Lung cancer

Diagnosing lung cancer

Physical exam
An annual check-up is a good way for your healthcare provider to review risk factors and be watchful for early symptoms of disease, including lung cancer. Your doctor will want to know if you smoke or if you have been exposed to any substances that could put you at higher risk for lung cancer. If you need a physician, call (203) 688-2000 or try Yale-New Haven Health Physician Referral Online.

Chest X-ray
A chest X-ray, which can be performed at the hospital or in your own doctor's office, shows if there is a tumor in the lung but does not tell whether it is cancerous. Additional tests are needed to determine whether a tumor is malignant (cancerous) or benign (noncancerous).

CT or CAT scan
Your doctor may order additional X-rays, such as a CAT scan (computer assisted tomography) that show the lung in more detail.

Sputum testing
Your doctor may test any sputum you cough up for the presence of cancer cells. This sample is examined by a pathologist under a microscope, a process called cytology.

Bronchoscopy
During this procedure, you first receive local anesthesia. Then your physician uses a miniature scope inserted into the lung to examine the inside of lung or takes a small tissue sample to be analyzed.

Needle aspiration
If brochoscopy is not able to reach the necessary part of the lung for testing, your doctor inserts a needle through your chest into the lung, locates the area using X-ray guidance and takes a small sample to be examined. Because of the high rate of false negatives, the test may be repeated or another procedure used.

Thoracentesis
Sometimes, cancer cells can be present in special sac called the pleura that surrounds and protects the lung. Your physician inserts a needle through your chest into the pleura and takes a small sample to be examined.

Mediastinoscopy
A more invasive procedure, mediastinoscopy involves making an incision into the chest and inserting a brochoscope through the opening to check for any signs of cancer.

Thoracoscopy
During this procedure, the lung is surgically opened and a tissue sample is taken. Physicians may also examine the area between the lungs, called a mediastinum. This procedure is performed under general anesthesia and may require the patient to remain in the hospital overnight.

Additional tests
If your physician suspects cancer, additional X-rays and tests may be ordered to see if the cancer has spread into the surrounding organs or the bone.

See also:

Questions to ask before cancer tests

Cancer Services home page

Treating lung cancer

Online physician referral service

Last revised: May 1, 2007 (dh)

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