As a medical oncologist, I would like to express my views on the diagnosis and treatment of lung nodules and early-stage lung cancer. Due to the promotion and popularization of lung cancer screening in China and the increasing awareness of the people, the number of patients with lung nodules and early stage lung cancer has been increasing in the last two years. First of all, we must make a clear diagnosis, and in this regard, thin-section CT scan has a very important position, and the recommendation of an experienced imaging physician plays a decisive role in the choice of treatment plan and cannot be ignored. For malignant nodules, I think the current status of surgery is all other treatment modalities can not be shaken, 90% of stage IA1 patients can live past five years, 85% of stage IA2 patients can live past five years, 80% of stage IA3 patients can live past five years, 73% of stage IB patients can live past five years, 65% of stage IIA patients can live past five years, 56% of stage IIB patients can live past five years. There is no doubt that the five-year survival of stage I patients is over 70%, and the five-year survival of stage 1Ai patients is over 90%, while other treatment modalities cannot achieve such treatment effect. The treatment of tumor is developing rapidly and the demand for survival is getting higher and higher! Especially in recent years, the development of precision targeted and immunotherapy has brought hope of cure to many lung cancer patients. Even for advanced lung cancer, if there is a mutation, the 5-year survival rate of targeted therapy is already at 50%, and the median survival of advanced patients with ALK is more than 80 months, therefore, the goal of early lung cancer treatment is eradication and long-term survival, and 5-year survival is no longer our goal. In a recent article published by JCO, more than 100 cases of early-stage lung cancer were treated with radiotherapy with very good results, and the status of radiotherapy in the treatment of early-stage lung cancer is rising, which I think is a good thing and another option for patients. But I also want to emphasize that this article should not be read too much into it! What is the five-year survival rate for radiation therapy for early-stage lung cancer in this article? It’s 5O%, that’s right, 50%! Whereas surgery is 70% and can even reach 90%! The goal of early stage lung cancer treatment is not only 5 years survival, but l0 years, 20 years or even cure, besides, the majority of early stage lung cancer patients are young and middle-aged patients, 50-60 years old is the main group, long-term survival and cure for this group is the goal! In recent years, interventional ablation treatment for lung cancer has been developing by leaps and bounds, which has indeed brought survival benefits to many patients, and individual cases have reached the possibility of cure, which is one more option for early stage lung cancer patients! However, there is a lack of clinical evidence for interventional ablation for early-stage lung cancer in a large sample, so if surgery is ruled out in favor of interventional ablation at the beginning, it is too early to draw a conclusion and more evidence is needed to prove it! In conclusion, for early-stage lung cancer, surgery is still the first choice. For patients who cannot or do not want to undergo surgery, radiotherapy and interventional ablation are both alternative options that can be considered instead of hand wood.