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Diagnosis and Staging

Diagnosis is the process of identifying the disease that is causing someone’s symptoms. Diagnosing lung cancer can start with visiting your doctor for a symptom or being referred to a doctor because of abnormal screening results. Based on your symptoms and a physical examination, your doctor may refer you to a specialist or order further tests to check for lung cancer.

The diagnosis process can be lengthy, stressful, and frustrating. It’s natural to worry or feel anxious about your test results. However, it’s important to remember that conditions other than lung cancer can cause your symptoms. Therefore, your medical team will conduct various tests to rule out other illnesses before confirming a lung cancer diagnosis. The tests listed below are used to detect lung cancer, confirm the diagnosis, and determine if it has spread to other parts of the body. Some of these tests also assess your overall health and help tailor your treatment plan.

Imaging Tests

Imaging tests use X-rays, magnetic fields, nuclear imaging, and sound waves to create detailed images of what’s happening inside your body. Imaging tests include Chest X-ray, CT Scan, MRI Scan, PET Scan, Bone Scan and Ultrasound.

Imaging tests are used to:

Check areas that might be cancer
See how far the cancer has spread in the body
Check how well the cancer is responding to treatment
Follow up after treatment to see if the cancer is returning

For detailed information on the different types of imaging tests visit your comprehensive guide to lung cancer.

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Biopsy

The imaging test results guide your doctor to the location of the suspected cancer. However, the definitive diagnosis is confirmed when the lab finds cancer cells in the tumour sample. A biopsy is a procedure where doctors extract a small tissue sample from a tumour to examine it for cancer cells. Various methods can be used to perform a biopsy, including fine need aspiration (FNA), core biopsy, liquid biopsy, thoracocentesis and surgical biopsy.

Endoscopy

Endoscopy is a procedure where doctors use a thin, flexible tube with a tiny camera on the end, called an endoscope, to look inside the body. The tube can also have an open channel that allows doctors to slide in small tools to take out biopsy samples or do other surgical procedures. Various endoscopic procedures help diagnose lung cancer and determine its spread. These include bronchoscopy, mediastinoscopy, mediastinotomy, thoracoscopy, sputum cytology.

For more information on the different types of procedures visit your comprehensive guide to lung cancer.

Evaluation of your samples

Tissue samples taken during biopsies and endoscopic procedures are sent to a lab. There, a pathologist examines these samples for cancer cells. If they find any, they determine the type of cancer. They also assess how the cancer cells look. More normal-looking tumour cells mean the cancer is less aggressive. However, the more abnormal-looking cells suggest a more aggressive cancer that grows and spreads quickly. The pathologist puts all this information in a report. This report helps your doctor confirm the diagnosis and plan the treatment. If a sample is too small or doesn’t show the tumour well, the pathologist cannot run all the necessary tests. In such cases, you may need another biopsy.

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Pulmonary Function Tests

Pulmonary Function Tests (PFTs) check the health of your lungs. They determine how much air they can hold and how well you can let air out of the lungs. Based on these tests, your doctor can decide whether surgery is the right treatment for you. If surgery is deemed suitable, PFTs guide how much of the lung can be safely removed, ensuring you can breathe comfortably afterward. Sometimes, an arterial blood gas test might be performed with a PFT. In this test, blood is taken from a small artery to measure oxygen and carbon dioxide levels. It helps determine how effectively your lungs add oxygen to and remove carbon dioxide from your blood.

Other Tests

Based on your health history, your doctor might order other tests. For example, your doctor might order heart function tests like echocardiogram and electrocardiogram (ECG) before surgery. These tests check your heart’s health to ensure it is strong enough for surgery and recovery.