Lung cancer tests

Usually you begin by seeing your GP who will ask you about your general health and will examine you. They may ask you to breathe into a small device called a spirometer. The machine measures the amount of air you breathe in and out and also measures how quickly you breathe. They call this test spirometry.

Your GP will refer you to hospital for any X-rays or other tests you may need. You will usually be asked to go for a chest X-ray to check for anything that looks abnormal in your lungs.

You may have some routine blood tests. Your GP may also ask you to give some samples of phlegm. They may send them to the hospital for you or may ask you to take them to the hospital. At the hospital the laboratory staff will examine the samples for cancer cells.

At the hospital the doctor will ask about your medical history and your symptoms. They will then probably arrange for you to have some tests, which may include any of the following.

This test looks at the inside of the airways. Your doctor puts a narrow, flexible tube called a bronchoscope down your throat and into the airway. The tube has a light at the tip and an eye piece so that the doctor can see inside.

You usually have this test as an outpatient under local anaesthetic. This means you are awake for the test, but your throat is numbed. But you may have it with a general anaesthetic or after an injection of a sedative into a vein. If you have an anaesthetic, you may need to stay in hospital overnight. This depends on the time of day you have the test and on your general health. If you feel strongly about having a general anaesthetic or sedation for a bronchoscopy, talk to your doctor about this before the day of your bronchoscopy. It will be easier for your doctor to arrange this in advance and you will feel less nervous if you know they have already planned it.

If you are going to have sedation or an anaesthetic, your doctor will ask you not to eat or drink anything on the morning of the test. When you arrive at the outpatient department, a nurse may ask you to change into a gown or you may be able to stay in your own clothes. Then your nurse will show you into the test room. Once you are lying on the couch, you will have a sedative to help you relax. Just before the test, the doctor sprays a local anaesthetic onto the back of your throat.

The doctor puts a long, thin, flexible tube called a bronchoscope either down your nose, or into your mouth and down the airway. This will be a bit uncomfortable, but it doesn't last long. The doctor then looks for anything abnormal and can take tissue samples (biopsies) for testing. They can take photographs of the inside of your airways if necessary.

After the bronchoscopy, you will not be able to eat or drink anything until the local anaesthetic has worn off. Your throat will be too numb to swallow safely at first. The numbness usually passes off after about an hour. You should not drive until the day after the test because of the sedative. Someone should collect you from the hospital and make sure that you get home safely. You may have a sore throat for a couple of days after the test because of the tube, but it will soon go.

A CT scan takes X-rays through sections of the body. The scanner feeds the pictures into a computer and they form a detailed image of the inside of your body. You might have a CT scan done before having a bronchoscopy or biopsy. The scan can show the area where the cancer is. You will have an injection of dye before the scan to help show up any abnormal areas. There is detailed information about having a CT scan in the cancer tests section.

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.

You may have a PET-CT scan instead of a CT scan before having a bronchoscopy or biopsy. 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. There is detailed information about PET-CT scans in the cancer tests section. PET-CT scans are not available in every hospital so you may need to travel to have one.

This type of biopsy is called a percutaneous lung biopsy. The doctor puts a thin needle through the skin and muscle of your chest to take samples of cells from the lung tumour. The area of the test depends on the position of the abnormal area in the lung. The test can be uncomfortable. The actual biopsy only takes a few minutes but getting ready may take between 30 minutes and an hour.

You usually have this test in the X-ray department or a special procedures room. You have a local anaesthetic injection into the area where the needle is to be put in. The doctor will ask you to hold your breath for a moment while they put the needle through the skin into the lung. Once the needle is in, the doctor uses X-ray, CT scan or ultrasound to make sure the tip is in the tumour. The doctor then sucks out a sample of cells with a syringe. They send the cells to the laboratory for examination under a microscope.

After a biopsy through the skin your nurse will monitor you closely for a few hours. You may need to stay in hospital overnight. There is a small risk that the lung may collapse after the biopsy (pneumothorax). Let your nurse know if you suddenly feel breathless or dizzy.

If it is difficult to get enough tissue using a biopsy through the skin, your doctor may do an open lung biopsy under general anaesthetic in a similar way to mediastinoscopy. Or you may have a thoracoscopy to get a biopsy.

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. You may have contact details for a lung cancer specialist nurse and you can contact them for information if you need to. 

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

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 other people who can help and support you. 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 CancerChat, our online forum. Or go through My Wavelength. This is a free service that aims to put people with similar medical conditions in touch with each other.