Lung Cancer Staging: A Tutorial for the Macintosh

Lung Cancer Staging: A Tutorial for the Macintosh is an easy-to-use program, developed by Friedman and Dana Software, that is designed to facilitate understanding of the complicated lung cancer staging system. The program takes advantage of the interactional capabilities of computer learning combined with the user friendliness of Apple computers to produce a valuable teaching aid. The purpose of the program is to assist in the understanding and learning of the 1986 TNM (tumor/node/metastasis) Classification for the staging of non-small cell lung cancer and the 1988 modification of the American Thoracic Society Classification of lymph node regions. The program is divided into tutorials, quizzes, and management, all of which utilize computer representations of computerized tomography anatomy to facilitate comprehension. The tutoring division of the program is broken down into TNM, stage, and node groups components. The TNM tutor provides an introduction to the TNM classification , leading the user through the definitions of gradations of tumor, node, and metastasis and demonstrating these gradations anatomically. The stage tutor is a logical progression, following the TNM tutor as it demonstrates the various combinations of tumor, node, and metastasis that comprise the stages of lung cancer. The node groups tutor outlines the complicated nodal classification scheme as adopted by the American Thoracic Society. All tutors simultaneously show both frontal and transverse plane anatomy in addition to the formal definition being described. This visual reinforcement of the classification systems is the most valuable asset of the program. It allows the operator to see anatomically the various possibilities that exist for each stage of lung cancer or nodal pattern. Two helpful features are that thoracic anatomy can be readily viewed at any cross-sectional level and that, by clicking to another screen, the cross section is enlarged with anatomical labels provided. Once the classification schemes have been mastered using the tutorials, TNM and node quizzes are available to test expertise. These quizzes anatomically display a randomly selected tumor stage or node pattern for the operator to identify correctly. The quizzes help to consolidate the information acquired from the tutorials. The final section of the program discusses management of the various stages of lung cancer. Although this portion is not interactive, it is particularly helpful because it describes how management options vary depending on the surgical aggressiveness of the clinician. The management considerations do not take into account concurrent illness, tumor histology, or other factors that influence …