Dear Dr. Roach: Is it possible for X-rays and a CT scan to miss advanced lung cancer? My brother worked two days before he died. He went to the hospital, was admitted to hospice and died the next day. I wonder if he knew at least a year ago, but didnt tell anyone. He said his scans showed pneumonia. His son was called to the hospital and spent the day with him until he died. During his last day, my brother told him that he had lung cancer and that it was not diagnosed earlier. N.W.
Answer: I am very sorry about your brother.
Lung cancer, especially early lung cancer, is often missed on a regular chest X-ray. Pneumonia can accompany early lung cancer, and the pneumonia can hide the cancerous mass, but experienced radiologists should be able to see something. Also, experienced clinicians should check an X-ray weeks after a pneumonia to be sure there is no cancer in a person at risk, such as a current or former smoker.