One or more of these tests may be used by your doctor to help diagnose lung cancer.
Imaging tests (x-ray, CT, MRI or PET scan)
Your doctor may want to look at the inside of your chest. The most common imaging tests are 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 look at lymph nodes in the middle of the chest or spread outside the chest.
A biopsy is the only way to confirm the presence of cancer and identify its type and stage. A doctor removes a small piece of tissue from the lung and looks at it under a microscope. This can be done two ways, either with a thin needle (needle aspiration), a slightly larger needle (core needle biopsy), or through surgery with anesthesia. Biopsies of the chest lining, lymph nodes, bone or liver also may be done.
This procedure involves the use of a flexible tube-like instrument called a bronchoscope to look at the airways into the lungs and to collect tissue samples.
Endoscopic Bronchial Ultrasound (EBUS)
A bronchoscope with ultrasound is used to more accurately find and biopsy cancer in the smaller airways and lymph nodes. It allows these areas to be seen and biopsied more accurately.
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. This is infrequently used today, and in most cases is replaced by EBUS, described above.
Sputum (mucus from the airways) is examined for signs of cancer, but is infrequently used today. Sputum can be coughed up or collected through a tube called a bronchoscope. This technology can find cancer cells long before a tumor appears on other tests, but it may not detect cancers deeper in the lungs and cannot determine a tumor's size or location.
This surgical procedure is done using general anesthesia. An instrument called a thoracoscope is inserted through a small incision in the chest wall to allow the doctor to check the lining of the chest wall and the surface of the lungs for tumors.
Video-Assisted Thoracic Surgery (VATS)
A tiny video camera guides the surgeon, making it possible to remove tumors through small incisions in the chest. Occasionally, small cell lung cancers can be entirely removed this way.
This procedure uses a needle inserted between the ribs to remove fluid that is collecting between the lungs and the chest wall. The fluid is sent to a lab to check for cancer cells.