There was a spot on Joanne Spiegel''s chest x-ray.

Joanne Spiegel, then 71, of Chesterfield, Mo., felt fine and still worked regularly. But she and her primary care physician agreed that Joanne needed to have the spot on her right lung checked out immediately.

Joanne was referred to a surgeon. The surgeon looked the x-rays and performed a bronchoscopy, then told Joanne she had cancer and scheduled surgery. But in the operating room, the surgeon found the case more complicated than expected.

"He told me to see an oncologist, because I couldn''t have surgery," Joanne said.

But before Joanne sought an oncologist, her son discussed her case with one of his friends, a physician at Barnes-Jewish Hospital who encouraged Joanne to seek a second opinion. Joanne made an appointment with pulmonologist John Wood, MD, a member of the voluntary faculty of Washington University School of Medicine.

Dr. Wood examined Joanne, and after studying her x-rays and test results, told her that her cancer might indeed be operable. He sent Joanne to the Washington University thoracic surgery team at Barnes-Jewish Hospital.

There she met with Alec Patterson, MD, head of thoracic surgery and surgical director of lung transplant. Dr. Patterson and the thoracic surgery team — Richard Battafarano, MD, PhD, and Bryan F. Meyers, MD — are known worldwide for their skill and innovation in thoracic surgery. Backed by resources including dedicated thoracic imaging radiologists at the Mallinckrodt Institute of Radiology, thoracic surgery clinical nurse specialists and the pulmonology department at Washington University School of Medicine. This expertise allows the thoracic surgery team to offer a second opinion service.

At their first meeting, Dr. Patterson was able to tell Joanne she was a candidate for surgery.

"He looked at the x-rays and said, ''I can take care of that,''" she said. "It was a relief."

After a complicated lobectomy that involved reconstructing the pulmonary artery, Joanne remains cancer free and has returned to her active life, working and going out with family and friends.

"I can''t say enough about Dr. Patterson," Joanne said.