Lung Cancer Diagnosis and Staging

Lung Cancer Diagnosis
If you have lung cancer, it is important to get an accurate diagnosis as early as possible so your medical team can plan the best treatment options for you.
The process starts with a thorough physical examination, during which your doctor will ask about your general health, symptoms, family history, lifestyle – including smoking habits and possible exposure to cancer-causing substances.

If lung cancer is suspected following the physical exam, your doctor will order additional tests, which include:
  • Imaging Tests: This can include computed axial tomography (CT or CAT), magnetic resonance imaging (MRI) and/or positron emission tomography (PET) scans, all of which take images of your lungs to determine presence and location of lung cancer.
  • Needle biopsy: CT scan images guide a needle through the skin into the lung tissue to collect cells. A biopsy sample may also be taken from lymph nodes or other areas in the body where cancer has spread.
  • Endobronchial Ultrasound (EBUS): This minimally invasive technique uses a thin, flexible camera with an ultrasound probe to examine and biopsy structures near the windpipe and its branches. At City of Hope, this has largely replaced mediastinoscopy, which is a procedure that gives the same information but requires an incision in the neck and passage of surgical tools to take tissue samples from lymph nodes.
  • Navigational Bronchoscopy: A special computer creates a three-dimensional map of the lungs and helps guide a thin, flexible tube down the mouth, through the windpipe, and directly to the tumor. This allows the doctor to take biopsies or place markers for other treatments much more accurately than with traditional methods.
  • Thoracentesis: Fluid from around the lungs is drawn out with a needle and looked at under a microscope.
In addition to the above tests, City of Hope is on the forefront of genomic testing, a revolutionary diagnostic tool that can classify lung cancer beyond its physical characteristics. By looking at the cancer’s molecular and genetic characteristics, our physicians can determine whether the disease is sensitive or resistant to specific therapies—allowing them to plan a treatment regimen that is more effective.
To properly plan for treatment, lung cancer patients are staged in accordance to how advanced the disorder is. This is primarily done by taking a number of factors into consideration, including:
  • Size of the tumor
  • If the tumor have grown into the chest wall, diaphragm, main brochus or tissue surrounding the heart
  • Whether the cancer has spread to nearby lymph nodes and how many lymph nodes are affected
  • If the cancer has metastasized to distant organs, such as the bone, liver or brain
Based on these factors, patients are staged according to their risk level, with higher risk patients typically requiring more intensive treatments.
More information on lung cancer staging criteria is available on the American Lung Association’s website.
If you have been diagnosed with lung cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.