title: Slow-growing lung cancer as an emerging entity: from screening to clinical management.
abstract: The current paradigm is that untreated lung cancer is invariably and rapidly fatal, therefore the medical community normally dismisses the idea that a patient could live with such a disease for years without any therapy. Yet evidence from lung cancer screening research and from recent clinical series suggests that, although rarely recognised in routine practice, slow-growing lung cancers do exist and are more common than previously thought. Here, current evidence is reviewed and clinical cases are illustrated to show that slow-growing lung cancer is a real clinical entity, and the reasons why management protocols developed in the screening setting may also be useful in clinical practice are discussed. Features suggesting that a lung cancer may be slow-growing are described and appraised, areas of uncertainty are examined, modern management options for early-stage disease are evaluated and the influence that all this knowledge might have on our clinical decision-making is weighed. Further research directed at developing appropriate guidelines for these peculiar but increasingly common patients is warranted.
authors.affiliation: IRCCS Istituto Clinico Humanitas, Milan, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Infante
authors.forename: Thierry
authors.initials: T
authors.lastname: Berghmans
authors.forename: Marjolein A
authors.initials: MA
authors.lastname: Heuvelmans
authors.forename: Gunnar
authors.initials: G
authors.lastname: Hillerdal
authors.forename: Matthijs
authors.initials: M
authors.lastname: Oudkerk
mesh_terms: D003657:Decision Making; D018450:Disease Progression; D055088:Early Detection of Cancer; D006801:Humans; D021621:Imaging, Three-Dimensional; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D055613:Multiple Pulmonary Nodules; D011379:Prognosis; D012306:Risk; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome