NEGLECTED LUNG-CANCER

Pulmonary nodules of unknown nature may be cancerous and are best trea ted by early resection. During the past 20 years we have seen 65 patie nts in whom asymptomatic pulmonary nodules from 5 to 20 mm in diameter were discovered on routine roentgenograms between 1 and 4 years prior to their referral to surgery. These patients have not been investigat ed for cancer. Instead, they had been 'observed' or treated with antib iotics while their nodules increased in size. At the time of referral, 29 patients had widespread metastases, 28 had locally invasive State III lung cancer, eight had Stage I or Stage II lesions. Only 16 patien ts had their tumors resected. Sixteen patients (24.6%) survived 1 year or longer; six patients (9.3%) survived more than 2 years. Early rese ction of all undiagnosed pulmonary nodules is essential. 'Expectant' o r antibiotic treatment of these lesions should be condemned. Education al programs for family physicians are urged.