After cancer has been staged (link to staging), a complete examination is done to evaluate general health and specifically the performance of the heart and lungs. This examination is referred to as a work-up and helps to assess whether the lungs can withstand treatments such as surgery, radiation and/or chemotherapy.
Once the work-up is completed or in progress, the NYU Thoracic Oncology Program's multidisciplinary lung cancer tumor board will discuss the case. This approach unites the disciplines of medical oncology, surgery, radiation therapy, pulmonary medicine, radiology and pathology, allowing for evidence-based discussions. The multifaceted expert opinions that result from this method allow us to tailor our care to a patient's individual needs.Pulmonary Function Testing
Pulmonary Function Testing measures both the capacity of the lung and the strength used to achieve this capacity. Results of testing are compared to known standards to help determine if surgery is a safe option.
Other tests that provide insight into lung function include nuclear medicine scans, which measure the contribution of different parts of the lung, as well as exercise testing. Since a majority of patients who have lung cancer are smokers or former smokers, it is important to consult with a pulmonologist (lung doctor) and determine if lung function can be improved prior to treatment. If so, a brief yet intense period of rehabilitation and tobacco cessation may be required.Cardiovascular Assessment
Many lung cancer patients also have disease of arteries in the body, including the heart, which may need to be addressed prior to lung cancer treatment. A cardiologist (heart doctor) may be consulted to perform an electrocardiogram , an echocardiogram , or ultrasound of the heart, and possibly nuclear medicine scans to ensure the heart is healthy enough to withstand the stress of treatment.