Lung Cancer Diagnosis

When lung cancer is suspected, an immediate medical diagnosis is required. This process begins with your doctor discussing and evaluating your medical history, smoking history, exposure to environmental and occupational substances, and family history of cancer. You doctor will also perform a basic physical examination, including:

Listening to your breathing with a stethoscope.

Measuring your breathing capacity and lung function.

Checking for swollen armpit and neck lymph nodes.

Examining your mid-section for signs of an enlarged liver or any unusual masses that may be indicative of a tumor.

Depending on the results of this initial assessment, your doctor may then complete other tests to determine the cause of the symptoms you've been experiencing. For example, while blood tests aren’t used to give a definite diagnosis of lung cancer, they may reveal abnormalities that are often associated with cancer. If cancer has metastasized to the bones, for instance, there may be elevated levels of calcium in the blood. Other types of cancer are often accompanied by a rise in certain hormones in the blood.

X-rays, CAT scans and even PET scans can only indicate that there are conditions suspicious of a cancer diagnosis. In order to definitely diagnose lung cancer, a pathologist must confirm the diagnosis by examining a tissue sample and finding cancerous cells in it. The simplest and least expensive tissue test is a sputum analysis (sputum cytography). Unfortunately, it’s not the most reliable of tests, and can give both false positive and false negative results. There are a number of other tests that a pathologist can do to confirm or discard a diagnosis of lung cancer.

Sputum Cytology
Sputum is mucus from the lungs. Sputum Cytology is a microscopic examination of sputum cells obtained from a deep-cough sample. This is often useful in detecting the presence of lung cancer.

Bronchoscopy
Bronchoscopy can be performed on a same-day, outpatient basis. The procedure, carried out by a pulmonologist or a surgeon, involves inserting a thin probe through a tube into the airways. The probe can then be used to visualize the tumor, and to scrape or draw a tissue sample from it. A bronchoscopy can be used if the tumor is in the central portion of the lungs or one of the larger airways. If a tumor is found and a large enough sample of tissue can be extracted, it’s usually possible to get an accurate diagnosis.

Fine Needle Aspiration
When the tumor is not accessible using bronchoscopy, fine needle aspiration, also known as a needle biopsy, may be used instead. A fine needle is inserted through the skin and into the lung, and a sample of cells is drawn up to be examined beneath a microscope. That sample will be examined for the presence of cancerous cells. The error margin for fine needle aspiration is low, but significant as there is a chance that the sample will be taken from an area adjacent to the tumor rather than from the tumor itself.

Thoracentesis
When the cancer involves the lining of the lungs – the pleura – sometimes fluid collects between the lungs and the chest wall. A sample of this fluid may be drawn with a fine needle as in a needle biopsy. Examination of the fluid sample may reveal the presence of cancerous cells.

Mediastinoscopy
Sometimes it’s not possible to obtain a sample without major surgery. A mediastinoscopy involves inserting a probe surgically into the cavity between the lungs and removing a tissue sample for biopsy. Thoracotomy is the opening of the chest wall surgically to remove as much of the tumor as possible. Obviously, both carry the risks of major surgery.

By using the above techniques, the presence of lung cancer can either be confirmed or discounted. Once a diagnosis of lung cancer is definite, the options for treatment include surgery, chemotherapy and radiation therapy, as well as combinations of the three. The exact treatment recommended will be based on the stage at which the cancer is detected and other factors, including your own wishes.

Lung Cancer Related Articles

Lung Cancer In Non-Smokers - Evidence suggests that there is a lung cancer gene which predisposes offspring to develop lung cancer. However, the evidence is far from conclusive as the situation is made difficult by the fact that offspring of smokers have been exposed to a smoking environment since childhood and would therefore have a greater risk for developing the disease.

Lung Cancer Survival Rate - Several factors influence lung cancer survival rates. The type of cancer, the stage it is at when diagnosed, and the overall condition of the patient all play a role in determining survival.

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