Diagnosis Day #1

The patient 45 year old male 170 lbs 5’11” Complaining of a cough that hasn’t gone away for 4 months

Good What should we do first? Dr. Chase says he’s a good surgeon, and he can operate to find the cause. Dr. Taub says it’s probably just allergies, and to prescribe some allergy medicine. Dr. Foreman says we should ask the patient questions about his medical history, and listen to his chest. Good

Pick some questions to ask: Any other allergy symptoms? Runny nose, sneezing Any other chest pains? History of smoking? Fever?

New information No sneezing or runny nose No fever No sore throat Has been a regular smoker for over 20 years Abnormal sound in right lung

What now? Dr. Chase says he thinks it might be pneumonia Dr. Wilson says he thinks it might be lung cancer Dr. Adams says she thinks it might be a virus

Normal lungs Front Side

What pneumonia might look like Fluid buildup

What cancer might look like

X-ray of our patient Dr. Wilson says this is a good sign that it’s lung cancer.

What else can we do to check if it’s cancer? Dr. Chase says we should do a biopsy on it now to see what it is. Dr. Wilson says we should do a PET scan first to find out if it has spread to other parts of the body Dr. Taub says we should do an echocardiogram to see if there is anything wrong with his heart Good

Cancer tumor on a PET scan

Patient PET scan Brain lights up Bladder lights up

What now? Dr. Chase says now we need to do the biopsy to try to remove the tumor and find out more about the type of cancer Dr. Foreman says we should start the patient on chemotherapy Dr. Adams says we should use radiation to treat the cancer Good

What might cancer cell biopsy look like?

What do we know now? Patient has lung cancer, but it hasn’t spread It seems to be a slow growing non-small cell cancer Surgery and radiation are both good when the cancer is all in one spot

Questions to answer What was the most significant thing that contributed to his risk for lung cancer? What can an x-ray tell us about lungs? What can a PET scan tell us about cancer? Why is a biopsy of the cancer important even after the patient has been diagnosed?