Lung Cancer

Diagnosis

Bronchoscopy :  Bronchoscope is a thin, lighted, flexible tube with a tiny camera on the end. This  is passed through the mouth or nose and down through the windpipe. From there, the tube can be inserted into the airways (bronchi) of the lungs. Small samples of tissue are collected through this tube. Bronchoscopy, which is used to determine the extent of the tumor, has some risks and requires a specialist proficient in performing the procedure.

Needle biopsy : If a tumor is on the periphery of the lung, it usually cannot be seen with bronchoscopy. After the chest surface is cleaned and prepared, the skin and the chest wall are numbed. A long, thin needle is inserted through the chest wall in the lung to remove a lung tissue sample. A chest x-ray or CT scanning is used to guide the needle.

Thoracentesis : Lung cancers, both primary and metastatic, can cause fluid to collect in the sac surrounding the lung. This is called pleural effusion. Thoracentesis, which is important for both staging and diagnosis, is similar to needle biopsy. The skin is numbed and a needle is placed between the ribs to remove a fluid sample. 

Thoracoscopy : It uses a thin, lighted tube connected to a video camera and monitor to view the space between the lungs and the chest wall. It is used to check whether the fluid around the lungs is caused by cancer.

Thoracotomy : Sometimes a lung cancer tumor cannot be reached by bronchoscopy or needle procedures. In such cases the only way to obtain a biopsy is by performing a surgery. The chest is opened and as much of the tumor as possible is removed surgically. A biopsy is taken from the removed tumor. This procedure is a major operation performed in a hospital.

Mediastinoscopy : It is performed to determine the extent that the cancer has spread into the area of the chest between the lungs. A small cut is made into the lower part of the neck, above the breastbone. A mediastinoscope is inserted and sample tissues are taken from the enlarged lymph nodes along the windpipe. Mediastinoscopy is a very important step to determine whether the tumor can be surgically removed or not.

Bone marrow biopsy :  After the area is numbed, a needle is used to remove a small piece of bone, usually from the back of the hip bone. This is done mostly to help find if small cell lung cancer has spread to the bones.

Blood tests : Blood tests are performed to identify any chemical imbalances, blood disorders, or other problems that might complicate treatment. A complete blood count (CBC) shows whether your blood has the correct number of different cell types. This test will be done often if you are treated with chemotherapy because these drugs can affect the blood-forming cells of the bone marrow. 

Once a tumor is found, it must be determined if and how widely the cancer has spread. It is known as staging.