How is lung cancer diagnosed?
If a doctor suspects that you may have lung cancer, the common initial test is a chest x-ray. This is a simple and quick test, and may show changes such as abnormal shadowing. However, a chest x-ray cannot confirm cancer as there are various causes of shadowing on a chest x-ray. Other tests are needed.
Confirming the diagnosis
For all suspected cancers, it is best to confirm the diagnosis by getting a small sample or 'biopsy'. The biopsy sample is then examined under the microscope to look for the abnormal cells of cancer. The type of cancer can also be determined from the sample (and other causes of the symptoms or abnormal tissue ruled out.) One or more of the following procedures may be done to obtain a sample for testing.
Assessing the extent and spread
If you are confirmed to have lung cancer, further tests may be done to assess if it has spread. For example, a CT scan, an MRI scan, a bone scan, a PET scan, or other tests. (There are separate leaflets which describe each of these tests in more detail.) This assessment is called 'staging' of the cancer. The aim of staging is to find out:
By finding out the stage of the cancer it helps doctors to advise on the best treatment options. It also gives a reasonable indication of outlook (prognosis). See separate leaflet called 'Cancer Staging' for details.
What are the treatment options for lung cancer?
Treatment options which may be considered include surgery, chemotherapy and radiotherapy. The treatment advised for each case depends on various factors such the site of the primary tumour in the lung, the type of the cancer, the stage of the cancer (how large the cancer is and whether it has spread), and your general health.
You should have a full discussion with a specialist who knows your case. They will be able to give the pros and cons, likely success rate, possible side-effects, and other details about the various possible treatment options for your type of cancer.
You should also discuss with your specialist the aims of treatment. For example:
Surgery
An operation may be an option if the cancer is in an early stage. Surgery usually involves removing part or all of an affected lung. However, in many cases, the cancer has already spread when it is diagnosed and surgery is not usually then an option. Also, surgery may not be an option if your general health is poor. For example, if you have other lung problems such as chronic obstructive airways disease (COPD) which is also common in smokers.
Radiotherapy and chemotherapy
There are separate leaflets which give more details about these treatments. Briefly:
What is the prognosis (outlook)?
The outlook is best in those who are diagnosed when the cancer is still small, and has not spread. Surgical removal of a tumour in an early stage may then give a good chance of cure. However, most people with lung cancer are diagnosed when the cancer has already spread. In this situation a cure is less likely. However, treatment can often slow down the progression of the cancer.
The treatment of cancer is a developing area of medicine. New treatments continue to be developed and the information on outlook above is very general. The specialist who knows your case can give more accurate information about your particular outlook, and how well your type and stage of cancer is likely to respond to treatment.