After hearing the symptoms, health care formulates a list of possible diagnoses. This raises questions about symptoms, medical and surgical history, smoking and work history, and other aspects of life, general health, and drugs.
Unless severe hemoptysis is ongoing, a chest radiograph is likely to be first made to find the cause of respiratory symptoms.
X-rays may show an abnormality or not.
Types of anomalies observed with lung cancer have a small lump or nodule or mass large.
Not all abnormalities on chest x-ray is cancer. For example, some people develop scarring and calcium deposits in their lungs, which can resemble tumors on an X-ray of the chest.
In most cases, CT or MRI scan of the chest to define the problem.
If symptoms are severe, X-ray can be skipped, and CT or MRI can be done immediately.
The advantages of computed tomography and magnetic resonance imaging are showing much more detail than X-rays, and is able to demonstrate to the lungs in three dimensions.
These tests help determine the stage of the tumor that shows the size of the tumor or tumors.
They can also help identify the cancer spread to nearby lymph nodes or in some other organs.
If a person's chest X-ray or CT scan suggests a tumor is present, he or she undergoes a diagnostic procedure.
This procedure includes a collection of sputum, removing a small piece of tumor tissue (biopsy) or a small amount of fluid around the breathing bag.
The extracted cells are examined microscopically by a doctor who specializes in diagnosing diseases by looking at cells and tissue types (a pathologist).
There are several ways to obtain these cells.
Sputum test: This is a simple test that is sometimes performed to detect lung cancer.
Sputum is a thick mucus, which can be produced by coughing.
The cells in sputum can be examined to see if they are cancerous. This is known as cytology.
This is not a completely reliable test. If the result is negative, the results usually need to strengthen further testing.
Bronchoscopy: Endoscopic This is a test, which means a slim, flexible, lighted tube with a tiny camera on the end is used to view internal organs of the body.
Bronchoscopy and endoscopy in the lungs. Bronchoscope is pushed into the mouth or nose and down the trachea. From there, the pipe can be added to the airways (bronchi) and lungs.
A tiny camera transmits images to a video monitor.
The doctors who work bronchoscope can find tumors and to collect samples of suspected tumors.
Bronchoscopy is generally used to determine the extent of the tumor.
The procedure is uncomfortable. A local anesthetic is given to the mouth and throat, and sedation to bronchoscopy bearable.
Bronchoscopy is a risk and requires a qualified expert in performing the procedure.
Biopsy: If the tumor is isolated and the lungs, usually can not be seen with bronchoscopy. In contrast, a biopsy is taken through a needle inserted into the chest wall and into the tumor.
Typically, a chest radiograph or CT scan is used to guide the needle.
This procedure is safe and effective to get enough tissue for diagnosis. After the surface of the breast is cleaned and prepared, the wall of the skin and chest numb.
The most serious risk of this procedure is that the puncture needle can cause leakage of the lung (pneumothorax). This air leakage occurs in as many as 3% -5% of cases. Although this condition can be dangerous, it is almost always recognized early and treated without serious consequences.
Thoracentesis: This procedure removes a sample of fluid from the pleural cavity surrounding the lungs. Lung cancer, both primary and metastatic, can cause the collection in the sac surrounding the lungs. This liquid is called pleural effusion.
The liquid usually contains cancer cells.
The sample of this fluid can confirm the presence of lung cancer.
The fluid is removed with a needle in a procedure similar to needle biopsy.
Thoracentesis can be important both for staging and diagnosis of the condition.
Thoracotomy: Sometimes a lung cancer tumor can not be achieved by bronchoscopy or needle procedures.
In these cases, the only way to get a biopsy by performing an operation.
The chest is open (thoracotomy), and tumor as possible is removed surgically. The tumor removed is then examined under a microscope.
Unfortunately, this may not be able to eliminate all tumor cells if the tumor is large or has spread to lymph nodes outside of the lungs.
Thoracotomy is major surgery that is performed in a hospital.
Mediastinoscopy: This is another endoscopic procedure. It is performed to determine the extent the cancer has spread in the area of the chest between the lungs (mediastinum).
A small incision is made in the lower neck above the sternum (breastbone). An alternative is to make incisions in the chest.
Mediastinoscopy that resembles the bronchoscope is inserted behind the sternum.
Samples of lymph nodes are taken to assess the cancer cells.
Mediastinoscopy is a very important step to determine if the tumor can be surgically removed or not.
Other tests: More tests are performed in the stage of the tumor and to assess a person's ability to withstand surgery and other treatments.
Pulmonary function tests to assess respiratory capacity.
Blood tests are performed to identify the chemical imbalances, blood disorders or other problems that could complicate treatment.
CT or MRI can be performed to check the most common areas of metastatic spread. These tests are usually only if symptoms are present, indicating metastasis. Some treatment methods require that these tests are performed.
A bone scan can determine if the cancer has spread to the bones.
Staging: Staging is a way to classify the tumor for treatment planning.
Set according to tumor size, tumor location, and degree of metastasis of the tumor (if available).
The treatment will be individualized to the stage of the tumor.
Status of the tumor is related to the prospects for recovery and survival (prognosis). The higher stage tumor, the less likely that the disease can be cured.
Unlike staging, the "classification" of lung cancer is the classification of tumor cells under a microscope. The degree of cancer is a measure of how abnormal the cancer cells compared with normal cells. High grade tumors have a very abnormal and tend to grow rapidl
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