Preparing for Your Appointment | Saint John’s Cancer Institute

What to expect on your first visit

You should bring with you records (which may include x-rays, CT scan images and reports, PET scan images and report, and pulmonary function tests) for your initial consultation. The office will send you a 5 page questionnaire to fill out. If you do this before arriving for your consultation, that will greatly expedite the time for the consultation. The surgeon will review your history, physical examination and your records. After that, the discussion will include diagnostic options, treatment options, and any next steps for you to consider. This would be a good time to discuss any specific treatment recommendations or any tests that the surgeon would suggest before making a definitive recommendation.

Questions to ask your surgeon

What to look for in a surgeon

Are you board-certified in Thoracic Surgery? Our surgeons are board certified, that re-assures you they are fully trained in chest surgery. Meet our team to learn more about our experience as surgical pioneers, authors and investigators.
Do you specialize in Thoracic Surgery or do you perform other procedures, such as vascular surgery, general surgery, or heart surgery? If the surgeon specializes in thoracic surgery, he will likely have more experience and often additional skills than a surgeon who performs many different types of surgery.
How much of your practice is dedicated to Thoracic Surgery?
Do you perform minimally invasive thoracoscopic (VATS) surgery? Minimally invasive thoracic surgery has been shown to reduce complication rates and possibly increase survival rates compared to open procedures (operations through larger incisions that involve spreading the ribs).
How many minimally invasive thoracoscopic lung cancer operations have you performed? Studies have shown that complication rates are lower when the procedures are performed at high volume centers.
Do you remove the entire lobe? In general the standard operation for lung cancer is removal of a lobe of the lung and many lymph nodes. A wedge resection (removal of a small part of the lung and less than a lobe) is usually reserved for patients with poor lung function so that removal of a lobe is not safe. A wedge resection has been shown to not provide as high a survival rate as removal of a rib. The most common lung cancer operation involves removal of a lobe from the lung.
The lobes of the lung are divided into segments. Our surgeons have performed studies which demonstrate that under certain conditions, removal of a segment may provide cure rates as good as removal of a lobe, while preserving more lung function than removal of a lobe. Therefore, patients should understand the exact scope of their operation. There are several factors which impact the surgeon’s decision about the extent of a lung resection and the best course of treatment for you. Your surgeon should be willing to discuss these issues at length during your consultation and you should feel comfortable asking questions.
How often do you convert to an open chest operation? Our thoracic surgeons are able to perform >90% of their lung cancer operations with minimally invasive surgery.
Do you remove lymph nodes? A complete lung cancer operation includes removal of lymph nodes from several different areas in the chest. This does not compromise your immune system and does not have side effects cause by removal of axillary lymph nodes for breast cancer surgery. Removal of the nodes are important for the staging of lung cancer which in turn helps to determine proper treatment (if chemotherapy or radiation is needed after the operation).

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Recovering from Lung Cancer