Trial Short Case 2
Case Summary
70 year old man
Presents with posterior chest pain. Nagging, constant dull ache.
Presented at Lung Cancer MDT for surgical opinion
Background:
Osteoarthritis
Gout
Cholecystectomy
Ex Smoker: 20 pack years
Good exercise tolerance
Medications
Allopurinol
Panadol Osteo
Examination
Normal cardiovascular exam
Slight “fullness” to posterior right chest.
Crepitus on inspiration right lower zone.
Respiratory Function Tests
FEV1: 1.7L (71% predicted)
FVC: 2.15L (75% predicted)
FEV1/FVC: 79%
DLCO 14ml/mmHg/min (60% predicted)
MRI Brain
No abnormality detected
CT Guided Biopsy
Adenocarcinoma
PET Scan
Avidity in right lower lobe lesion. Equivocal avidity in hilar nodes.
Questions:
The Lung Cancer MDT asks your opinion about surgery.
Discuss your confidence in the staging to this point on which you are basing your opinion.
Considering chemotherapy, radiotherapy and surgery, discuss the optimal treatment plan for this patient.
Depending on your opinion about the role of surgery, discuss what the surgical options may involve