MD

Medical Oncology

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When you get diagnosed with lung cancer, the very important thing is to determine the stage. Usually you can tell on a CT chest scan what may be involved. Is it just the tumor in the lung or are there lymph nodes? But if you can’t tell on the CT scan, we often do a PET scan. PET scans get hot basically where there’s increased activity. If it’s hot, it may be infectious or something else. But if it looks suspicious and is in the same anatomical distribution, this kind of gives us an idea of the stage. That part is very important because that dictates whether you get surgery first, whether you don’t need surgery and you should do chemo and radiation, and all those other things we discussed earlier. However, if nodes look suspicious and like we said, it dictates the difference of having that surgery or not, you can do what’s called a mediastinoscopy or an EBUS, which we discussed in another video. But those basically go into the chest and sample those lymph nodes, which are key decision-maker on the way to go forward. If there’s any doubt, it’s important to sample them to see if you do indeed have N2 disease where really you don’t want to do surgery up front for the most part, or if indeed those lymph nodes are negative for cancer and you feel better knowing that surgery is the right option.