Understanding How Lung Cancer Is Diagnosed
The possibility of lung cancer (LC) is frightening because the disease can spread quickly. Survival rates are closely tied to its metastasis. For example, if the condition is caught while it is in Stage 1, the 5-year survival rate rises to eighty percent. By the time it has reached Stage 2 (i.e. the tumor has spread to the lymph nodes), the rate drops to fifty percent. By Stage 4, only one in ten patients can expect to live more than five years.
The problem is that most cases of lung cancer are identified after the disease has reached its later stages. The patient typically remains unaware there is a problem until she experiences chest pain or a blood-tinged cough. During a routine examination, her doctor takes x-rays that reveal the abnormality present in her lungs. Further testing is needed to confirm whether the abnormality represents lung cancer.
Below, we’ll describe the tests that are done to diagnose the disease. Some are slightly invasive while others are not. Your physician will decide which of the following tests are appropriate.
Medical History, Physical Exam, And Chest X-rays
If your doctor identifies an abnormality, and suspects it could be LC, he or she will examine your medical history. This is done to determine whether any preconditions or risk factors exist that increase your likelihood of getting the disease. A physical examination is also done to check for signs that suggest the presence of cancerous cells. These include strange sounds in the lungs and swollen lymph nodes. Lastly, chest x-rays are taken to provide a better view of the lungs, and expose abnormal masses.
CT And MRI Scans
A computerized tomography scan (also known as a CT scan) is done to build a 3-dimensional image of your lungs. A scanner rotates around your body as you lie on a table, and takes multiple x-rays of your chest. These x-rays are clearer than those ordered for the preliminary workup.
In contrast to a CT scan, magnetic resonance imaging (MRI) uses no radiation. Instead, it employs magnets and radio waves. By using magnets to arrange your body’s hydrogen atoms, and bouncing radio waves off them, a MRI scanner can produce relatively clear images of your lungs.
Neither CT or MRI scans can confirm the presence of lung cancer. They can, however, support a case for further testing.
PET Scan
CTs and MRIs look at the structures within your body (e.g. lungs, bones, etc.). PET scans look at your body’s activity. A radioactive solution containing glucose is injected and allowed to flow through your bloodstream. Active cells use glucose, which causes them to illuminate in 3-dimensional images. Because cancerous cells are very active, your doctor can often use the results of a PET scan to identify lung cancer.
Bronchoscopy
During this procedure, a flexible tube called a bronchoscope is inserted in your nose or mouth, and advanced into your major airways. This allows your physician to view the area. If a tumor is present in your airways, the bronchoscope can be used to extract a small sample. The sample is then sent to a lab for further study.
Needle And Open Biopsy
A biopsy is the removal of tissue or cells for examination. There are two approaches: fine needle aspiration and open biopsy. With the first approach, a doctor inserts a needle directly into the tumor, and extracts a portion of it. This portion is studied by a pathologist, who can identify cancer.
The second approach is used when a tumor exists, but cannot be easily reached with a needle. Your physician must make an incision between your ribs, and advance instruments to the diseased tissue to take a sample. One of the drawbacks to this approach is that it poses a risk of bleeding.
If you suspect you may have lung cancer, ask your doctor to check for abnormalities. The earlier the disease can be diagnosed, the better the odds it can be treated successfully.
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