Lung Cancer

If you have symptoms of lung cancer, you should schedule a visit to your doctor. Your healthcare provider will ask about your health and family history and perform an exam. You’ll then work together to plan your next steps, which may include imaging tests.

Imaging tests give your care team detailed pictures of your lungs or other areas of your body to look for cancer. Some imaging tests are used to detect lung cancer, while others may look for signs that cancer has spread:

• Chest X-ray: A chest X-ray is a noninvasive imaging test that creates a picture of the inside of your chest. You may undergo further testing if your doctor sees a chest mass or possible lung tumor.
• CT scan: A low-dose computed tomography (CT) scan with low radiation is the recommended screening test for lung cancer for eligible patients. The actual scan only takes about five minutes and you can find cancer even before you have symptoms.
• MRI: An MRI of the lungs uses magnets and radio waves to create detailed images. MRIs are most often used to provide further insights about lung cancer after it has been diagnosed.
• PET: During a PET scan, a small amount of radioactive material is injected into your blood. This material shows where cancer cells are in the body, which helps diagnose and stage your lung cancer.

Lung cancer cells can be found in your sputum, the mucus you cough up from your lungs. With sputum cytology, you’ll take samples of this mucus and then send them to a lab, where they’ll be viewed under a microscope.

A thoracentesis provides a fluid sample and can relieve symptoms of fluid buildup. During this procedure, a doctor inserts a needle into the space between your chest wall and lung to retrieve fluid for testing.

A biopsy takes tissue samples for testing if you have a lung nodule on an imaging test or lung cancer that may have spread to other areas. These samples are then sent to the lab and are tested for signs of lung cancer.

• CT-guided needle biopsy: During this type of biopsy, a needle is guided into the nodule or mass in your lung to take a tissue sample.
• Bronchoscopy: In a bronchoscopy, a doctor inserts a thin tube down your throat and into your airways to look inside the lungs and take samples. The procedure is used to both diagnose and treat symptoms of lung cancer.
• Thoracoscopy or video-assisted thoracic surgery (VATS): Thoracoscopy is a surgical procedure that uses a scope and a tiny camera inserted through a small incision to video your lungs. It allows your care team to take tissue samples and drain fluid and can also be used during lung cancer treatment.
• Endobronchial ultrasound: An endobronchial ultrasound uses ultrasound technology during a bronchoscopy to help your doctor view the inside of your lungs and airways. It’s used to diagnose lung cancer and take samples of nearby lymph nodes.
• Endoscopic esophageal ultrasound combines an ultrasound with an endoscope (a thin, flexible tube with a camera) to view the upper digestive tract. In lung cancer, it may be used to let your team reach nearby lymph nodes for biopsy.
• Mediastinoscopy or mediastinotomy: These procedures allow your team to take samples of the lymph nodes in the middle of your chest. Mediastinoscopy uses a small incision and scope to reach the area between your lungs under your breastbone. Mediastinotomy is slightly more invasive and uses an incision between two ribs near your breastbone.

Surgery is often one of the main treatment options in earlier stages of non-small cell lung cancer. It isn’t a standard treatment for small cell lung cancer. The goal is to remove as much of the lung cancer as possible, and often, these procedures are performed using minimally invasive techniques.

• Segmental or wedge resection: These surgical procedures remove only a segment of a lung lobe or a wedge-shaped area of tissue that contains the lung tumor.
• Lobectomy: A lobectomy is one of the most common surgical procedures for lung cancer. It removes the entire lobe where the tumor is located.
• Pneumonectomy: Pneumonectomy is surgery that removes your entire lung on one side. It’s used when the location or spread of the lung cancer doesn’t allow for a lobectomy.
• Sleeve resection: This surgery removes part of a bronchus, one of the large air passages connecting to your windpipe. The remaining end is then reconnected to the lung.

The primary type of radiation therapy for lung cancer is external beam radiation. It uses high-energy rays from a machine outside the body to target specific areas of cancer. It’s sometimes used along with surgery or chemotherapy to destroy cancer cells. In people with advanced lung cancer, radiation therapy is a treatment to manage symptoms.

Stereotactic body radiotherapy, also known as radiosurgery, uses highly targeted radiation beams from many different angles to destroy areas of cancer. Unlike traditional radiation therapy, you may only need one or two treatments. It’s more common as a treatment for non-small cell lung cancer, where surgery often isn’t an option.

There are several different types of chemotherapy used to treat lung cancer. These drugs typically work by stopping fast-dividing cancer cells from multiplying. Chemotherapy may be used before or after surgery, especially for non-small cell lung cancer. In small cell lung cancer, chemotherapy is often the primary treatment.

Targeted drug therapy targets specific abnormalities (or markers) in cancer cells to stop them from growing. As targeted therapies only work on particular cell changes or mutations, you may undergo biomarker testing to decide if these drugs could work on your cancer.

Lung cancer cells may have certain features that prevent your body’s immune system from identifying them as harmful. Immunotherapy utilizes your immune system, helping it recognize and attack cancer cells. This treatment can be used with or without chemotherapy for operable and non-operable lung cancer.

Your care team may recommend supportive palliative care for lung cancer. Palliative care focuses on improving quality of life, managing symptoms and providing additional support services. You may choose to continue other treatment options while receiving palliative care.