Lung Cancer Screening and Tests

If you're a smoker or have other risks for lung cancer, you may want to get a screening test that can help your doctor find the disease before you notice any symptoms. The heads up would let you start treatment early, when the condition is easier to fight.

If your screening shows you may have lung cancer, your doctor will likely order up "diagnostic" tests. Those can pinpoint the type of the disease and whether it's spread to other places in the body.

Who Should Get Screened?

Experts have different views. Several health organizations, including the American Cancer Society, American Lung Association, and the U.S. Preventive Services Task Force, say you should do it if you're at least 55 and you are or were a long-term smoker. But they disagree on some details, such as how many cigarettes a day you had.

Besides smoking, there are other reasons you could have higher odds of lung cancer. Your doctor may suggest you get screened if you:

How Screening Works

If you decide to get a screening test, you'll likely get something called low-dose computed tomography (LDCT). It's a machine that uses X-rays to make detailed pictures of your lungs.

It's a super-easy exam to take. You don't need any special prep, like fasting. You just need to hold your breath for about 6 seconds while a technician takes a scan. The whole thing takes about 10 minutes.

One thing to keep in mind: Sometimes an LCDT can give a result that looks like cancer, but really isn't. Doctors call this situation a false-positive. You may need to take some other tests to double-check.

Diagnostic Tests

If your doctor thinks you might have cancer because of your symptoms or your screening test, you may need to take some of these exams:

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Sputum Cytology. This test looks for cancer cells in your mucus. To get a sample, you'll breathe deeply and then cough with enough force to bring some up from your lungs. Then you'll spit it out into a cup.

Imaging Tests. They look for growths that might be lung cancer. Your doctor will be able to figure out if the disease has spread, and if so, where in your body it is.

Some imaging tests that may be useful to make a diagnosis are:

Chest X-ray. It uses radiation in low doses to make images of your lungs. It might be the first test you get. If your doctor sees something that looks like cancer, you might need more exams.

CT (computed tomography). This powerful X-ray can show the size and shape of cancer, and where it is. You may get a scan of your chest and belly. If you have the disease, the doctor can see whether it has spread to places like your liver or adrenal glands.

PET (positron emission tomography). It uses a special type of radiation that collects in cancer cells. A camera then takes pictures of these areas. Your doctor can use this exam to find out if a growth that showed up on an X-ray is really cancer, and to see if it's moved to other places.

Biopsy

In this test, your doctor removes some cells from your lungs to check under a microscope for cancer, and to figure out which kind it is. There are a few different ways it's done:

Needle biopsy or needle aspiration. Your doctor numbs your skin and uses a needle to remove a sample of tissue.

You may hear him talk about two different types. If he uses a thin needle it's called fine needle aspiration.

A procedure that uses a slightly thicker, hollow needle to remove a piece of tissue along with the cells is called a core biopsy. Your doctor may use a CT scan or X-ray to guide the needle to the right spot.

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Bronchoscopy . For this test, he removes a tissue sample through a thin tube that he places into your lungs.

Thoracentesis. Your doctor puts a needle into the space between your lung and chest wall to remove fluid, which he checks for cancer cells.

Endoscopic ultrasound. When you get this test, he inserts a needle through a lighted tube called an endoscope.

Open biopsy. You need to be in a hospital operating room to get this done.A surgeon removes tissue through a cut in your chest. You'll get anesthesia that puts you to sleep while this is going on.

However your biopsy is done, after it's over the cells that were removed are sent to a lab. A specialist called a pathologist looks at them under a microscope to check if any of them are cancer.

If you get a diagnosis of lung cancer, your doctor will discuss a treatment plan. But make sure you also get the emotional backing you need. Reach out to your family and friends. They can be a huge source of support while you manage and treat your condition. Also look into support groups, where you can talk to people who are going through the same things you are.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on April 23, 2016

Sources

SOURCES:

American Cancer Society: "Exams and tests that look for lung cancer." "Tests for small cell lung cancer."

American Society of Clinical Oncology: "Lung Cancer - Non-Small Cell: Diagnosis."

CDC: "Lung Cancer Screening Guidelines and Recommendations." "What are the Risk Factors for Lung Cancer?" "What Screening Tests are There?"

National Comprehensive Cancer Network: "Lung Cancer Screening."

National Institute for Health and Care Excellence: "Lung cancer: diagnosis and management."

U.S. Preventive Services Task Force: "Screening for Lung Cancer: Consumer Guide."

University of Kansas Cancer Center: "Frequently Asked Questions About Lung Cancer Screening with Low-Dose CT."

UptoDate: "Endoscopic ultrasound-guided fine-needle aspiration in the mediastinum."

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