Endobronchial ultrasound for lung cancer

You might have this test if your doctor has seen an abnormal looking area on your lung using an x-ray or CT scan. It is also known as Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA).

An endobronchial ultrasound can show if it’s lung cancer and the size of the tumour. It can also show if the cancer has spread into other areas of the lung or outside the lung.

How you have it

A bronchoscopy uses a narrow flexible tube to look at the inside of the breathing tubes (airways) in your lungs. The tube has an ultrasound probe. It uses high frequency sound waves to create pictures of the lungs and structures outside the airway walls, such as the lymph nodes.

Your doctor can see any areas that look abnormal and take samples (biopsies) to test.

Diagram showing a bronchoscopy

You normally have this test in the endoscopy unit at the hospital. It can take around 40 minutes.

Check your appointment letter to see how to prepare.

You sign a consent form before the test. This is a good time to make sure you ask the doctor any questions you have.

Take your usual medicines as normal unless your doctor tells you otherwise. If you take medicines to thin your blood, you need to stop them before your bronchoscopy. Your doctor tells you when to stop.

You have the test under local or general anaesthetic. 

Local anaesthetic

It is more common to have this test under a local anaesthetic. Having a local anaesthetic means you should be able to eat and drink as normal beforehand. Your doctor sprays your throat to numb it.

You might also have medicine to make you drowsy (a sedative).

General anaesthetic

Some people have this test under a general anaesthetic. You then need to stop eating a few hours beforehand. You usually need to stop drinking fluids 2 hours beforehand. Your doctor or nurse will tell you when to stop eating and drinking.

At the hospital

When you arrive at the department, a nurse might ask you to change into a gown or you might be able to stay in your own clothes. Then your nurse shows you into the test room.

You lie on the procedure couch. Your nurse puts a small tube (cannula) into a vein in the back of your hand. They might inject sedative into the tube to help you relax.

Just before the test, your doctor sprays a local anaesthetic onto the back of your throat.

What happens

Your doctor puts a long, thin, flexible tube called a bronchoscope into your mouth and down the airway. This is a bit uncomfortable but is only for a short time. You can breathe normally but you might cough.

Once the ultrasound probe is in the right place the doctor passes a hollow needle through the bronchoscopy tube. They then take tissue samples (biopsies) to test. The doctor can also take photographs of the inside of your airways.

Your nurse checks your oxygen levels and heart rate using a clip on your finger. This doesn’t hurt.

After your endobronchial ultrasound

You won’t be able to eat or drink anything until the local anaesthetic wears off. Your throat is too numb to swallow safely at first. This usually passes off after about an hour.

You should be able to get changed into your own clothes once you feel less sleepy.

Going home

You can usually go home the same day.

Someone should collect you from the hospital if you have had a sedative or a general anaesthetic. Also, don’t drive until the day after the test because you might still be drowsy. 

You need to take things easy for a day or so. You might have a sore throat for a couple of days.

Possible risks

An endobronchial ultrasound is a very safe procedure. But your nurse will tell you who to contact if you have any problems afterwards. Your doctors will make sure the benefits of having an endobronchial ultrasound outweigh these possible risks.

The possible risks include:

Bleeding

You might see a small amount of blood in your spit after the test. Let your doctor or nurse know if this doesn’t go away.

Chest infection

See your GP straight away if your phlegm (sputum) changes colour, you start feeling more breathless or you feel as though you have a temperature.

Needing extra oxygen

You might need oxygen through a mask for some time after the bronchoscopy. If you normally have oxygen at home you might need to have more than usual for a little while.

A collapsed lung (pneumothorax)

Air or gas can collect in the space around the lung and make it collapse, but this is rare. Contact a doctor if you become short of breath or have chest pain. You have a tube put into the lung to remove the air.

Getting your results

You should get your results within 1 or 2 weeks. Contact your doctor if you haven’t heard anything after this time.

Waiting for test results or for further tests can be very worrying. You might have contact details for a specialist nurse and you can contact them for information if you need to. It may help to talk to a close friend or relative about how you feel.

For support and information, you can also contact the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, from Monday to Friday.

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