Initially, your doctor will do a physical examination to search for signs indicating small cell lung cancer. He may use a stethoscope to hear the sound of your lungs to determine if they work fine. In addition, you will be asked about the conditions of your medical history and the symptoms you experience.
However, to confirm the presence of cancer in your lungs, your doctor needs to perform several tests: complete blood count (CBC), spectrum test, imaging techniques, liver function tests and biopsy.
Sputum Test – a sputum culture is the easiest way to detect and identify bacteria or fungi that infect the lungs or breathing passages. However, this test cannot confirm a small cell lung cancer; other diagnostic procedures are needed.
Complete blood count (CBC) – this exam aims to analyze quantitatively and qualitatively elements of the blood: red cells, white cells and platelets. It is a very simple blood test consisting of taking simple 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 changes or abnormalities 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 the bones. The purpose of this test is to determine if the cancer has spread to any bone in your body.
CT scan – a CT scan is necessary to detect abnormalities that are not visible on standard x-rays and ultrasound. In general, it consists of using x-rays to create images of the internal organs. The scanner 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 an MRI, your physician can visualize organs inside your thoracic cage such as the lungs. In the diagnosis of small cell lung cancer, your doctor can visualize and analyze the structure of your lungs, to look for abnormal shape, inflammation, benign/malignant growth. The MRI not only allows your physician to detect the cancer but also to know the exact size and extent of the tumor.
Bronchoscopy – this is a medical procedure designed to visualize the interior of the bronchial tree (airways). During the test, your physician introduces a bronchoscope – a thin and flexible camera – into the air passages of your lung to look for abnormalities. A bronchoscopy can be performed for diagnostic purposes, or as a surgical treatment for some lung conditions.
Chest x-ray – a chest x-ray is a painless test which lasts between 5 and 10 minutes. It allows your physician to view and examine your lungs and your trachea, bronchi and layers surrounding the lungs (pleura). This procedure cannot give specific details on the cancer, but it can reveal presence of a malignant growth in your lung.
Ultrasound – during thisimaging technique your physician 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 create images of your lungs.
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 treatment – removing fluid to improve lung functions. During the procedure, a cannula or hollow needle is carefully injected into your chest to the fluid; usually after administering a local anesthetic to remove the liquid.
Biopsy – to accurately confirm the diagnosis, your doctor will takes a sample from the tumor for microscopic examination. This microscopic study aims 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 one of these biopsies: CT scan-directed needle biopsy, mediastinoscopy with biopsy, open lung biopsy or pleural biopsy.