LUNG CANCER DIAGNOSIS

1. Examination of the sputum can show cancer cells. The sputum is generally collected over a three day period to increase the likelihood of making a correct diagnosis as compared to a single sputum collection.
2. Fiberoptic bronchoscopy utilizes a small flexible lighted tube which is passed into the nasal canal and then into the appropriate bronchus (airway) to the cancer, which is then biopsied. A biopsy (a small piece of tissue) is obtained by either brushing the surface of the lesion or inserting a needle into the lesion and withdrawing a small sample of tissue.
3. Percutaneous needle biopsy involves inserting a thin needle into the mass through the skin and chest wall. This is useful for lesions that are close to the surface of the lung. This approach is often aided by the use of a CAT scan to guide the needle into the mass. In a small number of cases, a slight collapse of the lung (pneumothorax) occurs. This is usually self-limiting and only in about five percent of cases is it necessary to insert a tube into the chest to re-expand the lung.
4. Excision or surgical removal of the suspected mass can lead to the diagnosis. This can be performed through a small incision into the chest (thoracotomy), or more recently with thoracoscopy. This procedure involves inserting a small thin video camera into the chest and removing a small wedge of lung tissue using either a mechanical stapling device or laser.