Diagnosis of Lung cancer

There is no screening programme for lung cancer in the UK and diagnosis is usually made through one of three routes:

  1. Patients reporting their symptoms to their General Practitioners who suspect Lung cancer and refer for more investigations.
  2. Patients presenting to emergency department with acute symptoms of lung cancer and diagnosed while inpatients.
  3. Lung cancer is diagnosed incidentally when patients have a chest x-ray or CT scan for other reasons than lung cancer.

Patients with Lung cancer have a better chance of being cured of their disease when the diagnosis is made early.

When Lung cancer is suspected a physical examination will be carried out, and the doctor will ask about risks, such as being a smoker. Tests may also be carried out to rule out other conditions, such as chest infections. You may be referred to have the following tests:

Chest X-ray

Chest X-rays can show tumours in the lungs, but cannot show the difference between a tumour and other lung conditions, such as an infection. Further tests may be arranged.

CT scan

The CT scan, short for computerised tomography, takes many X-ray images to give doctors computer-generated images of the lungs. A special contrast dye injection is given before the scan to help enhance the images.

PET-CT scan

A PET-CT scan, or positron emission tomography-computerized tomography scan, takes images after the patient has been given an injection of safe radioactive material to help detect early-stage lung cancer.

Bronchoscopy

After a mild sedative is given, the bronchoscopy procedure uses a thin tube passed down the throat into the lungs through the mouth or nose. A tissue sample or biopsy is then taken for laboratory testing.

Biopsy

A biopsy is a procedure when a small sample of the cancer is taken with the help of a needle to examine under the microscope. Biopsy from a lung cancer can be obtained in different ways:

  • Percutaneous needle biopsy using a needle passed through the skin to take samples from peripheral tumours. Usually, this type of biopsy is done with the help of CT scan to locate cancer within the lung.
  • Bronchial biopsy is done while doing a bronchoscopy to obtain samples from cancers close to the centre of the chest

There are other ways to obtain lung biopsy and your doctor will explain more about this in the clinic.