This case presentation summarizes a 50-year-old male businessman who has been coughing off and on for 5 months. His past medical history includes pneumonia after a biopsy, lung cancer previously treated with chemotherapy and radiation, and anxiety. A physical exam and lab/image studies were performed. The diagnosis is recurrent lung cancer that has spread to lymph nodes. The plan is to perform surgery tomorrow to remove the upper right lobe of the lung. The patient was informed of the surgical risks and alternatives.