The Value of Exploration in Silent Lung Disease

¹ Member of the Staff of the New England Deaconess Hospital, the New England Center Hospital, and the Cambridge Tuberculosis Sanatorium.

1) Diseases of the lungs can be more easily discovered during their early and silent form than those in any other internal organ.

2) Different pathologic processes within the lungs may produce identical x-ray shadows. Conversely, the same disease entity may produce different x-ray shadows.

3) All shadows cannot be labeled accurately at a time favorable for successful treatment unless surgical exploration is employed. In The Overholt Thoracic Clinic, it was impossible to establish an absolute diagnosis pre-operatively in more than two-thirds of the patients in whom excisional therapy was indicated.

4) In the past year, in 61 per cent of the cases of cancer seen, an absolute diagnosis could not be established until after exploration.

5) When symptoms are present, the likelihood of an extra-pulmonary extension of the cancer is high (88.6 per cent), and cure rates have been low.

6) When silent cancer is treated promptly, the chances of an extrapulmonary extension (lymphatic spread) is low (75 per cent), and cure rates should be high.

7) Cancer of the lung is the most favorable of all internal cancer because its silent shadow appears in survey films, and it can be properly identified and excised in its early and local form.