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J Thorac Cardiovasc Surg 2009;137:33-35
© 2009 The American Association for Thoracic Surgery

Invited Commentary

Discussion

The first 300 words of the full text of this article appear below.

Dr Joel D. Cooper (Philadelphia, Pa). I think you have probably disclosed conflict, which I was going to disclose, having been involved in setting this up. I have no financial conflict. Ego is another matter. [Laughter.]

Dr Veeramachaneni, it was a very good presentation, providing a lot of very useful information. Perhaps I can summarize, as you did, and add a little bit more.

Why does a surgeon want to get involved with ditzels, with little nodules? As you pointed out, it certainly is a way of alleviating anxiety on the part of the patient and providing a service to the patient and the primary physician, both of whom have received letters from the radiologist saying, "You have a nodule. It could be lung cancer. You should be followed up." And who better to follow it up than a surgeon, ideally a conservative surgeon, who is in the best position to make a judgment as to what should be watched and what should be excised? By the way, I think it does promulgate the interest of thoracic surgeons in all things relating to lung cancer. I have often been quoted as saying nothing is too small, in my opinion, for a thoracic surgeon to be involved in.

I think it also fosters research into the early diagnosis: how to tell which nodules are cancer or not. It not only maintains the radiologic skills of the thoracic surgeons, but also encourages other investigators to use this as a population base to figure out some tag, some marker, some immunologic way of determining if a nodule is malignant. Here you have a database, a group of patients who are being followed up. I think that is another potential environment.

I think it supports the minimally invasive treatment of early cancers, whether by . . . [Full Text of this Article]






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