Lung Cancer Tests - The National Lung Cancer Forum For Nurses

What are the different tests for lung cancer?

There are many methods of testing for lung cancer. Remember that each patient is treated as an individual and therefore your specialist will recommend which tests are required to obtain the diagnosis and stage of the disease. This may also be discussed through the Lung Cancer Multi Disciplinary Team. Below is a list of tests that are often used to diagnose lung cancer:

Chest x-ray
A simple x-ray of the chest which can sometimes show abnormalities such as inflammation, infection, scarring or growths.

CT scan (computed tomography)
A scan that gives a 3D picture of your body's organs. Can help to determine whether the cancer has spread to other organs and if it is affecting any of the lymphatic nodes (glands) or blood vessels. Sometimes an injection or drink (gastrografin) is given to highlight some of the organs in the gut. The scan is painless but you might feel slightly "boxed in" as it rotates around your body. If you suffer from claustrophobia you should tell the staff as they will be able to reassure you throughout the scan.

Bronchoscopy
Allows the doctor to examine, photograph, and when possible, take a tiny sample (biopsy) of tissue from the inside of your lungs/airways. Before this test your throat is sprayed numb and a relaxing sedative may be given. A narrow flexible tube with a tiny camera on
the front will then be inserted down your nose or mouth. This shows a picture of airways/lungs, and when possible can slide down towards the area in your lung that seems suspicious. Little pinchers on the end of the camera will then be used to take a sample of
the growth. If the sample is found to be cancerous it is called malignant, if not it is benign. At this point the cell type of lung cancer you have may be established. This test is not painful but can be uncomfortable and leave you with a sore throat for a few days. A
bronchoscopy can be done either as an outpatient or an overnight stay in hospital.

PET scan (positron emission tomography)
A scan that gives pictures showing where there is active cancer throughout the body. A PET scan should be used before lung cancer surgery and radical radiotherapy, to make sure that curative treatment is possible (A PET scan is more accurate than a CT scan for this purpose). A PET scan can also be used to investigate a suspected cancer, if diagnosis has not been possible using other tests. An injection with a tiny amount of radiotracer is given to highlight any active cancer cells. The scan is painless and quiet and you will not be fully
encased during the examination.

Lung Function Tests
These are tests to establish how well your lungs are working (air/oxygen capacity). May help decide if you are fit enough for surgery, radiotherapy, or if you have any ongoing lung conditions, such as emphysema. These simple tests usually involve blowing into a mouth-piece.

Ultrasound
This is a painless scan that uses soundwaves to create an image of the inside of your body. It may be used to examine inside the kidneys, liver and lung. It is frequently used to pinpoint fluid in the lung.

Mediastinoscopy
A surgical procedure for examining lymph nodes under the breastbone (will leave a small scar). This test requires a general anaesthetic and a short stay in hospital.

Blood test
Can help in finding out about your general health and possible spread of lung cancer. Can provide information on many aspects of health including:
• How well your kidneys and liver are working (Creatinine/LFT's).
• If your body's biochemistry is balanced (for example, enough calcium and protein).
• Ongoing/vulnerability to infection (white cell count).
• Anaemia/lack of circulating oxygen (haemoglobin).
• Susceptibility to bruising/bleeding (platelets).

Sputum (spit)
A sample may assist in establishing if you have any infections or blood present. Your hospital or GP can perform this test.

MRI Scan (magnetic resonance image)
A painless but noisy scanning machine which is similar to a CT scanner but gives a different type of 3D image-using magnets instead of x-rays. No jewellery
must be worn during scan, as it will be attracted to the magnet inside the machine. If you suffer from claustrophobia you should tell the staff as they will be able to reassure you throughout the procedure.

Bone scan
A scan where a small amount of radioactive material is injected into a vein to highlight any areas of the bones that have been affected by cancer, trauma, or inflammation. Normally done on an outpatient basis.