Medical History Review & Physical Exam
Your doctor will conduct a thorough review of your personal and family medical history to identify hereditary or genetic risk factors. Your medical team will also perform a deeper inquiry into your specific symptoms and perform a physical exam to examine your lungs and heart.
Imaging Tests
Imaging tests are a helpful tool but cannot detect lung cancer on their own. Your doctor may conduct one or more imaging tests to identify the location of the tumor and determine whether it has spread (metastasized) to other organs.
Chest X-Ray
X-rays emit high energy rays to take pictures inside the body. A chest X-ray is often the first test your doctor performs in order to check for masses in the lung, but an X-ray cannot diagnose lung cancer on its own. If a mass appears, your team may administer additional exams.
Computed Tomography (CT) Scan
A CT scan is a type of imaging test that uses X-rays to create detailed cross-sectional pictures inside the body. It can show the size, shape and position of lung tumors.
Magnetic Resonance Imaging (MRI) Scan
An MRI scan uses magnets and radio waves to provide cross-sectional images of the lungs and nearby organs such as the brain, spinal cord or liver.
Positron Emission Tomography (PET) Scan
For a PET scan, your doctor injects a slightly radioactive form of sugar that collects in cancer cells. Your doctor then uses a special camera to take pictures of areas of radioactivity. A PET scan is primarily used to look for cancer spread to help determine the stage of lung cancer.
Blood Tests
If a tumor is detected by an ultrasound or CT scan, your doctor may order a CA-125 blood test to help determine the likelihood of cancer. This blood test checks the level of several key substances in your blood, including a cancer antigen called CA-125.
The CA-125 tests for a blood protein that increases in people with cancer, but it is not specific to lung or other types of cancer. It can also increase due to non-cancerous conditions.
A blood test alone will not diagnose cancer but is useful as a tumor marker to help guide treatment. Your doctor uses your blood test results to help determine the next steps.
Biopsy
A biopsy is a type of exploratory surgery to remove cells, tissue or fluid from your lung for testing. If the suspected area of cancer is deep within the body, a CT scan may be used to guide a needle biopsy. Your pathologist then examines the sample of abnormal cells to determine whether a tumor is cancerous.
Types & Stages of Lung Cancer
If you receive a lung cancer diagnosis, your doctor will also determine the type and stage of the cancer to help guide your treatment plan.
There are two main types of lung cancer:
- Non-small cell lung cancer (NSCLC) – The most common form, accounting for 80% of lung cancer cases. It typically grows and spreads more slowly. If detected early, it can be cured with surgery in more than half of all cases.
- Small cell lung cancer (SCLC) – This rare type of lung cancer is typically fast-growing and aggressive. It is commonly found after it has already metastasized elsewhere in the body. This type is almost always caused by smoking.
Oncologists use the same staging system for both types of lung cancer to determine the tumor size and spread of the cancer. There are four stages of lung cancer:
- Stage 1 – The tumor is small (4 cm or less) and only in the lung. It has not spread to nearby lymph nodes or outside the chest.
- Stage 2 – There are larger tumors (more than 4 cm) or signs the cancer has spread to nearby lymph nodes. It has not spread outside the lung.
- Stage 3 – There is cancer in the lymph nodes of the chest further away from the lung or large tumors that spread to nearby lymph nodes.
- Stage 4 – There is cancer outside of the chest cavity where it started, such as in the other lung, bones, brain or adrenal gland on top of the kidney.
