Pulmonary disease specialists in Southern Nevada

The comprehensive lung program at Sunrise Hospital and Medical Center aims to diagnose lung cancer in its earliest possible stage. Since early detection is key, we are committed to educating the Southern Nevada community on the importance of pulmonary tests and lung cancer screenings.

Our team of specialists in pulmonology, pathology, radiology and surgery hold monthly conferences that provide coordinated care for inpatient and outpatient cases. Further, our nurse navigators serve as liaisons between you and your treatment team and can assist with answering any questions.

To speak to someone at the comprehensive lung program at Sunrise Hospital, call (702) 961-9324.

Lung cancer screenings

With over 155,000 deaths per year, lung cancer is responsible for more deaths than breast, colorectal, melanoma, and prostate cancer combined. Lung cancer can be curable when found in its early stages, but it has been historically difficult to detect until now.

We offer noninvasive, low-dose computed tomography (LDCT) lung cancer screenings for patients who may be at risk of lung cancer. The low dose CT screening is painless, only takes a few minutes, and exposes the patient to five times less radiation compared to a regular CT scan.

LDCT is a screening designed to catch cancer in its early stages. Those at high risk who are routinely screened are more likely to detect lung cancer at an earlier, more treatable stage.

After the exam, your report will be sent to your primary care provider and a result letter will be mailed to you. If necessary, you may be referred for pulmonary care. In that case, a lung nodule coordinator will schedule an appointment for you with a pulmonologist.

Who Should Get a Lung Screen?

Because a CT scan requires a physician's order, you should talk with your doctor if you are interested in having this screening. Your doctor will determine your eligibility for screening and refer you to our clinic if appropriate.

LDCT is recommended for:

  • People between 50 and 77 years old
  • People who have at least a 20 pack-year smoking history
    • Pack years calculation: (# of packs smoked per day) x (# of years smoking) = pack-year smoking history
  • People who are either still smoking or have quit smoking within the last 15 years and are asymptomatic, meaning they have no symptoms of lung cancer

Patients with symptoms of a lung condition at the time of the screening, such as a new cough or shortness of breath, are not eligible for LDCT screening.

Pulmonary nodules

Pulmonary nodules can become indicators of the presence of lung cancer. A nodule is a small, round-or-oval-shaped growth in the lung, also known as a “spot” or “coin lesion.”

Pulmonary nodules are smaller than three centimeters in diameter (approximately 1.2 inches). However, if the growth is any more significant, it is referred to as a pulmonary mass. These are more likely to represent cancer rather than a nodule. Over 90 percent of pulmonary nodules smaller than two centimeters in diameter (approximately 3/4 inch) are benign.

Types of pulmonary nodules

The two primary types of pulmonary nodules are malignant (cancerous) and benign (noncancerous). In addition to old age, smoking is a major cause of malignant pulmonary nodules. As such, the best way to avoid getting one is to forgo smoking or quit if you are already a smoker.

Benign pulmonary nodules can have a wide variety of causes. Many are the result of inflammation in the lungs caused by an infection or underlying disease. Alternatively, these nodules can represent an active process or scar tissue as a result of prior inflammation.

How common are pulmonary nodules?

Many pulmonary nodules are discovered each year during imaging exams and are referred to as "incidental findings." However, most nodules are benign and thus noncancerous. While solitary pulmonary nodules are found on only up to 0.2 percent of all chest X-ray films, they can also be found on up to half of all lung CT scans.

Pulmonary nodule symptoms

Typically, there are no symptoms associated with pulmonary nodules. If present, signs would be related to the condition that led to the nodule developing. If an otherwise healthy patient develops a new cough or coughs up blood, the nodule could be from lung cancer.

Most of the time, patients will not know they have a lung nodule until an imaging exam is performed. A variety of testing options can be used to detect nodules, including:

  • Chest X-rays and CT scans — These tests are usually performed when patients see their doctor for a respiratory illness. If there is the possibility for a pulmonary nodule, your doctor will ask about your medical history, including whether you previously had cancer. After an X-ray, your doctor may recommend that you undergo a CT scan to obtain a more detailed image of the nodule.
  • Positron emission tomography (PET) scans — This test captures an image of the nodule's metabolic activity level through the use of a radiolabeled substance, such as glucose. The nodule then absorbs this substance to illuminate any potential complications. Nodules can light up on PET scans if they are malignant or if there is active inflammation.
  • Biopsy — This test involves a small tissue sample being removed from the nodule by a needle so it can be examined under a microscope. When other tests are deemed inconclusive, a biopsy may be performed to rule out the possibility of malignant growth. A pulmonologist may also perform a bronchoscopy (biopsy that inserts breathing tubes into the windpipe to reach the nodule) a needle biopsy, which inserts a needle through the chest wall and into the nodule or endobronchial ultrasound (EBUS), a test that inserts a flexible tube through your mouth and into your lungs.

If any of these tests are ruled inconclusive, or the nodule has a concerning appearance or growth pattern, surgery may become necessary. One of our distinguished pulmonary disease specialists can assist you in determining the best course of treatment.

Pulmonary nodule treatment

If the pulmonary nodule is benign, it likely will not require treatment. If an active infection or disease is found, treatment would be based on the condition identified and any present symptoms.

If the nodule is malignant, but the patient is fit and there is no appearance of cancerous spread, then the cancer should be surgically removed. If there is a high concern for malignancy and a nonsurgical biopsy is deemed inconclusive, it is also recommended that the nodule be removed.

Surgical techniques to remove pulmonary nodules include:

  • Thoracotomy — This procedure is considered open lung surgery, and is performed by making a cut in the chest wall to remove pieces of diseased lung tissue. While the mortality risk is low, patients usually need to remain in the hospital for a few days after the operation.
  • Video-assisted thoracoscopy — This procedure utilizes a thoracoscope, a flexible tube with a miniature camera on its end. The thoracoscope is inserted through a small cut into the chest wall and allows the surgeon to view an image of the nodule on a television screen. This technique requires a smaller cut and a has shorter recovery time than a traditional thoracotomy.