Lung Cancer Tests, Diagnosis, Stages and Prognosis

How is Lung Cancer Diagnosed?

Your doctor may recommend a diagnostic screening after discussing certain symptoms or medical and genetic history with you. Your doctor will ask questions about smoking, medical and family history.

Types of Lung Cancer Tests

Your doctor may recommend one or more tests to get an accurate diagnosis. There are various types of diagnostic tests to help detect lung cancer and determine the stage, such as:

• X-rays
• Endobronchial ultrasound (EBUS)
• Brain MRI
• CT scans
• PET scans

Blood tests cannot diagnose lung cancer. They can, however, give more insight into overall health, which is valuable information for your doctor.

If the results of the imaging scans indicate lung cancer, your doctor will want to obtain a biopsy of the tissue or fluid from your lungs. This test can be performed several different ways. Your doctor will discuss the best option for you. This test will help determine what type of lung cancer you may have.

Low-dose Lung Cancer Screening Program

Depending on your risk factors and eligibility, a low-dose CT scan can screen for lung cancer in its early stages and detect precancerous cells. Low-dose cancer screening tests can reduce mortality rates for those at high risk. If you're a current or former smoker aged 50 or older, you could meet the high-risk eligibility criteria. Talk to your doctor if you think you might qualify.

When Should You Start Getting Screened for Lung Cancer?

Lung cancer screening is recommended only for adults at high risk as they have a higher chance of getting the disease. You should talk to your doctor about scheduling a low-dose computerized tomography (CT or CAT scan) every year if you:

• Are 50-80 years of age
• Are a current smoker (or former smoker who quit in the past 15 years)
• Have a 20 pack-year smoking history For example, you smoked a pack a day for 20 years or two packs a day for 10 years.

How often should I be screened?

Frequency of screenings is determined during your first screening. Each lung cancer screening is scored into a Lung-RADS (lung imaging reporting and data system) numbered 1 through 4 with 4 being where the most frequent screenings are recommended.

Lung-RADS 1 and 2:

• Should get lung screenings annually.

Lung-RADS 3:

• Follow-up determined after tumor board review (group of doctors with different specialties that meet regularly to share knowledge and discuss cancer cases). These patients usually have a follow-up CT in 6 months as the radiologist saw a nodule, but it was probably benign (not cancer).

Lung-RADS 4:

• Follow-up determined after tumor board review and can follow-up with a PET/CT, biopsy or a CT in monthly intervals. 

What to Expect During Lung Cancer Screening Tests

The most common screening test for lung cancer is either a chest x-ray or a CT scan. A chest x-ray is usually done standing up with two views; one front to back and one from the side. In a CT scan, you will be asked to lie down on a table while you go through the CT scanner. This test will take images of the inside of your body. No matter the test, your doctor and physicians will guide you through what to expect for each procedure.

Stages of Lung Cancer

If you are diagnosed with lung cancer, your doctor will perform additional tests to help determine the extent of the cancer. This process is known as staging and will assist your doctor in knowing how to best treat your lung cancer.

Non-Small Cell Lung Cancer

There are four stages of non-small cell lung cancer. The four stages include:

• Stage 0: Abnormal cells are found that may become cancer.
• Stage 1: The cancer is found only in the lungs.
• Stage 2: The cancer has spread closer to the lymph nodes or may be in the lymph nodes.
• Stage 3: The cancer tumor has spread to the lymph nodes, to other parts of the lung and possibly to the other lung.
• Stage 4: The cancer is found in both lungs and potentially other parts of the body.

Small Cell Lung Cancer

The stages of small cell lung cancer are:

• Limited-stage small cell lung cancer - the cancer is limited to the lung regions
• Extensive-stage small cell lung cancer - the cancer extends outside of the lung region

Prognosis for Lung Cancer

The prognosis for lung cancer is dependent on when the cancer is originally found and if it has spread. If caught early on, the survival rate is higher and the cancer may not have spread. Consult with your doctor to better understand your prognosis.

Let the experts at Banner MD Anderson assist with all your lung cancer screening tests and questions.

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