Most lung nodules are completely benign. A proportion require assessment, and a smaller proportion need treatment. Where surgery is the right answer, Dr Lawrence Okiror, Consultant Thoracic and Robotic Surgeon (GMC 6150382), performs it using robotic keyhole technique at London Bridge Hospital and GSTT in the vast majority of cases — 153 lung cancer operations in 2024–25, with a 99.59% operative survival rate independently verified by the SCTS National Audit. Where cancer is found, every case is discussed with a specialist team before any decision is made. Private appointments within 2–3 days.
Last reviewed: May 2026 · Dr Lawrence Okiror FRCS(CTh) FRCSEd(CTh) · GMC 6150382
The majority of lung nodules found on CT scans are entirely harmless — old infection, scar tissue, or benign growths. Most patients who come for assessment leave with reassurance and a monitoring plan, not a diagnosis of cancer. The goal is clarity, not reflexive intervention.
Stage I lung cancer has an 80–90% five-year survival rate. Stage IV is below 10%. The difference is entirely determined by when it is found. Finding a cancer when it is still small enough to see on a scan — before symptoms appear — is when surgery is most likely to be curative.
Every cancer case is discussed with a multidisciplinary team of specialist oncologists at the London Bridge Hospital chest MDT, attended fortnightly by Dr Okiror. Urgent cases have direct access to specialist colleagues between meetings. No treatment plan is made by a single doctor alone.
A pulmonary nodule is a small, rounded area of dense tissue in the lung — typically under 3cm — that shows up as a white spot on a CT scan. It is one of the most common incidental findings in modern imaging, often discovered when a scan is done for an entirely different reason.
The causes range from entirely harmless to requiring treatment. Old infections leave small scars. Inhaled dust particles can calcify over decades. Benign growths such as hamartomas are common. These account for the vast majority. A smaller proportion of nodules turn out to be primary lung cancer, a metastatic deposit from another cancer, or a carcinoid tumour.
A single CT scan cannot always tell the difference with certainty. What it can do is provide the raw material for a proper specialist risk assessment. Nodule size, density, shape, location, and your personal risk profile are all inputs into a validated scoring system that gives an evidence-based probability of malignancy — not a guess.
Low-risk nodules are monitored with CT scans at agreed intervals — typically 3, 6, or 12 months — to confirm stability. A nodule that does not change over 2 years is almost certainly benign and can be confidently discharged. This is the most common outcome.
Where a tissue sample is needed to confirm what the nodule is, ION navigational bronchoscopy can reach nodules in the outer lung without surgery — giving a tissue diagnosis the same day, without an incision. Full ION biopsy page →
Where the nodule is almost certainly cancer, or where biopsy has confirmed it, surgical removal is the definitive curative treatment. Robotic keyhole surgery at London Bridge Hospital achieves the same oncological result as open surgery with significantly faster recovery. Full surgery page →
Not every nodule needs to come out. These are the situations where surgical assessment or surgical removal is the right next step — not because surgery is the default, but because the clinical picture makes it the most appropriate option.
A nodule that has grown between two CT scans has changed risk category, regardless of its initial score. Growth is the clearest sign that a nodule is not stable. The time to act is before the next scan cycle, not after the following one confirms it again.
Spiculated margins (irregular, spiked edges), part-solid or ground-glass density, upper lobe position, and size above 6mm in a solid nodule are all associated with higher malignancy probability. These features together warrant specialist assessment even without growth.
Where biopsy has confirmed lung cancer, surgical removal is the primary curative treatment for Stage I and II disease. The operation removes the cancer and the surrounding anatomical area of lung, with lymph node assessment to confirm complete clearance.
In some cases — a nodule that has grown, has highly suspicious features, and sits in an area difficult to biopsy safely — the probability of cancer is high enough that proceeding directly to surgical removal is the right clinical decision. The operation is both diagnosis and treatment.
Nodules found through the NHS Lung Cancer Screening Programme or targeted lung health checks require rapid specialist MDT assessment. Screen-detected cancers are overwhelmingly early-stage and highly treatable. Speed of assessment and treatment is the priority.
A patient who has completed multiple surveillance scans and remains significantly anxious is not being optimally managed. A single specialist surgical assessment often either provides the clinical authority to reassure definitively, or confirms that the right next step is action rather than another scan.
Every cancer case is discussed with a multidisciplinary team of specialist oncologists at the London Bridge Hospital chest MDT, which Dr Okiror attends fortnightly. Where a case needs urgent discussion, Dr Okiror has direct access to specialist colleagues outside the formal MDT — so no patient waits a fortnight for a decision that cannot wait. The MDT brings together the thoracic surgeon, oncologist, radiologist, and pathologist. No treatment plan is agreed without that consensus.
Where a cancer is found to be non-surgical — best managed by oncology, targeted therapy, or radiotherapy — Dr Okiror refers directly to the appropriate specialist colleague at GSTT or London Bridge Hospital. The goal is the right treatment for the patient, not the surgical one.
153
Personal anatomic resections 2024–25
99.59%
Operative survival rate vs 98.5% national
80%+
Operations by robotic or keyhole technique
6%
Wedge resections vs 14% national average
Source: SCTS National Thoracic Surgery Audit 2024–25 · Personal data 2024–25
In the last SCTS audit, Dr Okiror performed 1 in every 60 lung cancer operations across the UK.
Every element of the lung nodule journey is handled by the same consultant at the same institutions. Each page below covers one step in depth.
Symptom
What a shadow means, what the Brock score looks at, and what to expect at the first assessment appointment. The reassurance entry point for patients who have just received a scan result.
Read more →The Pathway
The complete integrated pathway from first scan result to definitive treatment. Covers the national screening context, the 53-day bottleneck on the NHS pathway, and how the private pathway compresses that to days.
Read more →Diagnosis & Biopsy
How ION reaches nodules in the outer lung without surgery. ROSE cytopathology in the procedure room. ICG dye marking for surgical guidance. London Bridge was the first centre in Europe to offer this outside NHS trials.
Read more →Surgery
The surgical detail: da Vinci FireFly infrared localisation, segmentectomy vs lobectomy, lymph node dissection, recovery, and the clinical evidence base. The UK's highest-volume robotic thoracic programme.
Read more →Questions most commonly asked by patients and family members following a lung nodule finding or lung cancer diagnosis.
Book a Consultation →Or call Jo Mitchelson:
020 7952 2882
Private appointments at London Bridge Hospital within 2–3 days. Dr Okiror reviews all imaging personally and gives a clear, honest assessment at the first appointment. Most patients leave knowing exactly what happens next.
Jo Mitchelson, Private PA · 020 7952 2882 · pa@lungsurgeon.co.uk
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