In short: The diagnosis and treatment of lung cancer have changed considerably in recent years. Treatment is now chosen according to the molecular features of the tumour, so an accurate and complete diagnosis is a key step.
The path to a diagnosis
- Imaging assessment of the finding: CT and, as needed, PET-CT
- Biopsy: bronchoscopy, including EBUS to sample lymph nodes in the chest, or a CT-guided biopsy
- Staging: the extent of the tumour and whether it has spread
- Molecular testing of the tumour (for example EGFR, ALK, ROS1, KRAS, BRAF, MET, RET, HER2, NTRK) and PD-L1 testing, sometimes with a liquid biopsy from a blood sample
Personalised medicine
When a specific genetic alteration is found in the tumour, there is often a targeted therapy directed at it, for example osimertinib (Tagrisso) for an EGFR mutation or alectinib (Alecensa) for an ALK alteration. For other patients, immunotherapy such as pembrolizumab (Keytruda) is appropriate, alone or in combination. In early stages, treatment may include surgery or stereotactic radiotherapy (SBRT), sometimes combined with drug therapy before or after surgery. Decisions are made in a multidisciplinary discussion (MDD) with a team we assemble for each case, including thoracic surgeons, medical oncologists, thoracic radiologists, pathologists and radiation oncologists.
What we do
Evaluation of suspicious findings and nodules, coordination of tests and biopsy, guidance along the way to a complete diagnosis, and second opinions on an existing treatment plan. The aim is for you to reach treatment decisions with all the information in hand.
Early detection
A low-dose CT scan can detect lung cancer at an early stage in people at high risk, mainly smokers and former smokers, depending on age and smoking history. You can find out whether the test is suitable for you. About CT screening for smokers
During treatment we also monitor lung-related side effects, such as pneumonitis after immunotherapy or radiotherapy. About pneumonitis
Frequently asked questions
How long does the work-up take?
It depends on the finding and on the tests required. We try to coordinate the steps back to back, because the work-up should be both prompt and complete.
When is a second opinion worthwhile?
When there is uncertainty about the diagnosis or treatment, when not all molecular tests have been done, or when you want to understand all the options before making a decision.
Further reading: Lung cancer: four challenges worth knowing (ynet, in Hebrew, Prof. Amir Onn) · The treatment extending the lives of lung cancer patients (Walla, in Hebrew, Prof. Amir Onn)
Related topics
General information only; it does not replace a medical consultation. עברית