1. Diagnosis Day #1

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

3. 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

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

5. 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

6. 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

7. Normal lungs
Front
Side

8. What pneumonia might look like
Fluid buildup

9. What cancer might look like

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

11. 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

12. Cancer tumor on a PET scan

13. Patient PET scan
Brain lights up
Bladder lights up

14. 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

15. What might cancer cell biopsy look like?

16. 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

17. 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?