Lung Cancer Screening and Tests

Articles On Lung Cancer Diagnosis

If you're a smoker or have other risks for lung cancer, you may want to get a screening test that may help your doctor find the disease before you notice any symptoms. The heads up would let you start treatment early, when the condition is easier to fight.

If your screening shows you may have lung cancer, your doctor will likely order "diagnostic" tests. Those can pinpoint the type of the disease and whether it has spread to other places in the body.

Your doctor will also use diagnostic tests to find out what's going on if you have possible lung cancer symptoms such as a long-lasting cough, shortness of breath, or chest pain.

Who Should Get Screened?

Experts have different views. The U.S. Preventive Services Task Force, say you should do it if you're between 50 and 80, have a 20 pack-year smoking history, currently smoke or it has been less than 15 years since you quit smoking. If you haven't smoked in the last 15 years, you shouldn't have to be screened. (A pack- year is the number of cigarette packs smoked each day multiplied by the number of years a person has smoked.) Talk to your doctor about your smoking history to see if you should be screened based on these guidelines.

Besides smoking, there are other reasons you could have a higher risk of lung cancer. Your doctor may suggest you get screened if you:

• Spent a lot of time around chemicals such as radon, arsenic, cadmium, chromium, nickel, silica, or asbestos
• Already had small-cell lung cancer, or cancer of the head or neck
• Had radiation therapy to the chest to treat cancer
• Had a parent, brother or sister, or child with lung cancer
• Have chronic obstructive pulmonary disease (COPD) or pulmonary fibrosis (scarring in the lungs)

How Screening Works

If you decide to get a screening test, you'll likely get something called low-dose computed tomography (LDCT). It's a machine that uses X-rays to make detailed pictures of your lungs.

It's a super-easy exam to take. You don't need any special prep, like fasting. You just need to hold your breath for about 6 seconds while a technician takes a scan. The whole thing takes about 10 minutes.

One thing to keep in mind: Sometimes an LCDT can give a result that looks like cancer but really isn't. Doctors call this situation a false-positive. You may need to take some other tests to double-check.

To find out if a screening test is right for you, take this quiz from the American Lung Association.

Diagnostic Tests

If you have possible symptoms of lung cancer, your doctor will probably start with a physical exam and a review of your medical history.

If they think you may have cancer, either because of your symptoms or your screening test, you may need some of these exams:

Sputum cytology. This test looks for cancer cells in your mucus. To get a sample, you'll breathe deeply and then cough with enough force to bring some mucus up from your lungs. Then you'll spit it out into a cup.

Imaging tests. They look for growths that might be lung cancer. Your doctor will be able to figure out if the disease has spread, and if so, where in your body it is.

Some imaging tests that may be useful to make a diagnosis are:

Chest X-ray. It uses radiation in low doses to make images of your lungs.

CT (computed tomography). This powerful X-ray can show the size and shape of cancer and where it is. You may get a scan of your chest and belly. If you have the disease, the doctor can see whether it has spread to places like your liver or adrenal glands.

PET (positron emission tomography). It uses a special type of radiation that collects in cancer cells. A camera then takes pictures of these areas. Your doctor can use this exam to find out if a growth that showed up on an X-ray is really cancer, and to see if it's moved to other places.

Biopsy

In this test, your doctor removes some cells from your lungs to check under a microscope for cancer, and to figure out which kind it is. There are a few different ways it's done:

Needle biopsy or needle aspiration. Your doctor numbs your skin and uses a needle to remove a sample of tissue.

You may hear them talk about two different types. If a thin needle is used, it's called fine needle aspiration.

A procedure that uses a slightly thicker, hollow needle to remove a piece of tissue along with the cells is called a core biopsy. Your doctor may use a CT scan or X-ray to guide the needle to the right spot.

Bronchoscopy. For this test, they remove a tissue a tissue sample is removed through a thin tube that is placed into your lungs.

Thoracentesis. Your doctor puts a needle into the space between your lung and chest wall to remove fluid, which is checked for cancer cells.

Endoscopic ultrasound. When you get this test, they insert a needle through a lighted tube called an endoscope.

Open biopsy. You need to be in a hospital operating room to get this done. A surgeon removes tissue through a cut in your chest. You'll get anesthesia that puts you to sleep while this is going on.

However your biopsy is done, after it's over the cells that were removed are sent to a lab. A specialist called a pathologist looks at them under a microscope to check if any of them are cancer.

The lab might also do biomarker testing on the tissue sample from your biopsy. This test provides more detailed information about the makeup of your cancer. That helps your doctor understand which treatments might work best.

If you get a diagnosis of lung cancer, your doctor will discuss a treatment plan. But make sure you also get the emotional support you need. Reach out to your family and friends. They can be a huge source of support while you manage and treat your condition. Also look into support groups, where you can talk to people who are going through the same things you are.

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