Screening Phase

CXR (chest x-ray) - is often the first screening method used by the doctor. It is a flat picture of the chest that can be useful in identifying abnormal growths.

CT scan (computed tomography) - this is a special kind of x-ray that allows for many pictures to be taken as a scanner moves in a circular pattern around you. A computer creates a two-dimensional image from the scanned images. This test reveals more detail than a chest x-ray and can be useful in determining the size and location of a tumor. It can also identifying lymph node enlargement, which may indicate the spread of the cancer.

MRI scan (magnetic resonance imaging) - MRI scan is similar to a CT scan except it uses a magnetic field in place of x-rays to create images. MRI is useful in identifying lung cancer that has spread to the brain or spinal cord.

PET scan (positron emission tomography) - this is a scan that identifies the way cells of the body absorb a specialized sugar. The sugar contains a radioactive atom and the use of specialized imaging equipment allows for the detection of the radioactivity. The test is useful in determining whether the cancer has spread when doctor suspects metastasis but is not sure where the cancer has spread. The test can also help determine whether a small spot on a chest x-ray is cancer.

Sputum cytology - involves a sample of sputum (saliva or spit) that has been coughed up by the patient. The sample is looked at under a microscope to identify abnormal or cancerous cells. This test can be useful in identifying asymptomatic lung cancer and the early diagnosis of lung cancers that originate in the proximal bronchi.

Needle biopsy - involves the insertion of a needle into the tumor to remove a piece of tissue. This tissue is then sent to the laboratory for analysis to determine if cancer cells are present.

Bronchoscopy - involves the insertion of a long flexible tube through the nose and throat into the main airways of the lungs. If abnormal areas or tumors are seen tissue or fluid samples can be obtained and sent for laboratory analysis to determine if cancer cells are present.

Mediastinoscopy - this is a surgical procedure in which a small incision is made in the neck or on the left side of the chest. A scope is then inserted into the mediastinum. Tissue samples of lymph nodes along the trachea can be collected through the scope and visualized under a microscope for identification of cancer cells.

Thoracentesis or Thoracoscopy - these tests are used to determine the cause of fluid around the lung. It is helpful in determining whether the fluid is caused by factors other than lung cancer such as congestive heart failure or infection. Thoracentesis involves the insertion of a needle between the ribs to remove fluid for microscopic evaluation for the presence of cancer cells. Thoracoscopy involves a surgeon making several small incisions on the side of the chest. A small endoscopic tube (camera tube) is the placed through one of the incisions, allowing the surgeon to view the lungs on a monitor to assess for the presence of lung cancer. Tissue biopsy and fluid samples can be taken for microscopic analysis for the presence of lung cancer.