Diagnosing Lung Cancer
Dr. Farrah strives to confirm the most accurate diagnosis and staging of your tumor.
In addition to a complete medical history to check for risk factors and symptoms, and a physical examination to provide other information about signs of lung cancer and other health problems, procedures used to diagnose lung cancer may include:
What Is a Chest X-Ray?
A chest X-ray is a type of diagnostic radiology procedure used to examine the chest and the organs and structures located in the chest. Chest X-rays may be used to assess the lungs, as well as the heart (either directly or indirectly) by looking at the heart itself. Certain conditions of the heart may cause changes in the lungs and/or the vessels of the lungs.
Chest X-rays are used to assess the lungs and heart including enlargement, masses, spots, or to help show whether cancer has spread into the lungs. A chest X-ray can see changes in the normal structure of the heart, lungs, and/or lung vessels like extra blood flow, which may indicate disease or other conditions.
Chest X-rays use invisible X-ray beams to produce images that provide important information regarding the size, shape, contour, and anatomic location of the heart, lungs, bronchi, great vessels (aorta, aortic arch, pulmonary arteries), mediastinum (an area in the middle of the chest separating the lungs), and the bones (cervical and dorsal spine, clavicles, shoulder girdle, and ribs).
Depending on the results of the chest X-ray, additional tests or procedures may be requested by your physician for further diagnostic information.
Other related procedures that may be used to diagnose problems of the chest and respiratory tract include:
- Chest fluoroscopy
- Chest ultrasound
- Computed tomography (CT scan) of the chest
- Lung biopsy
- Lung scans
- Positron emission tomography (PET scan) of the chest
- Pleural biopsy
- Sinus X-rays
- Pulmonary angiogram
Low-dose spiral CT scan
Low-Dose Spiral CT Scan
The low-dose spiral CT scan is one of the most advanced computer-aided diagnostic systems available for screening for lung cancer in high-risk individuals.
PET (Positron Emission Tomography) Scan
A PET scan is a type of nuclear scan that monitors the biochemical functioning of cells by detecting how they process certain compounds, such as glucose (sugar). Cancer cells metabolize glucose at a much higher level than normal tissues. This technique can be helpful in determining whether a lung nodule is in fact cancerous or not, although it is not 100% reliable. It has become the most sensitive way to determine if lung cancer has spread outside the chest, and if the lymph nodes have become involved with cancer spread.
A sputum cytology is a diagnostic test performed on the material that is coughed up from the lungs and into the mouth. The cells are viewed under a microscope and helps determine if an infection is present.
During a needle biopsy, a thin, hollow needle is guided into the mass while the lungs are being viewed on a fluoroscopy or CT scan, and a sample of the mass is removed and evaluated in the pathology laboratory under a microscope. This is most useful in trying to diagnose lung cancer when the tumor is located peripherally in the lung.
A bronchoscopy is the examination of the bronchi (the main airways of the lungs) using a flexible tube (bronchoscope) passed down the mouth or nose. Bronchoscopy is a good means to obtain samples of tissue to try to make a diagnosis of cancer when the tumor is located centrally, near the middle of the lung.
EBUS with TBNA
Endobronchial Ultrasound (EBUS) with Transbronchial Needle Aspirations (TBNA)
Endobronchial ultrasound (EBUS) with transbronchial needle aspirations (TBNA) is a newer procedure that allows lymph node biopsy from inside the airway using a bronchoscope. It is an alternative to mediastinoscopy.
Mediastinoscopy is a process in which a small cut is made in the neck so that a tissue sample can be taken from the lymph nodes (mediastinal nodes) along the windpipe and to evaluate for spread of tumor to the lymph nodes.
This is a procedure in which 2-3 small cuts are made in the side of the chest wall to allow your physician to look at the outer part of the lungs and chest wall, and sample any abnormal areas for viewing under a microscope. For a small, peripherally placed lung nodule, this is often the most efficient way to establish a diagnosis and also often perform the definitive operation.
Lung Cancer Staging
When lung cancer is diagnosed, tests will be done to find out if the cancer has spread from the breast to other parts of the body. This is called staging, and is an important step toward planning a treatment program.
- Stage I: Single tumor in lung
- Stage II: Tumor plus lung (hilar) lymph nodes
- Stage III: Tumor plus chest (mediastinal) lymph nodes
- Stage IV: Spread to organs (lungs, liver, adrenal gland, bone, brain)