Symptoms and Diagnosis
Common Signs and Symptoms
When lung cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that people should watch for. Common signs and symptoms of lung cancer include:
- a cough that doesn't go away and gets worse over time
- constant chest pain
- coughing up blood
- shortness of breath, wheezing, or hoarseness
- repeated problems with pneumonia or bronchitis
- swelling of the neck and face
- loss of appetite or weight loss
These symptoms may be caused by lung cancer or by other conditions. It is important to check with a doctor if you have symptoms because only a doctor can make a diagnosis. Don't wait to feel pain. Early cancer usually doesn't cause pain.
Tests for Lung Cancer
To find out if lung cancer may be present, the doctor evaluates a person's medical history, smoking history, their exposure to environmental and occupational substances, and family history of cancer.
The doctor also performs a physical exam and may order a test to take an image of the chest or other tests. Seeing a spot on an image is usually how a doctor first suspects that lung cancer may be present.
If lung cancer is suspected, the doctor may order a test called a sputum cytology. This is a simple test where a doctor examines a sample of mucous cells coughed up from the lungs under a microscope to see if cancer is present.
Biopsies to Detect Lung Cancer
But to confirm the presence of lung cancer, the doctor must examine fluid or tissue from the lung. This is done through a biopsy -- the removal of a small sample of fluid or tissue for examination under a microscope by a pathologist. A biopsy can show whether a person has cancer. A number of procedures may be used to obtain this tissue.
- Bronchoscopy -- The doctor puts a bronchoscope -- a thin, lighted tube -- into the mouth or nose and down through the windpipe to look into the breathing passages. Through this tube, the doctor can collect cells or small samples of tissue.
- Needle Aspiration -- The doctor numbs the chest area and inserts a thin needle into the tumor to remove a sample of tissue.
- Thoracentesis –- Using a needle, the doctor removes a sample of the fluid that surrounds the lungs to check for cancer cells.
- Thoracotomy -- Surgery to open the chest is sometimes needed to diagnose lung cancer. This procedure is a major operation performed in a hospital.
Doctors use imaging methods such as a spiral CT scan (also commonly known as helical CT) or a PET scan to look for signs of cancer. A CT scan, also known as computerized tomography scan, is a series of detailed pictures of areas inside the body. A PET scan, also known as positron emission tomography, is a computerized image of the metabolic activity of body tissues.
Other tests can include removal of lymph nodes for examination under a microscope to check for cancer cells. Lymph nodes are small, bean-shaped structures found throughout the body. They filter substances in a fluid called lymph and help fight infection and disease.