Lung Cancer Center

Lung Cancer Diagnosis

Screening for lung cancer is controversial among doctors. Ongoing studies aim to determine what types of tests may be helpful and who would benefit from lung cancer screening. In the mean time, talk with your primary of family doctor if you're concerned about your risk of lung cancer. Together you can determine strategies to reduce your risk and decide whether screening tests are appropriate for you.

Your doctor may refer you to a specialist who has experience treating lung cancer, or you may ask for a referral. Specialists who diagnose and treat lung cancer include:

  • Dieticians
  • Medical oncologists
  • Pulmonologist (a lung specialist)
  • Radiation oncologists
  • Respiratory therapist
  • Thoracic (chest) surgeons
  • Thoracic surgical oncologists

Medical history
Your doctor will start by asking you questions about personal and family medical history. Your doctor should then check for general signs of health, listens to your breathing, and look for fluid in the lungs. Your doctor may feel for swollen lymph nodes and a swollen liver. Keep in mind that your doctor may consider these factors when choosing a diagnostic test:

  • age and medical condition
  • location of the suspected cancer
  • previous test results
  • severity of symptoms
  • size of the suspected cancer
  • the type of cancer suspected

Medical exams
If you are experiencing symptoms that suggest lung cancer, your doctor must confirm or exclude cancer as a possible diagnosis.

Imaging tests can be used to find out whether the cancer has metastasized, but they are not used to diagnose lung cancer. The only sure way to know if lung cancer is present is for a pathologist to check samples of cells or tissue. For most types of cancer, a biopsy is the only way to make a definitive diagnosis.

Doctors use many tests to diagnose cancer and determine if it has spread from the lung. If a biopsy is not possible or more information is needed, the doctor may suggest other tests that will help make a diagnosis. Some tests may also determine which treatments may be the most effective. Possible medical exams used to diagnose lung cancer include:

Bronchoscopy – During this procedure, doctors insert a thin, lighted tube (a bronchoscope) through the nose or mouth into the lung. This allows an exam of the lungs and the air passages that lead to them. The doctor may take a sample of cells with a needle, brush, or other tool. The doctor also may wash the area with water to collect cells in the water.

Chest x-ray - X-ray pictures of your chest may show evidence of tumors or abnormal fluid.

CT scan - Doctors often use CT scans to take pictures of tissue inside the chest. The pictures may show a tumor, abnormal fluid, or swollen lymph nodes.

Fine needle aspiration – Doctors use a thin needle to remove tissue or fluid from the lung or lymph node. Sometimes the doctor uses a CT scan or other imaging method to guide the needle to a lung tumor or lymph node.

Mediastinoscopy - The surgeon makes an incision at the top of the breastbone. A thin, lighted tube is used to see inside the chest. The surgeon may take tissue and lymph node samples.

Sputum cytology - Thick fluid (sputum) is coughed up from the lungs. The lab checks samples of sputum for cancer cells.

Thoracentesis – During this procedure, the doctor uses a long needle to remove fluid (pleural fluid) from the chest. The lab checks the fluid for cancer cells.

Thoracoscopy - The surgeon makes several small incisions in your chest and back to observe the lungs and nearby tissues with a thin, lighted tube. If an abnormal area is seen, a biopsy to check for cancer cells may be ordered.

Thoracotomy - The surgeon opens the chest with a long incision. Lymph nodes and other tissue may be removed.

People are sometimes diagnosed with lung cancer although they manifest no symptoms, when cancer cells are discovered on a chest x-ray or CT scan performed for some other reason, such as checking for heart disease. However, many people with lung cancer are diagnosed when the tumor grows, takes up space, or begins to interfere with nearby organs. To learn more about cancer stages lung, keep reading.

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