A lung cancer diagnosis can change your life in an instant. But advances in early detection, robotic surgery, and personalized medicine are giving patients more treatment options and new reasons for hope.
On this episode of Crazy Good Ageing, host Dorthy Shore welcomes Dr. Inderpal Sarkaria, Professor and Chief of the Division of Thoracic Surgery at UT Southwestern Medical Center, for an important conversation about lung cancer, screening, treatment decisions, and the future of cancer care.
For Dorthy, the conversation is deeply personal. Earlier this year, she was diagnosed with lung cancer and underwent a left upper lobectomy at UT Southwestern.
Having experienced the uncertainty, fear, and difficult decisions that accompany a cancer diagnosis, Dorthy brings a patient’s perspective to a discussion filled with practical information for women over 50.
Why Lung Cancer Is Often Discovered Too Late
One of the most concerning realities about lung cancer is that it frequently develops without noticeable symptoms.
According to Dr. Sarkaria, symptoms such as a persistent cough, coughing up blood, or difficulty breathing may not appear until the disease has reached a more advanced stage.
This makes early detection especially important.
For people over 50 with a significant smoking history, lung cancer screening with a low-dose CT scan can help identify suspicious nodules before symptoms develop.
Even those who quit smoking many years ago may still face an elevated risk of developing lung cancer.
Dorthy shares that she had stopped smoking long before her diagnosis and hadn’t realized that screening might still be important. Her cancer was discovered incidentally during imaging for another medical concern.
Her experience illustrates why understanding personal risk factors and discussing screening eligibility with a healthcare provider can be so valuable.
Can You Get Lung Cancer If You’ve Never Smoked?
Although smoking remains the best-known risk factor for lung cancer, it isn’t the only one.
Dr. Sarkaria explains that physicians are increasingly recognizing lung cancer among people who have never smoked, including women without an obvious history of exposure.
Environmental factors such as radon and radiation exposure may contribute to lung cancer risk.
Researchers are also identifying genetic changes associated with certain lung tumors, creating opportunities for targeted therapies that work against specific cancer characteristics.
These discoveries are helping physicians move toward more individualized cancer treatment.
What Does a Suspicious Lung Nodule Mean?
A lung nodule is a small abnormal area that may appear on a CT scan.
Not every nodule is cancerous, but certain characteristics can raise concerns.
Doctors may evaluate its size, appearance, growth over time, and the patient’s medical history before recommending additional testing.
During the conversation, Dorthy describes an especially challenging experience: Her initial biopsy came back negative, even though the nodule continued to look suspicious.
Dr. Sarkaria explains that a negative biopsy doesn’t necessarily mean cancer is absent.
Biopsies can produce false-negative results, particularly when the sample doesn’t capture malignant tissue.
This is why suspicious nodules should be evaluated in the context of the complete medical picture.
Dr. Sarkaria emphasizes the value of specialized lung nodule programs and multidisciplinary teams that bring together physicians with experience in diagnosing and treating lung cancer.
Their expertise can help determine whether a patient needs additional imaging, another biopsy, surgery, or continued monitoring.
The Importance of Acting Quickly and Getting a Second Opinion
When Dorthy asks when a patient should consider getting a second opinion, Dr. Sarkaria offers a simple answer: As soon as they think they need one.
A second opinion can confirm a diagnosis, clarify treatment choices, or help a patient feel more confident about moving forward.
Patients should never feel embarrassed about requesting one.
However, he also emphasizes that time matters.
Delays between identifying a suspicious nodule and beginning appropriate treatment can affect outcomes.
The goal is to gather reliable information, find a medical team you trust, and make informed decisions without unnecessary delays.
For Dorthy, speaking with multiple specialists ultimately helped her feel confident about her treatment decision.
Understanding Lung Cancer Stages and Treatment Options
Dr. Sarkaria explains that lung cancer care generally involves three important steps:
- Diagnosis: Establish whether the suspicious mass or nodule is cancerous.
- Staging: Determine whether the cancer is confined to the lung or has spread to lymph nodes or other parts of the body.
- Treatment: Select the most appropriate therapy based on the cancer’s stage, characteristics, and the patient’s overall health.
