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Further tests for lung cancer

Men and women discussing lung cancer

This page tells you about the tests you may have if you have been diagnosed with lung cancer. There is information about

 

A quick guide to what's on this page

Further tests for lung cancer

If your tests show that you have lung cancer, you may need further tests. The further tests show if the cancer has spread and can help your doctor decide on the best treatment. These tests may include an endoscopic ultrasound scan. The scan can help to show the size of the tumour and whether the cancer has spread into any lymph nodes. The doctor can also pass a hollow needle down the tube to take an ultrasound guided sample of cells (biopsy) from any enlarged lymph nodes or any lung tissue that looks abnormal.

You may have keyhole surgery (thoracoscopy) to take a sample (biopsy) of cells from the lung. The doctor puts a thin tube into a cut in the side of your chest. Through the tube, the doctor looks for anything abnormal and can take tissue or fluid samples. Or you may have a mediastinoscopy. The doctor puts the tube through a small cut at the base of the neck and into an area in the centre of your chest called the mediastinum.

Other possible tests are a bone scan, a CT scan, a PET-CT scan, an MRI scan or a liver ultrasound scan.

After the tests

Your doctor will ask you to go back to the hospital when your test results have come through. This may take a few days. It is a very anxious time for most people. While you are waiting it may help to talk to your specialist nurse, or a close friend or relative about how you feel. Or you may want to contact a cancer support group to talk to someone who has been through the same experiences. You can also find online support forums and chat rooms.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Diagnosing lung cancer section.

 

 

Why you need more tests

If your tests show that you have lung cancer, you may need further tests to see if the cancer has spread. These tests also help your doctor to decide on the best treatment for you. You may have one or more of the tests below.

 

Endoscopic ultrasound scan

Doctors call this test an EUS. You may have the test under a general anaesthetic. Or you may have medicine to make you drowsy. The doctor gently puts a long, flexible tube with an ultrasound probe down your throat and food pipe (oesophagus). This creates ultrasound pictures of the area around the heart and lungs. So it can help to show if the cancer has spread into any lymph glands at the centre of the chest.

The doctor can pass a hollow needle down the tube to take an ultrasound guided biopsy of any enlarged lymph nodes or any lung tissue that looks abnormal. They call this a EUS guided fine needle aspiration (EUS guided FNA). This test usually takes less than half an hour.

 

Keyhole surgery biopsy

Doctors may use keyhole surgery (a thoracoscopy test) to

  • Find the cause of fluid on the lung (pleural effusion)
  • Take tissue samples from the lung
  • Take tissue samples from lymph nodes in the centre of the chest (mediastinum)

You have this test under sedation or sometimes a general anaesthetic. You will have between 1 and 3 cuts (incisions) in your chest on the side the doctor is checking. The doctor puts a thin, flexible tube into the cut. Through the tube, the doctor looks for anything abnormal. They can also take tissue samples (biopsies) or suck out a sample of fluid. They send the biopsies and fluid sample to the lab to be checked for cancer cells.

After the test, you usually have a tube into your chest (a chest drain) for up to a couple of days. The tube allows any fluid to drain out and the lung to fully expand. You may have gentle suction on the tube to help this happen. You will need to stay in hospital while you have the drain in.

 

Mediastinoscopy

This test examines the mediastinum. The mediastinum is an area in the centre of your chest, between your lungs. It contains

  • The heart
  • Main blood vessels
  • Lymph nodes

You need to have a general anaesthetic for this test. So you may have to stay in hospital for at least 1 night. The doctor makes a small cut at the base of the neck. They then put a small, flexible tube through the cut and into the mediastinum. The doctor can look through this tube to examine the area and can take tissue samples (biopsies). The samples are examined under a microscope, to see if there are any cancer cells there.

When you wake up, you will have a small dressing over the cut where the tube was put in. Don't be afraid to say if you are feeling sore. Your nurses will give you painkillers. Once you have got over the anaesthetic, you will be able to go home. This will probably be the day after the test.

 

PET-CT scan

A PET-CT scan is a combination of a PET scan and a CT scan. A PET-CT scan takes CT pictures of the structures of your body. At the same time, a mildly radioactive drug shows up areas of your body where the cells are more active than normal. The scanner combines both of these types of information. This allows your doctor to see any changes in the activity of cells and know exactly where the changes are happening.

The scan can show the area where the cancer is. You will have an injection of dye before the scan to help show up abnormal areas. We have detailed information about having a PET-CT scan. PET-CT scans are not available in every hospital so you may need to travel to have one.

 

Liver ultrasound scan

You might have an ultrasound scan of your liver to see whether there is any sign of cancer there. An ultrasound uses sound waves to build up a picture of the inside of the body. It is painless and doesn't take long (probably less than half an hour). On this website you can read about having an ultrasound scan.

 

Bone scan

A bone scan looks for signs of bone damage. The damage could be caused by wear and tear or arthritis. Or it could be caused by cancer that has spread to the bones. Doctors use this test to check for any signs that the lung cancer has spread to the bone. We have information about having a bone scan.

 

Brain CT or MRI scan

With some types of lung cancer there is a chance that the cancer may spread to the brain. Your doctor may ask you to have a brain scan with either a CT scan or an MRI scan. The scans are painless and harmless. But MRI scans are very noisy. Both scans involve you laying inside the scanner for some time. 

If you are claustrophobic, do tell your doctor or nurse. You may want to have a sedative and they can organise that in advance. You will have an injection of dye before the scan. They dye helps to show up any abnormal areas. We have detailed information about having a CT scan and having an MRI scan.

 

MRI scan

MRI scans build up pictures of an area of the body using magnetic fields. They are not often used for lung cancer unless the cancer is very close to the top of the lung. Cancers in this area are called pancoast tumours. You might also have an MRI scan if your doctor thinks that the lung cancer cells could have spread into the ribs or spine. You can find out what it is like to have an MRI scan.

 

After the tests

Your doctor will ask you to go back to the hospital when your test results have come through. But this is bound to take a little time, even if only a few days. This is a very anxious time for most people. 

While you are waiting for results it may help to talk to your specialist nurse, or a close friend or relative about how you feel. Or you may want to contact a cancer support group to talk to someone who has been through the same experiences.

 

Help and support

You can phone the Cancer research UK nurses on freephone 0808 800 4040, from 9am to 5pm Monday to Friday. Our lung cancer organisations page gives details of people who can help and support you. They can put you in touch with a cancer support group

You can find details of counselling organisations in our counselling section. Our lung cancer reading list has information about books and leaflets about lung cancer and its treatment.

If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.

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Updated: 26 March 2014