If you experience any significant symptoms of lung cancer, including nagging cough, shortness of breath, fatigue, back or chest pain, your doctor may ask you about your health history including information about smoking or exposure to environmental risk factors. Your doctor may also order several tests, including:

  • Physical Exam - During the physical exam, your doctor will listen to your lungs and the sounds of your breathing (and may request special breathing or pulmonary function tests to determine if breathing is impaired), check for swollen lymph nodes in the neck or the region above the collarbones and feel the liver to see if it is enlarged or if any masses are present in the abdomen.
  • Imaging tests (X-ray, CT, MRI or PET scan) - Your doctor may use several diagnostic tests. The most common include CT and MRI scans to help diagnose lung cancer and determine the size, shape, and location of a tumor.  PET scans are also used to determine if there is lymph node involvement in the middle of the chest or spread outside the chest.
  • Biopsy - A biopsy is the only reliable way to confirm the presence of cancer and identify its type and stage. In this procedure, a small piece of tissue is removed either through a thin needle (needle aspiration) or surgery with anesthesia as appropriate. Biopsies of the chest lining, lymph nodes, bone, or liver also may be done.
  • Bronchoscopy - This procedure involves the use of a flexible tube-like instrument called a bronchoscope to view the airways into the lungs and to collect tissue samples.
  • Endoscopic Bronchial Ultrasound (EBUS) – A bronchoscope with ultrasound is used to view more distant airways and regional lymph nodes. It allows these areas to be seen and biopsied more easily.
  • Mediastinoscopy – A rigid instrument called an endoscope is inserted through a small incision in the neck just above the breastbone or elsewhere in the chest into the area. Anesthesia is used. This procedure can show if cancer has spread to lymph nodes near the trachea, one of this first places lung cancer is likely to spread.
  • Sputum Cytology - If cancer cells are in the bronchi, some are likely to be carried up the throat in mucus from the airways called sputum, which can be examined for signs of cancer. Sputum can be coughed up or collected through a tube called a bronchoscope. This technology can find cancer cells long before a tumor is evident on other tests, but it may not detect cancers deeper in the lungs and cannot determine a tumor's size or location.
  • Thoracoscopy – This is a limited surgical procedure, performed under general anesthesia. An instrument called a thoracoscope is inserted through a small incision in the chest wall to allow examination of the lining of the chest wall and the surface of the lungs for tumors.
  • Video-Assisted Thoracic Surgery (VATS) – The use of a tiny video camera to guide the surgeon, which makes it possible to remove a small piece of the tumor.
  • Thoracentesis - If fluid is collecting between the lungs and the chest wall, this procedure is used to extract some of the fluid through a needle between the ribs to see if cancerous cells are present.

Updated March 11, 2015