Lung
Let’s see what are the tests used to diagnose lung cancer:
• First of all, a history and physical examination, looking for symptoms and signs of lung cancer.
• The chest x-ray is the first step in the presence of any signs and symptoms of lung cancer. You should know that having a chest x–ray doesn’t mean your doctor suspects you have lung cancer and a normal result usually means you don’t have lung cancer.
Chest x-rays may reveal suspicious areas in the lungs but are unable to determine if these areas are cancerous.
• CT (computerized axial tomography scan) scans may be performed on the chest, abdomen, and/or brain to examine for both metastatic and primary tumor. A CT scan of the chest may be ordered when x-rays are negative or do not yield sufficient information about the extent or location of a tumor. One advantage of CT scans is that they are more sensitive than standard chest x-rays in the detection of lung nodules. CT scans of the abdomen may identify metastatic cancer in the liver or adrenal glands, and CT scans of the head may be ordered to reveal the presence and extent of metastatic cancer in the brain.
• Magnetic resonance imaging (MRI) scans may be indicated when precise detail about a tumor’s location is required. The MRI technique uses magnetism, radio waves, and a computer to produce images of body structures. The image and resolution produced by MRI is quite detailed and can detect tiny changes of structures within the body.
• Bronchoscopy - Examination of the airways by bronchoscopy (visualizing the airways through a thin probe inserted in a tube through the nose or mouth) may reveal areas of tumor that can be sampled for pathologic diagnosis. A tumor in the central areas of the lung or arising from the larger airways is accessible to sampling using this technique. When a tumor is visualized and adequately sampled, an accurate cancer diagnosis is generally possible.
• Needle biopsy - Fine needle aspiration (FNA) through the skin, most commonly performed with radiological imaging for guidance, may be useful in retrieving cells for diagnosis from tumor nodules in the lungs. Needle biopsies are particularly useful when the lung tumor is peripherally located in the lung and not accessible to sampling by bronchoscopy. Cells are suctioned into the syringe and are examined under the microscope for tumor cells.
• Thoracentesis - Sometimes lung cancers involve the lining tissue of the lungs (pleura) and lead to an accumulation of fluid in the space between the lungs and chest wall (called a pleural effusion). Aspiration of a sample of this fluid with a thin needle (thoracentesis) may reveal the cancer cells and establish the diagnosis.
• Blood tests – While routine blood tests alone cannot diagnose lung cancer, they may reveal biochemical or metabolic abnormalities in the body that accompany cancer. For example, elevated levels of calcium or of the enzyme alkaline phosphatase may accompany cancer that is metastatic to the bones.
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