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Cancer Care Center

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Lung CancerDiagnosis

If you have a suspected or confirmed diagnosis of lung cancer, your physicians will use a variety of diagnostic procedures to stage the disease and to determine its severity and spread. Your doctor may request several of the following tests and diagnostic procedures:

Blood Tests
A common tool for disease screening, blood tests provide information about many substances in the body, such as blood cells, hormones, minerals and proteins.
 
CT Scan
Computed tomography (CT) scans provide a two-dimensional image of your body, including a view of your glands (lymph nodes). If a contrast dye is used to improve the image, you may need to fast for several hours before the test. Tell your clinician in advance if you have allergies or kidney problems.

Magnetic Resonance Imaging (MRI)
This test uses a magnetic field, radiofrequency pulses and a computer to produce images that are more detailed than X-rays and of higher quality than CT scans for certain organs.
   
Brain MRI
Magnetic resonance imaging of the brain creates cross-sectional views (slices) of both healthy and unhealthy tissue using powerful magnet and radio signals. Inform your physician if you have a pacemaker or other metal implant. 

PET Scan
A positron emission tomography (PET) scan reveals abnormal cells by their reactions to a harmless radiotracer that is injected into your blood stream. A scanner follows the radiotracer and sends 3-D images to a computer screen. You may have to fast in advance. Tell your doctor if you are pregnant or breastfeeding or have diabetes.

Pulmonary Function Tests
Pulmonary function tests (PFTs) show how your lungs are working. As you breathe in and out, an instrument measures how much air your lungs take in, how the air moves through your lungs, and how well your lungs deliver oxygen to your bloodstream.

Stress Test
As you walk on a treadmill at graduated speeds, this test measures how your heart functions during exercise by monitoring your heartbeat and blood flow.

Ventilation and Perfusion Scans
These tests assess breathing and circulation in the lungs. As you inhale a harmless radioactive gas, the ventilation scan monitors your lungs. Next, you receive an injection of radioactive material for the perfusion scan, which monitors blood flow through your lungs. No preparations are needed, but tell your doctor if you are pregnant or breastfeeding.

Your physician may also request diagnostic procedures that require sedation, such as:

Bronchoscopy
A small, hollow tube (bronchoscope) is inserted through your nose and throat into the main airway of your lungs, enabling the physician to view any abnormal areas and extract a tissue sample for analysis.

Endobronchial Ultrasound (EBUS)
The physician inserts a bronchoscope through your mouth and trachea into the lungs and surrounding tissues to assess lymph nodes along the bronchial tubes and takes samples.

Endoscopic Ultrasound (EUS)
Using an endoscope (a long, flexible tube) with a tiny ultrasound transducer on its tip, the physician obtains images of the digestive tract. The transducer generates images by sending sound waves to the organs and back. You will fast in advance, so do not plan to drive or work for 24 hours after the test.

Mediastinotomy and Mediastinoscopy
When performing a mediastinotomy, the surgeon makes a two-inch incision into the center of your chest cavity (the mediastinum) to evaluate and remove tumors in your heart and lung area. This procedure is often performed with a mediastinoscopy, in which the physician inserts a lighted instrument (mediastinoscope) to view the area and take a tissue sample. You will be required to fast in advance and refrain from driving following the procedure.  

Needle Biopsy
Your physician applies an anesthetic (numbing agent) and, guided by CT scan or X-ray, inserts a needle into your chest to obtain a tissue sample for analysis.

Video-Assisted Thoracoscopic Surgery (VATS)
VATS is a minimally invasive alternative to open chest surgery that involves less pain and recovery time. It is used to both diagnose and treat a variety of thoracic conditions. The physician makes tiny incisions in your chest and inserts a thorascope (a fiber-optic camera) as well as surgical instruments. As the physician turns the thorascope, its views are displayed on a video monitor to guide investigation or surgery. 

Lung Cancer Staging
If you are diagnosed with lung cancer, your multidisciplinary care team will these diagnostic procedures to stage the disease and to determine its severity and spread.
The stage indicates the location and spread of the cancer:

Stage I Present in lung tissue but not lymph nodes
Stage II In lymph nodes and the chest wall
Stage IIIA In lymph nodes within the center of the chest
Stage IIIB In local areas such as the heart, blood vessels, esophagus or trachea or lymph nodes of the collarbone or pleura (tissue that surrounds the lungs)
Stage IV Spread to other parts of the body such as the liver, brain or bones

Whether your diagnosis indicates an early-stage tumor or advanced disease, your BMC care team will customize your care and with compassion and skill provide you with the course of treatment that is of the utmost benefit to you.

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830 Harrison Avenue
Boston, MA 02118

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