To find out if lung cancer may be present, the doctor evaluates a person's medical history, smoking history, their exposure to environmental and occupational substances, and family history of cancer. The doctor also performs a physical exam and may order a chest x-ray or other tests. Seeing a spot on a chest x-ray is usually how a doctor first suspects that lung cancer may be present.
If lung cancer is suspected, the doctor may order a test called a sputum cytology. This is a simple test where a doctor examines a sample of mucous cells coughed up from the lungs under a microscope to see if cancer is present. But to confirm the presence of lung cancer, the doctor must examine fluid or tissue from the lung. This is done through a biopsy -- the removal of a small sample of fluid or tissue for examination under a microscope by a pathologist. A biopsy can show whether a person has cancer. A number of procedures may be used to obtain this tissue.
Bronchoscopy -- The doctor puts a bronchoscope -- a thin, lighted tube -- into the mouth or nose and down through the windpipe to look into the breathing passages. Through this tube, the doctor can collect cells or small samples of tissue.
Needle Aspiration -- The doctor numbs the chest area and inserts a thin needle into the tumor to remove a sample of tissue.
Thoracentesis - Using a needle, the doctor removes a sample of the fluid that surrounds the lungs to check for cancer cells.
Thoracotomy -- Surgery to open the chest is sometimes needed to diagnose lung cancer. This procedure is a major operation performed in a hospital.
Doctors may also use imaging methods such as a spiral CT scan or a PET scan to look for signs of cancer. A CT scan, also known as computerized tomography scan, is a series of detailed pictures of areas inside the body. A PET scan, also known as positron emission tomography, is a computerized image of the metabolic activity of body tissues.
Other tests can include removal of lymph nodes for examination under a microscope to check for cancer cells. Lymph nodes are small, bean-shaped structures found throughout the body. They filter substances in a fluid called lymph and help fight infection and disease.
