To begin the diagnosis, your doctor will do a physical examination of your body to search for signs indicating non-small cell lung cancer. He can use a stethoscope to listen to the sound of yourbreathing to determine how your lungs function. He can also ask you to inhale very deeply, and tap on your chest. In addition, you will be asked about your medical history and the characteristic of the symptoms you experience.
However, to confirm a non small cell lung cancer, several tests must be performed. In general, your oncologist can recommend complete blood count (CBC), spectrum test, imaging techniques, liver function tests and biopsy.
Sputum Test – a sputum culture can be the first test recommended by your physician. It is the easiest way to detect and identify bacteria or fungi that infect the lungs or the airways. However, although useful, sputum test cannot confirm you have non small cell lung cancer; other diagnostic procedures must be performed
Complete blood count (CBC) – this exam aims to analyze your red cells, white cells and platelets. It is a very simple procedure during which a nurse takes sample of your blood for laboratory analysis. Usually, the sample obtained is analyzed by a lab specialist who measures the number of red blood cells, hemoglobin and hematocrit, the volume of cells circulating in the blood compared to the total volume of blood. In addition, the CBC used to calculate the MCV (mean corpuscular volume), the MCHC (corpuscular hemoglobin concentration) and the MCH (Mean corpuscular hemoglobin).
Bone scan – this imaging technique allows your doctor to detect very early pathogenic changes in your bones, sometimes not even visible on standard x-rays. During the procedure, the specialist will inject a small amount of radioactive substance which will bind to the diseased bone, and gives off radiation. The radiation emitted is detected by a gamma camera that create picture of your bones. The purpose of this test is to determine if the cancer has spread to any bone in your body.
Ct scan – a scanner is the use of x-rays to create images of your internal organs. It can detect abnormalities not visible on standard x-rays and ultrasound. The CT scan allows not only to detect the primary cancer in your lungs but also to highlight lymph nodes or/and liver metastases.
Magnetic resonance imaging (MRI) – with this imaging technique, your health care provider can visualize organs inside of your body, and detect disease. In the diagnosis of small cell lung cancer, your doctor can visualize and analyze the structure of your lungs, to look for abnormalities, inflammation, and presence of a tumor. The MRI not only allows your physician to detect the cancer but to know the exact size and extent of the tumor.
Bronchoscopy – this is a medical procedure used to examine the interior of the airways. During the test, your physician introduces a thin and flexible camera (bronchoscope) into the air passages of your lung to search benign or malignant conditions. A bronchoscopy can be performed for therapeutic or diagnostic purposes.
Chest x-ray – a chest x-ray is a painless diagnostic procedure that about 10 minutes. It creates pictures of your thoracic cage, which allow your health care provider to detect abnormalities in your lungs, trachea, bronchi and layers surrounding the lungs (pleura). This procedure cannot give specific details on the cancer, but it can reveal abnormal tissue growth.
Ultrasound – during thisimaging technique a medical technician uses painless high-frequency sound waves to visualize different organs of your body including your lungs. It involves applying an ultrasound sensor (transducer) on your chest in order to obtain images of your lungs. Images obtained will be sent to your doctor or an ultrasound specialist who will declare whether or not you have a tumor in your lung.
Liver function tests – this is a group of tests that are used to evaluate the function of the liver. Usually, a medical technologist will perform those tests to determine if the cancer has spread to your liver.
Positron emission tomography (PET) scan – this imaging technique gives your doctor an idea on how your tissues and organs are functioning. During the test, a radioactive tracer is injected into your body which will accumulate on the diseased tissue. Usually, the location where the tumor is located shows up as brighter spots on the PET scan. A PET differs from conventional X-rays and MRI; it can detect the tumor at an earlier stage.
Thoracentesis – also known as pleural TAP, thoracentesis is an invasive procedure involves draining fluid or air from your pleural cavity. Thoracentesis may be performed for diagnostic purposes, removing fluid for examination; or a palliative treatment – removing fluid to improve lung function. During the procedure, a cannula or hollow needle is carefully injected into your chest to remove the liquid; usually after administering a local anesthesia.
Biopsy – to accurately confirm a non small cell lung cancer diagnosis, your doctor will takes sample from the tumor to microscopically examine it. This microscopic study is done to obtain accurate information on the overall structure of the fragment removed. The biopsy is important to confirm with certainty the presence of cancer cells in your lungs. In general, your physician will perform CT scan-directed needle biopsy, mediastinoscopy with biopsy, open lung biopsy or pleural biopsy.