Diagnosing Lung Cancer

06 Apr, 2021

Dr. Rajesh Bollam

After a physical examination, your doctor will tell you how to prepare for specific tests, such as:

Imaging tests: An abnormal mass can be seen on X-ray, MRI, CT, and PET scans. These scans produce more detail and find smaller lesions.
Sputum cytology: If you produce phlegm when you cough, microscopic examination can determine if cancer cells are present.

A biopsy can determine if tumor cells are cancerous. A tissue sample can be obtained by:

Bronchoscopy: While under sedation, a lighted tube is passed down your throat and into your lungs, allowing closer examination.
Mediastinoscopy: The doctor makes an incision at the base of the neck. A lighted instrument is inserted and surgical tools are used to take samples from lymph nodes. It’s usually performed in a hospital under general anesthesia.
Needle: Using imaging tests as a guide, a needle is inserted through the chest wall and into the suspicious lung tissue. Needle biopsy can also be used to test lymph nodes.

Tissue samples are sent to a pathologist for analysis. If the result is positive for cancer, further testing, such as a bone scan, can help determine if cancer has spread and to help with staging.

For this test, you’ll be injected with a radioactive chemical. Abnormal areas of bone will then be highlighted on the images. MRI, CT, and PET scan are also used for staging.

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Treatment for lung cancer

It’s usually a good idea to seek a second opinion before beginning treatment. Your doctor may be able to help make that happen. If you’re diagnosed with lung cancer, your care will likely be managed by a team of doctors who may include:

a surgeon who specializes in the chest and lungs (thoracic surgeon)
a lung specialist (pulmonologist)
a medical oncologist
a radiation oncologist

Discuss all your treatment options before making a decision. Your doctors will coordinate care and keep each other informed.

Treatment for non-small cell lung cancer (NSCLC) varies from person to person. Much depends on specific details of your health.

Stage 1 NSCLC: Surgery to remove a portion of the lung may be all you need. Chemotherapy may also be recommended, especially if you’re at high risk of recurrence.

Stage 2 NSCLC: You may need surgery to remove part or all of your lung. Chemotherapy is usually recommended.

Stage 3 NSCLC: You may require a combination of chemotherapy, surgery, and radiation treatment.

Stage 4 NSCLC is particularly hard to cure. Options include surgery, radiation, chemotherapy, targeted therapy, and immunotherapy.

Options for small cell-lung cancer (NSCLC) also include surgery, chemotherapy, and radiation therapy. In most cases, the cancer will be too advanced for surgery.

Clinical trials provide access to promising new treatments. Ask your doctor if you’re eligible for a clinical trial.

Some people with advanced lung cancer choose not to continue with treatment. You can still choose palliative care treatments, which are focused on treating the symptoms of cancer rather than the cancer itself.

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Diagnosing Lung Cancer

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