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Diagnosing lung cancer
After taking your medical history and completing a physical examination, your doctor may suspect you have lung cancer. To confirm the diagnosis, your doctor will arrange special tests. These tests may also be used to “stage” the cancer. You may have one or more of the following tests.
Imaging studies
Imaging studies allow tissues, organs and bones to be looked at in more detail. Using x-rays, ultrasounds, CT scans or MRIs, your healthcare team can get a picture of the size of the tumour and see if it has spread. The pictures may also show abnormal fluid buildup or swollen lymph nodes. These tests are usually painless and do not require an anesthetic.
Sputum cytology
Samples of phlegm (called sputum) coughed up from the lungs are checked for cancer cells under a microscope.
Biopsy
A biopsy is usually necessary to make a definite diagnosis of cancer. Cells are removed from the body and checked under a microscope. If the cells are cancerous, they may be studied further. There are many ways to do a biopsy.
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A fine-needle aspiration uses a thin needle to remove a small amount of fluid or cells from the lung or nearby lymph nodes. The doctor may use ultrasound or CT scan pictures to guide the needle to the suspicious area.
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Thoracocentesis is done if pleural fluid has built up in the area between the lungs and the chest wall. You will be given a local anesthetic (freezing) to numb an area of the chest. The doctor inserts a long needle between the ribs and removes the fluid
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Bronchoscopy uses a thin, flexible tube with a light at the end (called a bronchoscope) to look at the trachea and the large air passages in the lungs. The tube is inserted through the nose or throat and passed down to the lungs. You will be given a mild sedative and an anesthetic to numb your throat. If an abnormal area is found, the doctor can take samples of tissue through the bronchoscope. You may have a sore throat afterwards. This is normal and should disappear after a couple of days.
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A mediastinoscopy is done when it is necessary to check the tissues and lymph nodes around the trachea. The surgeon makes a small cut at the base of the neck and passes a thin, flexible tube through it to take tissue samples. You will need a general anesthetic for this procedure.
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A thoracoscopy is done for tumours in the lung that may be beyond the reach of bronchoscopy, or that involve the pleura. A small cut is made through the chest wall and an instrument called a thoracoscope is inserted into the chest between two ribs. This procedure allows the doctor to look inside the chest cavity through the thoracoscope directly. Tissue samples can be taken through additional small cuts in the chest wall. You will need a general anesthetic for thoracoscopy.
Blood tests
Blood is taken and studied to see if the different types of blood cells are normal in number and appearance. Other bloods tests can show how well your organs are working and may suggest whether or not you have cancer.
Further testing
If the initial diagnostic tests show that you have lung cancer, your doctor may order more imaging studies or other tests to find out if the cancer has spread.
Last modified on:
07 January 2009
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