After Lung Cancer Screening (LCS)

The patient and ordering physician take a shared decision regarding the next steps. The 'sharing' is not merely of information but more so the input and opportunity to take the next steps together.

Depending on the results, recommendations for patients generally fall into two categories.

• A follow up low-dose CT scan of the chest (usually in 12 months, it could be sooner)

• A PET/CT scan, a CT scan with contrast (dye) or a biopsy (sometimes a combination of steps in needed)

It is similar to the LDCT scan except it typically covers your body from the middle of your thighs to about the bottom of your skull (but can vary). Also, unlike the LDCT scan, the PET/CT scan involves administering a unique dye that causes faster growing cells to capture more of that dye. Those cells appear 'hot' or 'active' or 'avid'.

A biopsy in this context is the removal of a small piece of abnormal tissue that is suspected to be from lung cancer.

Principally, it can be done in three ways.

BRONCHOSCOPY

A bronchoscope is a thin, flexible tube with a camera at the end). With the patient typically under general anesthesia ('asleep'), this device is inserted via the mouth and guided to the appropriate part of the lung and a biopsy is performed. Sometimes, different varieties of sedation are used and the access (mouth or nose) varies accordingly.

CT-GUIDED LUNG BIOPSY

A needle is inserted into the lung tissue from the outside of the chest wall and samples are taken. As above, different levels of sedation can be used and 'moderate sedation' is typical.

SURGERY

Depending on the circumstance, surgery may be appropriate.

Please discuss the details with your doctor regarding the risks, benefits and alternatives of each technique (along with types of sedation) with your doctor.

More information is available regarding the types of procedures through the American Lung Association as well: https://www.lung.org/lung-health-diseases/lung-procedures-and-tests