Tests and procedures that examine the lungs are used to detect, diagnose and stage small cell lung cancer.
The following tests and procedures may be used:
Chest X-ray: This is often the first test your doctor will do to look for any spots or masses on the lungs. It creates a picture of the organs and bones inside the chest.
Physical exam and history: An exam of the body to check for general signs of disease, such as lumps or anything that seems unusual. A history of a patient’s health habits, past jobs, illnesses and treatments will also be taken.
Computed tomography (CT) scan: The CT scan uses X-rays to make detailed pictures of areas inside the body at different angles. A CT scanner takes many pictures as it rotates around you while you lie on a table. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly.
Positron emission tomography (PET) scan: This test finds malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
Sputum cytology: To check for cancer cells present in sputum (mucus coughed up from the lungs).
Bronchoscopy: This procedure looks inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
Fine-needle aspiration (FNA) biopsy of the lung: Tissue or fluid from the lung is removed using a thin needle. A CT scan, ultrasound or other imaging procedure is used to locate the abnormal tissue or fluid in the lung. A small incision may be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid. A sample is removed with the needle and sent to the laboratory. A pathologist then views the sample under a microscope to look for cancer cells. A chest X-ray is done after the procedure to make sure no air is leaking from the lung into the chest.
Thoracoscopy: To look at the organs inside the chest to check for abnormal areas. An incision is made between two ribs, and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. In some cases, this procedure is used to remove part of the esophagus or lung. If certain tissues, organs, or lymph nodes can’t be reached, a thoracotomy may be done. In this procedure, a larger incision is made between the ribs and the chest is opened.
Thoracentesis: This test looks for cancer cells in the fluid in the space between the lining of the chest and the lung. The fluid is removed using a needle, and a pathologist views it under a microscope.