For many patients with early-stage lung cancer, surgery is an important treatment option.
However, the choice depends on several considerations, including lung function and whether a procedure can safely remove the cancer.
Other treatments may include radiation, chemotherapy, immunotherapy, or combinations of these approaches.
Dr. Sarkaria stresses that the primary objective is always the best possible cancer treatment for the individual patient.
How Robotic Surgery Is Changing Lung Cancer Treatment
One of the most encouraging developments in thoracic surgery is the growing use of minimally invasive and robotic-assisted procedures.
Traditional open surgery may require a large incision in the chest. Robotic-assisted surgery allows surgeons to perform complex procedures through smaller incisions using specialized instruments and cameras.
Dr. Sarkaria discusses several potential benefits:
- Smaller incisions and reduced postoperative pain
- Shorter hospital stays
- Faster recovery and return to daily activities
- Greater precision during complex procedures
- The possibility of preserving more healthy lung tissue when appropriate
Some patients undergoing minimally invasive surgery may be able to leave the hospital within one or two days.
New technologies can also help surgeons identify tumors more precisely during an operation and confirm that they have removed the necessary tissue.
Nevertheless, Dr. Sarkaria emphasizes that the ultimate goal is not simply to perform robotic surgery. It is to provide a safe, effective cancer operation that offers the strongest opportunity for long-term survival.
Chemotherapy vs. Immunotherapy: What’s the Difference?
Many patients are familiar with chemotherapy but may be less certain about immunotherapy.
Dr. Sarkaria explains the distinction.
Chemotherapy uses medications that act directly against cancer cells.
Immunotherapy works by helping the body’s immune system recognize and attack cancer cells more effectively.
These treatments are considered systemic because they can affect cancer throughout the body.
Surgery and radiation therapy, by comparison, are primarily local treatments directed at cancer in a specific location.
Depending on the situation, doctors may recommend combining different therapies.
This is one reason multidisciplinary cancer teams are so important: they can evaluate the full range of available treatments and develop an individualized plan.
The Future of Lung Cancer Treatment
Despite the seriousness of lung cancer, Dr. Sarkaria expresses considerable optimism about the future of treatment.
Artificial intelligence may help physicians identify suspicious findings on CT scans and improve the process of connecting patients with appropriate specialists.
Advances in robotic bronchoscopy are making it possible to reach difficult-to-access nodules and obtain tissue samples with greater precision.
Meanwhile, molecular testing is helping doctors understand the genetic characteristics of individual tumors.
Dr. Sarkaria discusses EGFR mutations as an important example of how identifying a cancer’s molecular signature can lead to targeted treatment.
As these technologies develop, physicians may be able to customize treatment even more precisely.
He also envisions a future in which some early-stage lung cancers could be treated through increasingly precise, less invasive methods that might reduce the need for surgery.
Three Questions to Ask After a Lung Cancer Diagnosis
For anyone facing a suspicious lung nodule or a new cancer diagnosis, the conversation highlights three important questions:
- What should happen next, and who should evaluate my results?
- What additional testing is needed to confirm the diagnosis and determine the stage?
- What treatment options do I have, and would a second opinion be helpful?
Being informed and participating actively in medical decisions can make a significant difference during an overwhelming time.
Finding Hope After a Lung Cancer Diagnosis
Dorthy Shore’s personal experience brings an important message to this episode of Crazy Good Ageing: A lung cancer diagnosis is frightening, but it is not a reason to surrender hope.
Early detection, advances in surgical techniques, and increasingly personalized treatment approaches are transforming lung cancer care.
Finding an experienced medical team, asking the right questions, and advocating for yourself can help patients navigate the journey with greater confidence.
Watch the full episode of Crazy Good Ageing as Dorthy Shore speaks with Dr. Inderpal Sarkaria about lung cancer, treatment decisions, and the medical advances creating new possibilities for patients.
For more expert conversations about women’s health, wellness, and living well after 50, visit PrimeWomen.com.
Medical disclaimer: This article is intended for educational purposes and should not replace advice from a qualified healthcare professional. Screening eligibility, diagnosis, and treatment decisions should always be discussed with your medical team.