When your lung nodule is considered highly suspicious based on its size, shape and appearance on chest x-ray or CT scan and your history of smoking and family history of lung cancer, it will need to be biopsied to determine if it is cancerous. The biopsy is a simple procedure of getting a sample from the pulmonary nodule for microscopic exam. It can be done surgically, bronchoscopically and by placing a needle thru the chest wall under radiographic guidance.
The bronchoscope approach is an out-patient procedure without any cutting, sutures or sticking needles thru the chest wall. After heavy sedation and numbing of mouth and throat, the bronchoscope is inserted in the lung and is guided to the lung nodule with (at National Jewish Health) or without navigation system and ultrasound confirmation. A sample is taken an immediately examined by a pathologist (a doctor who identifies diseases by studying cells and tissue under a microscope).
The pathologist will determine if the nodule is cancerous. If it is not cancerous, your physician will ask you to come back to re-examine the spot so he can watch it for any changes and catch it early if it becomes cancerous. If the nodule is cancerous, a few more samples will be taken to determine how far the cancer has spread. Next steps will be discussed.
Most non-cancerous lung nodules do not need treatment. Cancerous nodules if localized are usually removed surgically. If nodules have spread to other parts of the body, you may need radiation and/or chemotherapy with or without surgery.