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    Non-Small-Cell Lung Cancer

    Getting a Diagnosis

    First, your doctor will talk with you and ask questions like:

    • When did you first notice problems?
    • How have you been feeling?
    • Are you coughing or wheezing?
    • Does anything make your symptoms better or worse?
    • Do you, or did you, smoke?
    • Has anyone in your family had lung cancer?

    He'll also give you a physical exam. You might need tests, too.

    Imaging tests help your doctor find tumors inside your lungs. They can also show whether the cancer has spread.

    • X-rays use low doses of radiation to make images of structures inside your body.
    • MRI, or magnetic resonance imaging, shows blood flow, organs, and structures.
    • Ultrasound creates a picture by bouncing sound waves off tissues inside you.
    • PET scans use a radioactive compound or tracer that collects where your cells are very active.
    • CT scans are powerful X-rays that make detailed pictures of the tissue and the blood vessels in the lung.

    Sputum cytology is a lab test that checks the mucus you cough up for cancer cells.

    Fine-needle aspiration biopsy takes cells from an abnormal growth or the fluid in your lungs.

    Your doctor may want to look inside your lungs and chest using a thin, flexible tube with a light and tiny camera. He may also take samples of tissue, including from nearby lymph nodes, to check for cancer cells. He can do this a few different ways:

    Bronchoscopy goes through your nose or mouth and into your lungs. 

    Endobronchial ultrasound uses bronchoscopy with an ultrasound placed at the tip of the tube to look at lymph nodes and other structures.

    Endoscopic ultrasound is like the endobronchial ultrasound, but your doctor puts the endoscope down your throat into the esophagus.

    Thoracoscopy uses a few small cuts along your side to look at the outside of your lung and the tissue around it.

    Mediastinoscopy makes a small cut in your neck to see behind your breastbone, in the space between your lungs.

    Based on what your doctor finds, he'll assign a stage, describing where the cancer is. That will help your medical team figure out the best treatment for you. You’ll want to know what each stage means:

    • Occult stage: "Occult" means "hidden." Cancer cells are in lung fluid or sputum, but the doctor can't find where the cancer is in your lungs.
    • Stage 0: Cancer cells are in the lining of your airways.
    • Stage I: A small tumor is in only one lung. The cancer hasn't spread to lymph nodes.
    • Stage II: A larger tumor is in one lung, or the cancer has spread to nearby lymph nodes.
    • Stage III: Cancer in one lung has spread to farther lymph nodes or into nearby structures.
    • Stage IV: Cancer has spread to both lungs, to fluid around the lungs, or to other parts of the body, such as the brain and liver.

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