Guardrails, Gray Areas, and a Spiculated Surprise: A Stage I Lung Cancer Case

A 49-year-old individual who never smoked learns a routine scan has uncovered a suspicious lung lesion—low PET uptake, a negative bronchoscopy, and “stable” imaging… yet clinical instincts say, “Don’t ignore this.” In this story-driven episode, host Lisa Moores, MD, FCCP, is joined by CHEST Guideline Chair John Howington, MD, MBA, FCCP, and thoracic surgeon Sudish Murthy, MD, PhD, FCCP, to walk through what to do when the data conflict and the stakes are real.

Together, they translate the CHEST guideline “guardrails” into bedside decision-making: when surveillance stops being safe, why minimally invasive surgery matters, and how lung-sparing resection can deliver an oncologically sound plan while preserving future options.

Faculty 

• Host: Lisa Moores, MD, FCCP

• Guideline Chair: John Howington, MD, MBA, FCCP

• Case Guest: Sudish Murthy, MD, PhD, FCCP