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Faces of Lung Cancer

 

Diagnosis

Detecting Lung Cancer:

Early diagnosis of lung cancer remains difficult because many patients do not exhibit symptoms until the disease has advanced. Certain tests need to be performed in order to diagnose lung cancer and correctly identify the type and staging.

Physical Exam

You physician will do some of the following:

  • Listen to you breathe. He or she may order breathing tests or other tests to measure breathing capacity and lung function
  • Check for swollen lymph nodes in and around your neck and collarbone
  • Examine your midsection to feel for an enlarged liver or any unusual masses
  • Discuss your medical and social histories

Diagnostic Tests

  • Chest X-Ray. The most common test used when lung cancer physicians suspect lung cancer, a chest x-ray uses small amounts of radiation to take a two-dimensional picture of the inside of the chest cavity. Tumors may be seen on a chest x-ray, however tumors that are too small or hidden by a bone will not be seen. Chest x-rays are valuable tools for indicating a problem related to lung cancer, such as pneumonia
  • Computed Tomography (CT) Scan. Known as CT or CAT scans, this test gives a more detailed picture than chest x-rays. CAT scans detect small extremely small tumors and help the doctor determine if the tumor has spread to lymph nodes surrounding the lungs
  • Magnetic Resonance Imaging (MRI). MRIs use magnetic fields to create clear images of body parts, including tissues, muscles, nerves, and bones. The images produced show the presence of tumors
  • Positron Emission Tomography (PET) Scan. Physicians use PET Scans to determine if the cancer has spread to other parts of the body. Before receiving a PET scan your physician will administer a special type of sugar. Cells use sugar for energy to function. PET Scans identify “hot spots” throughout the body. These are bright colored areas on the scan where a large amount of sugar has been utilized. The more sugar a tumor takes in, the more likely it is cancer
  • Biopsy. Biopsies confirm the presence of cancer. Small pieces of the suspicious tissue are removed from the body and examined under a microscope by a pathologist. The pathologist determines the type of cell and any other abnormalities. Biopsies can be performed on the chest lining, fluid in the chest cavity or lungs, the bones, or the liver
  • Sputum Cytology. This test involves the collection of sputum (mucus) that has been coughed up. Once collected, a pathologist examines the sputum looking for normal or abnormal cells. The most effective method for this test is to collect and analyze the sputum each morning for three days
  • Bronchoscopy. This procedure involves inserting a thin, flexible tube (bronchoscope) through the nose and down into the lungs. At the end of the bronchoscope a small camera takes pictures of the tissues. Because of this, physicians are then able to look directly into the airways and the lungs. On occasion, a needle inserted into the bronchoscope will be used to obtain samples of the tumor or fluid. These cells are then biopsied to determine the type of lung cancer

  • Autofluorescence Bronchoscopy.  A physician advances a flexible tube into the lungs.  A camera at the end captures live color video which the physician views on a monitor.  The difference with a conventional bronchoscopy is that this technology can detect light that that tissue gives off.  The light that abnormal/precancerous tissue gives off is different than light from normal tissue.  The physician can remove samples of abnormal tissue for laboratory examination or biopsy.

  • Thoracoscopy. This surgical procedure, performed by a physician, allows for the exploration of the surface of the lungs and the chest wall lining in search of tumors. It is important to note, that this procedure is performed while the patient is under general anesthesia
  • Thoracentesis. When fluid is present and begins collecting in the area between the lungs and the chest wall, a thoracentesis is used to remove this fluid through a needle. A pathologist then performs a biopsy on the cells in the fluid to determine if it is cancerous
  • Mediastinoscopy. An endoscope, a device with a light attached, is inserted into the mediastinum. This test determines whether cancer cells have spread the area around the trachea. This procedure is performed while the patient is under anesthesi.