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Diagnosis

Although there are currently no screening tests for lung cancer, there are many procedures that can be used to diagnose lung cancer. Some of these tests may be used in combination to obtain the most accurate diagnosis possible.

Chest X-rays

A common method that photographs the lungs. Specialists can spot abnormal areas that may indicate the presence of cancer.

CAT scans

A specialized X-ray machine which uses radiographic beams to create precise computerized pictures of the lung

Bronchoscope

A thin flexible tube with a tiny camera, which is inserted through the nose or mouth and down into the lungs. A bronchoscope can also take a small tissue sample for biopsy.

Fine Needle Aspiration (FNA): A thin needle attached to a syringe is inserted through the chest into the lung tissue and cells are drawn out for examination under a microscope.

Cells taken from mucus expelled by coughing are analyzed for the presence of cancer.

Thoracentesis

Fluid from around the lungs is drawn out with a needle for examination.

Video Assisted Thoracoscopic Surgery (VATS): VATS can be used to aid in the diagnosis of thoracic cancers. Using a limited number of tiny incisions, small diameter video-thoracoscopes can allow examination of the entire thoracic cavity. Biopsies of the lining of the chest cavity (pleura), lung nodules, mediastinal masses and pleural fluid can easily be obtained for diagnosis.

Doctors describe non-small cell lung cancer based on the size of the lung tumor and whether cancer has spread to the lymph nodes or other tissues. A staging system, below, is used to characterize the tumors. Staging is very important when deciding the best form of treatment for each patient. Early stage lung cancer is considered to be any tumor classified as stage 0 through stage IB, in which the cancer is still localized and hasn't spread to nearby lymph nodes.

Occult stage

Lung cancer cells are found in sputum or in a sample of water collected during bronchoscopy, but a tumor cannot be seen in the lung.

Stage 0: Cancer cells are found only in the innermost lining of the lung. The tumor has not grown through this lining. A stage 0 tumor is also called carcinoma in situ. The tumor is not an invasive cancer.

Stage IA: The lung tumor is an invasive cancer. It has grown through the innermost lining of the lung into deeper lung tissue. The tumor is no more than three centimeters across (less than 1 ¼ inches). It is surrounded by normal tissue and the tumor does not invade the bronchus. Cancer cells are not found in nearby lymph nodes.

Stage IB: The tumor is larger or has grown deeper, but cancer cells are not found in nearby lymph nodes. The lung tumor is one of the following:

  • Cancer cells are not found in nearby lymph nodes, but the tumor has invaded the chest wall, diaphragm, pleura, main bronchus or tissue that surrounds the heart
  • Cancer cells are found in nearby lymph nodes, and one of the following:
    • The tumor is more than three centimeters across
    • It has grown into the main bronchus
    • It has grown through the lung into the pleura

Stage IIIA: The tumor may be any size. Cancer cells are found in the lymph nodes near the lungs and bronchi, and in the lymph nodes between the lungs but on the same side of the chest as the lung tumor.

Stage IIIB: The tumor may be any size. Cancer cells are found on the opposite side of the chest from the lung tumor or in the neck. The tumor may have invaded nearby organs, such as the heart, esophagus or trachea. More than one malignant growth may be found within the same lobe of the lung. The doctor may find cancer cells in the pleural fluid.

Stage IV: Malignant growths may be found in more than one lobe of the same lung or in the other lung. Cancer cells may be found in other parts of the body, such as the brain, adrenal gland, liver or bone.