A man in his late 60s enters a lung cancer screening program and is found to have a 4.5 cm tumor—stage II by size, with high-stakes decisions ahead. The case seems to point toward modern perioperative therapy, until biomarker testing changes everything. In this episode, host Lisa Moores, MD, FCCP, is joined by CHEST Guideline Chair John Howington, MD, MBA, FCCP, and oncologist Natasha Leighl, MD, to show how multidisciplinary care—and molecular results—can reroute the entire treatment journey.

They discuss why nodal staging matters, when perioperative therapy improves outcomes, and how biomarker-driven choices can reshape the safest path, while still leaving room for shared decision-making.

Faculty

• Host: Lisa Moores, MD, FCCP

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

• Case Guest: Natasha Leighl, MD

A woman in her early 60s, who never smoked in her lifetime, is diagnosed with stage II lung cancer after an abnormal chest X-ray—and believes surgery has ended the story. But postoperative pathology and molecular testing open a new chapter of therapy designed to lower recurrence risk. In this episode, host Lisa Moores, MD, FCCP, is joined by CHEST Guideline Chair John Howington, MD, MBA, FCCP, and medical oncologist Natasha Leighl, MD, to unpack how stage II decisions continue long after the operating room.

They explore how staging and lymph node assessment shape what comes next; how targeted therapy can fit into survivorship; and how to counsel patients weighing work, travel, side effects, and the emotional whiplash of “I’m cured… unless I’m not.”

Faculty

• Host: Lisa Moores, MD, FCCP

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

• Case Guest: Natasha Leighl, MD

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