What steps are necessary to diagnose lung cancer?

Question by conlund: What steps are necessary to diagnose lung cancer?
I have a friend whom says she has lung cancer. I actually don’t believe her. She is only 42 yrs. old. She said she has the opinion of 3 doctors. My mom had lung cancer and she didn’t know for sure till they did a biopsy. This friend hasn’t had a biopsy. Is it possible to know you have lung cancer without a biopsy?

Best answer:

Answer by hermitcrab_rescue
Diagnosing Lung Cancer

To help find the cause of symptoms, the doctor evaluates a person’s medical history, smoking history, exposure to environmental and occupational substances, and family history of cancer. The doctor also performs a physical exam and may order a chest x-ray and other tests. If lung cancer is suspected, sputum cytology (the microscopic examination of cells obtained from a deep-cough sample of mucus in the lungs) is a simple test that may be useful in detecting lung cancer. To confirm the presence of lung cancer, the doctor must examine tissue from the lung. A biopsy — the removal of a small sample of tissue for examination under a microscope by a pathologist — can show whether a person has cancer. A number of procedures may be used to obtain this tissue:

Bronchoscopy. The doctor puts a bronchoscope (a thin, lighted tube) into the mouth or nose and down through the windpipe to look into the breathing passages. Through this tube, the doctor can collect cells or small samples of tissue.

Needle aspiration. A needle is inserted through the chest into the tumor to remove a sample of tissue.

Thoracentesis. Using a needle, the doctor removes a sample of the fluid that surrounds the lungs to check for cancer cells.

Thoracotomy. Surgery to open the chest is sometimes needed to diagnose lung cancer. This procedure is a major operation performed in a hospital.

……….Lung cancer is difficult to detect early because symptoms usually do not appear until the disease is advanced. Symptoms depend on the location of the tumor and can include persistent cough, hoarseness or wheezing, shortness of breath, sputum streaked with blood, recurring bronchitis or pneumonia, weight loss and loss of appetite, and chest pain.

Physicians use several techniques to diagnose lung cancer, including the following:

Imaging Tests
Chest x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) help locate abnormal areas in the lung.

Low-Dose Helical CT
A technique called low-dose helical (or spiral) CT may offer a novel approach for diagnosing lung cancer by exposing the patient to less radiation than a conventional chest CT scan while allowing the doctor to see areas of the chest normally obscured in a standard x-ray. Memorial Sloan-Kettering is now studying the effectiveness of low-dose helical CT in a clinical trial. Outside of New York, the National Cancer Institute has begun a multi-center study of the technology.

Combined PET/CT Scans
Memorial Sloan-Kettering’s radiology department includes the best combined PET/CT imaging technology available in the United States. This is particularly important in imaging lung cancer, which can be difficult to identify on a regular CT. To address this situation, a PET (positron emission tomography) scan, which picks up the metabolic signal of actively growing cancer cells in the body, is run simultaneously with the CT scan. This improved imaging capability provides for superior treatment planning because the details of the tumor are better defined.

Bronchoscopy & Biopsies
A sputum sample can be analyzed for the presence of cancerous cells. Doctors may perform a bronchoscopy, which allows them to examine the bronchial passages using an instrument called a bronchoscope. This is a small tube that is inserted through the nose or mouth, down the throat and into the bronchi. During the procedure physicians may remove some tissue for analysis.

A modified form of bronchoscopy called autofluorescence bronchoscopy, which can detect early invasive cancers not seen with standard x-rays or white-light bronchoscopy, is being used to detect very early lung cancer.

To examine areas of the lungs that are not accessible during a bronchoscopy, physicians may perform a needle biopsy (“fine needle aspiration” or FNA) to remove a small sample of tissue for analysis.

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