Grace is a 50-year-old woman working full-time and busy with her family. She has been feeling exhausted lately and feels like she may have had fevers on and off. She is having difficulty finding the energy to coach her daughter's early-morning hockey games. At the urging of her partner, she sees her family physician who notes that she is afebrile with mild dyspnea and a cough, having faint crackles on the right side of her chest. Suspecting pneumonia, her physician sends Grace for a chest x-ray and she is given an antibiotic prescription to treat community-acquired pneumonia. The x-ray report described a density in the right lower lung zone, and Grace starts her medication with follow up in 3 weeks. When she returns, she mentions that she finished the course of antibiotics but that they “did nothing” and that she feels a bit worse actually. Her exam is unchanged, but given that she has a 30 pack-year smoking history, her physician orders a repeat chest x-ray. This shows mild interval growth of the original opacity. This time, the radiologist states that the area is suspicious for possible malignancy. On further history, Grace was treated for Hodgkin's lymphoma at the age of 18, for which she received 3 cycles of ABVD chemotherapy followed by radiation to the mediastinal lymph nodes. She has been “cancer free” and completely well since, so much so that she stopped going to her AfterCare follow-up appointments. Grace grew up in a middle-class suburban neighbourhood and completed a geosciences degree at a local university. She has spent the last 20 years working for a mining company evaluating many different ore samples. She frequently deals with silica ores and metal-based ores, including iron, nickel, chromium, zinc and aluminum. She wears an N95 dust mask when handling the samples. Grace comes from a family of heavy smokers. Grace's father died 5 years ago from bladder cancer. Her paternal uncle, also a smoker and a heavy consumer of alcohol, had previously died of a throat cancer. Her older sister, yet another smoker, had cancer of the cervix treated successfully with radiotherapy. Due to the x-ray findings, Grace is sent for a CT scan of her chest. This confirms a 2.5 cm lesion in the central right lower lobe well away from the chest wall and the hilum.