How to manage lung cancer in older adults?

Question

my dad quit smoking about 8 months ago after smoking for nearly 22 years and we just found out last week that his CT scan showed some suspicious nodules in his left lung. the pulmonologist said its too early to confirm lung cancer but wants to do a PET scan next. hes 54 and his spirometry results came back with an FEV1 of 68% which the doctor said isnt great. we are really worried because his uncle died from lung cancer at 57 and the genetic history scares us. he smoked atleast a pack a day and only quit after developing that persistent cough that wouldnt go away for 3 months. the oncologist hasnt been consulted yet but our family doctor mentioned that quitting smoking earlier could have changed outcomes. his CEA levels came back slightly elevated at 5.8 ng/mL and we dont know what that mean for his situation. can quitting smoking this late still prevent lung cancer death or slow it down? is there any treatment or monitoring that helps someone in his position who already quit but maybe too late? please help us understand what we facing here.

Answer 1

Hello. Thank you for your query. First, it is very good that your father stopped smoking. Even after many years of smoking, quitting still has important benefits. In clinical practice we see that stopping smoking reduces further lung damage and improves overall health. It can also improve treatment outcomes if any lung disease, including cancer, is diagnosed. At this stage, the CT scan has only shown suspicious nodules, which does not automatically mean lung cancer. Many lung nodules are caused by infections, inflammation, or old scars in the lung. The PET scan your doctor advised is the correct next step because it helps determine whether these nodules are active and whether further testing such as a biopsy is needed. An FEV1 of 68% suggests some degree of airflow limitation, which is commonly seen in long-term smokers and may indicate chronic lung disease. This does not confirm cancer. The CEA value you mentioned is only mildly elevated and by itself cannot diagnose lung cancer, as it can also be slightly raised in smokers or other non-cancerous conditions. Regarding your concern about family history, most lung cancers are related to smoking and environmental exposures rather than strong inherited genetic factors. A relative with lung cancer does not necessarily mean your father will develop the same disease. Quitting smoking now is still very important and can reduce the risk of further lung damage and future complications. The most important step at this stage is completing the PET scan and following your doctor’s advice regarding further evaluation so that the exact cause of the lung nodules can be determined.