Scripps pulmonologists work with interventional radiologists, pathologists and clinicians to detect and diagnose a host of lung conditions, including cancer. Because lung cancer claims more lives than any other cancer, it’s important to recognize potential early signs, as well as visit your physician for yearly physical exams — especially if you’re at higher risk for lung cancer due to smoking, family history or other known factors.
Lung cancer primarily affects older adults. People 65 and older account for almost 70 percent of lung cancer diagnoses nationally, according to the American Cancer Society, which classifies the disease as three types:
- Non-small cell lung cancer comprises approximately 85 percent of all lung cancers. This most prevalent type of lung cancer includes these subtypes: squamous cell carcinoma, adenocarcinoma and large cell carcinoma.
- Small cell lung cancer accounts for approximately 10 to 15 percent of lung cancers and is most commonly linked to cigarette smoking.
- Lung carcinoid tumor cancer, sometimes referred to as lung neuroendocrine tumors, represents fewer than 5 percent of lung cancers.
Lung cancer can be detected and diagnosed through a combination of physical screenings, imaging tests and biopsy. The following procedures may be used in diagnosing, staging or monitoring a possible recurrence of lung cancer:
A chest CT (computed tomography) scan is used to diagnose and determine the stage of lung cancer. Additional CT scans can help physicians learn if lung cancer has spread. The procedure is also used to guide biopsies in which a sample of suspicious tissue is removed and tested to learn if it is malignant.
Chest PET/CT scan
A chest PET-CT/scan (positron emission tomography-computed tomography) CT scan helps provide an accurate assessment of lung tissue structure and function. A PET/CT scan allows a physician to determine if a patient with lung cancer is a candidate for specific surgeries or other courses of treatment. PET/CT scans may also be taken after surgery or radiation therapy to measure lung cancer treatment effectiveness and monitor progress.
A chest MRI (magnetic resonance imaging) helps provide detailed images of soft tissues through use of radio waves, magnets and a computer. The test is used to look for tumors in the chest, as well as to see blood vessels, lymph nodes and other structures in the chest. It can include the injection of contrast dye into a vein to capture more detailed pictures and can be reviewed in conjunction with findings from a chest X-ray or chest CT scan.
EBUS (endobronchial ultrasound) is a relatively new interventional pulmonology procedure that allows physicians to view the chest wall and surrounding lymph nodes for potential cancer. EBUS can be used as part of a biopsy when tissue samples are taken for testing, or to assist in determining the stage of a lung cancer. During the EBUS procedure, an endoscope equipped with an ultrasound probe and biopsy needle is inserted into the patient’s mouth and esophagus. At Scripps, EBUS is available at both Scripps Memorial Hospital Encinitas and Scripps Mercy Hospital San Diego.
This visual test uses a tube-like device that is inserted into the nose or mouth and through the patient’s windpipe (trachea) to visualize the upper airways and lungs.
Video-assisted thoracoscopic biopsy
Also known as thorascopy, video-assisted thoracoscopic biopsy for lung cancer requires only small incisions and allows physicians to see inside the chest cavity and remove masses close to the outer areas of the lung for testing to determine if they are cancerous.