How is lung cancer diagnosed?
There are a number of tests or procedures that assist your doctor in making a diagnosis of lung cancer.
Scans
CT Scan
Computed tomography, also known as CAT or CT scan, is a test used to provide a detailed picture of your lungs and chest. This scan can better define complex anatomy and very small nodules. It may be helpful in determining whether or not the tumor has spread into the surrounding lymph nodes.
PET Scan
Positron emission tomography, or PET scan, determines the way the body’s cells act in the presence of sugar. Normal cells take in sugar and use it to make energy. Cancer cells usually take in more sugar than normal cells. If you are going to have a PET scan your doctor will give you a special type of sugar before the test. After about 45 minutes the doctor will scan your body to see where the sugar has accumulated. The PET scan will find the presence of tumors by detecting “hot spots,” which are areas where the sugar has been taken in by cells. The more sugar the tumor takes in, the more likely it is a cancer.
MRI Scan
Magnetic Resonance Imaging, or MRI, is similar to a CAT scan but it uses magnetic fields instead of radiation to create a picture.
Biopsies
The various scans that allow the doctor to see the inside of the body do not test the tumor for the presence of cancer cells. Therefore, these tests do not prove that you have cancer but they give your doctor an idea of areas that look abnormal. A biopsy is the removal of a tissue sample from the tumor to determine if it is malignant (cancer) or benign (not cancer). Biopsies can be obtained in many different ways depending on the location and the size of the tumor.
Bronchoscopy
This test allows your pulmonologist to see the inside of your lungs and airways. It is a procedure in which a flexible hollow tube is inserted into the mouth, down the trachea, and into the lungs. There is a small camera on the end of the bronchoscope that takes pictures so the doctor can see the tissue and there is a small tool at the end of the bronchoscope that allows the doctor to remove a sample of tissue from the tumor.
CT guided fine needle aspiration
The radiologist inserts a needle into your chest wall and uses the needle to take a sample of the tissue. This is done with the guidance of a CT scan when the needle is inserted into the chest wall in order to accurately get a tissue sample from the tumor.
Mediastinoscopy
During a mediatinoscopy, a small incision is made in the neck at the top of the breastbone. Then a thin scope (mediastinoscope) is inserted through the opening in front of the trachea and into the mediastinum. A tissue sample (biopsy) can be obtained through the mediastinoscope and then examined under a microscope for lung problems, such as infection, inflammation or cancer.
Video-Assisted Thoracoscopy (VATS)
A thoracic surgeon uses a scope (called a thorascope) that is passed through a small incision in the chest in order to remove a sample of lung tissue. VATS allows for a less invasive procedure than traditional thoracotomy, leading to a faster recovery and the ability to begin other treatment sooner.
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