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The biopsy surgery usually can be done through three small incisions in the side of the chest in a procedure called video-assisted thoracic surgery (VATS). In VATS, a doctor inserts a tube (with a camera and light attached) through one of the incisions into the space between the lungs and the chest wall. The camera sends an image to a monitor that the doctor uses as a guide to take biopsy samples using instruments inserted through the other two incisions.

Lung Function Tests

Lung function tests (also called pulmonary function tests or spirometry) are a series of tests used to diagnose and monitor respiratory problems. These tests, which are administered by technicians, measure the amount of air the lungs hold, how effectively the lungs work, and the maximum air flow in a person’s breathing.

• Forced vital capacity Forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) measure the total volume of air exhaled (the FVC test) and the volume of air exhaled in 1 second (the FEV1 test) using a spirometer. To measure FVC or FEV1, you inhale and then exhale into the spirometer as hard and as quickly as you can for as long as you can. You repeat each test three times; the highest readings are your FVC or FEV 1 values. Your spirometer readings are compared with values based on age, sex, and body size from a standard table. FEV1 is normally 75 to 80 percent of FVC.

• Peak expiratory flow Peak expiratory flow (PEF) measures the degree of narrowing of your airways using a handheld device called a peak flow meter. To measure PEF, you inhale and then exhale into the meter as hard as you can. You do this three times; the highest reading is your PEF value. The result is normal if the highest value is 80 percent of the normal predicted value. This test is less accurate than FEV1.

Treatment

If you have lung cancer, stop smoking now (see page 29). Doing so may help slow or even stop the growth of the tumor. The treatment of lung cancer depends on the type of cancer, the location and size of the tumor, and your age and general health. Surgical removal of the tumor is the most effective treatment if the cancer is not too advanced and if you have no other health problems such as chronic bronchitis (see page 655) that would affect your breathing. The surgeon may remove all or part of your lung. Radiation therapy (see page 23) and chemotherapy (see page 23) may slow the growth of the tumor and may help relieve symptoms, but these treatments rarely cure lung cancer. Remission (a partial or complete disappearance of symptoms) that follows treatment may last months or years.

Infections of the Respiratory Tract

Most infections of the respiratory tract are caused by viruses or bacteria. Upper respiratory tract infections affect the nose, throat, sinuses, and larynx (voice box). Lower respiratory tract infections affect the trachea (windpipe) and lungs.

Colds

Approximately 200 different viruses can cause the common cold. In most cases, the virus that causes a cold is confined to the nose and throat. Sometimes a cold virus travels to other parts of the respiratory tract, such as the larynx (voice box) or lungs, causing other infections, such as laryngitis or acute bronchitis. A cold virus can also lead to a bacterial infection, which can have more severe symptoms. The bacteria can travel to the ears, sinuses, or airways in the lungs and cause infection.

Usually, you catch a cold by touching an infected person or contaminated surface or by inhaling infected droplets coughed or sneezed into the air. A sneeze or a cough from a person with a cold can spread virus-containing droplets up to 10 feet away. Most people have their first cold by the time they are 1 year old. With each cold, you develop lifelong immunity to that particular cold virus. Because most people acquire more immunity as they grow older, they tend to get fewer colds and have less severe symptoms when they do get colds.

Symptoms

To some extent, the symptoms of a cold depend on the cold virus that caused it. Symptoms can include watery