Upon hearing about the symptoms, a health-care provider will formulate a list of possible diagnoses. He or she will ask questions about the symptoms, medical and surgical history, smoking and work history, and other questions about lifestyle, overall health, and medications.
Unless severe hemoptysis is occurring, a chest x-ray will most likely be performed first to look for a cause of the respiratory symptoms.
- The x-ray film may or may not show an abnormality.
- Types of abnormalities seen in lung cancer include a small nodule or nodules or a large mass.
- Not all abnormalities observed on a chest x-ray are cancers. For example, some people develop scarring and calcium deposits in their lungs that may look like tumors on a chest x-ray film.
In most cases, a CT scan or MRI of the chest will further define the problem.
- If symptoms are severe, the x-ray may be skipped and a CT scan or MRI may be performed right away.
- The advantages of CT scan and MRI are that they show much greater detail than x-rays and are able to show the lungs in three dimensions.
- These tests help determine the stage of the cancer by showing the size of the tumor or tumors.
- They can also help identify spread of the cancer into nearby lymph nodes or certain other organs.
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If a person's chest x-ray film or scan suggests that a tumor is present, he or she will undergo a procedure for diagnosis.
- This procedure involves collection of sputum, removal of a small piece of the tumor tissue (biopsy) or a small volume of fluid from the sac around the lung.
- The retrieved cells are reviewed under a microscope by a doctor who specializes in diagnosing diseases by looking at cell and tissue types (a pathologist).
- Several different ways exist to obtain these cells.
Sputum testing: This is a simple test that is sometimes performed to detect cancer in the lungs.
- Sputum is thick mucus that may be produced during a cough.
- Cells in the sputum can be examined to see if they are cancerous. This is called cytologic review.
- This is not a completely reliable test. If negative, the findings usually need to be confirmed by further testing.
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