Lung Cancer Diagnosis
If you are worried that you have symptoms of lung cancer, make an appointment with your general practitioner. Your doctor will evaluate your me...
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Lung Cancer Diagnosis
Make an appointment with your doctor
if you think you have symptoms of lung cancer. They will evaluate your medical
history, assess any risk factors you have, and perform a physical
examination. Your doctor may then refer you to a specialist for additional
Because lung cancer testing can be invasive,
it’s debated in the medical community whether or not general screening for lung
cancer is beneficial. Some believe it puts the patient at unnecessary risk.
Since people don’t usually exhibit symptoms until the disease has advanced,
others think it is the key to catching lung cancer in the early, more treatable
stages. Your doctor will most likely recommend testing only if there is cause
to believe you might have lung cancer.
Your doctor will check your vitals, listen to
your breathing, and check for a swollen liver or lymph nodes. You will likely
be sent for testing if lung cancer is suspected. There are various methods that
can be used.
Computed Tomography Scan
A computed tomography (CT) scan is a special
kind of X-ray that takes several internal pictures as it rotates around your
body. This provides a more complete picture of the size, shape, and location of
any possible tumors.
A thin, lighted tube (bronchoscope) is
inserted through your mouth or nose into your lung to examine the bronchi and
lungs. A cell sample may be taken for examination.
Sputum, or phlegm, is a thick fluid coughed up
from the lungs. A sample of sputum is sent to the lab for a microscopic
examination for any cancer cells.
Imaging tests can detect masses or tumors, but
they cannot determine if they are benign or malignant. Based on preliminary
findings, your doctor may order a biopsy of the lung tissue to check for
cancerous cells. This biopsied tissue is sent for examination by a pathologist.
There are several methods of lung biopsy.
- thoracentesis: A long needle is
used to take a sample of fluid (pleural effusion) between the layers of tissue
that line your lung.
- fine-needle aspiration: A
thin needle is used to remove a tissue or fluid sample from your lungs or lymph
- thoracosopy: Small incisions are
made in your chest and back to examine tissue with a thin tube.
- mediastinoscopy: The doctor will
insert a thin, lighted tube through a small incision at the top of your
breastbone to take tissue and lymph node samples.
- thoracotomy: The chest is opened
with a long incision to remove lymph node and other tissue for examination.
- endobronchial ultrasound: This procedure uses sound waves to guide a bronchoscope down
your windpipe to locate and photograph tumors. If present, samples from the
areas in question will be taken for biopsy.
Testing for the Spread of Lung Cancer
Other tests may be required to locate where
the cancer may have spread (metastasis).
- MRI (magnetic resonance imaging): This is an imaging test that uses magnets and radio waves
instead of radiation. This test is often used in cases when lung cancer is
suspected to have spread to the brain or spinal cord.
- PET (positron emission tomography) scan: A PET scan is a
procedure that sends sugar containing a radioactive atom into your
body. Cancer cells consume the sugar and a special camera locates the
radioactivity, creating 3-D color images.
- bone scan: A trace amount of radioactive material is injected into a
vein. The radioactive material will build up in any abnormal bone. This test is
only done in cases where the cancer is suspected to have spread to the bones.
Stages of Lung Cancer
Once you have completed testing and received a lung
cancer diagnosis, the next step is to categorize the cancer by stage. The stage describes the progression or extent of the cancer. This will help your doctor determine
which treatment is best for you. Keep in mind that staging does not necessarily
indicate the likely course and outcome (prognosis) of your lung cancer. Your
prognosis depends on your overall health, strength, other health conditions, and response to treatment.
Lung cancer is usually classified as either
small cell lung cancer or non-small cell lung cancer.
Small Cell Lung Cancer
Small cell lung cancer is
described in two stages — limited and extensive:
- limited: This type of cancer is confined to the chest. It’s usually
just in one lung, and neighboring lymph nodes. It can be treated with
chemotherapy and radiation therapy.
- extensive: This type of cancer has spread to both
lungs and other
parts of the body and is treated with chemotherapy and supportive care.
The patient may be a candidate for a clinical trial, used to evaluate the
efficacy and safety of new drugs.
Non-Small Cell Lung Cancer
- occult stage:
Lung cancer cells are
found in sputum or in a sample collected during a test, but there is no
sign of a tumor in the lungs.
- stage 0: Cancer cells are found
only in the innermost lining of the lung and the cancer is not invasive.
- stage 1A: Cancer is found in the
innermost lining of the lungs and in deeper lung tissue. The tumor is not
more than 3 centimeters across and has not invaded the bronchus or the
- stage 1B: Cancer has grown larger
and deeper into the lung tissue. The tumor has grown through the lung into
the pleura, is more than 3 centimeters in diameter, or has grown into the
main bronchus. The cancer has not yet invaded the lymph nodes. Surgery and
sometimes chemotherapy is used to treat lung cancers in stage 1A/1B.
- stage 2A: Cancer is less than 3
centimeters in diameter but has spread to the lymph nodes on the same side
of the chest as the tumor areas.
- stage 2B: The
lung cancer has not spread to the lymph nodes but has grown into the chest
wall, main bronchus, pleura, diaphragm, or heart tissue. This stage can
also mean that the cancer has spread to the lymph nodes and one of the
following is true: the tumor is more than 3 centimeters in diameter, the
tumor has grown into the bronchus, or the tumor has grown into the pleura.
- stage 3A: The tumor is any size,
and the cancer has spread to the lymph nodes in the center of the chest,
but on the same side as the tumor. This stage is treated with a
combination of chemotherapy and radiation.
- stage 3B: The tumor can be any
size. The lung cancer has invaded the lymph nodes on the opposite side of
the chest and neck and possibly the heart, major blood vessels, or
esophagus. This stage is treated with chemotherapy and sometimes
- stage 4: The lung
cancer has spread to other areas of the body, likely the adrenal glands, liver,
bones, and brain. This stage is treated with chemotherapy and supportive
(or comfort) care. The patient may be a candidate for a clinical trial,
used to evaluate the efficacy and safety of new drugs.
the Healthline Editorial Team
Medically Reviewed by:
Jul 27, 2010
Published By: Healthline Networks, Inc.