Until there's a widely accepted lung cancer screening test, the best defense against lung cancer is to avoid smoking and second-hand smoke. One quarter of patients have no symptoms when their cancer is found, usually on a chest x-ray performed for another reason. If you do develop symptoms, the most common are a persistent cough that may worsen over time, coughing up blood, chest pain and shortness of breath.
Among the common risk factors for lung cancer are:
- Age over 50
- Being male
- Cigarette smoking
- Family history
- Being African-American
- Exposure to some chemicals
- High-fat diet
Lung tumors are typically identified by an x-ray, computerized tomography (CT), Magnetic Resonance Imaging (MRI) or Positron Emission Tomography (PET). If a tumor is found, you'll likely need further testing to determine if it's cancerous and if it has spread. Those tests could include:
- Positron Emission Tomography (PET) - PET is one of the most advanced and powerful diagnostic imaging techniques available. It can detect cell function at the cancer's earliest stages, effectively pinpoint the source of many of the most common cancers, and help distinguish between benign and malignant tumors. This helps streamline testing and decrease the need for invasive biopsies.
- Video Assisted Thoracic Surgery (VATS) - Usually done under general anesthesia, VATS enables doctors to view the inside of your chest cavity through very small incisions, remove masses close to the outside edges of the lung and test them for cancer.
- Bronchoscopy - In this procedure a thin tube with a camera is inserted through the mouth or nose and into the lungs to view the lungs and collect samples for analysis. Because it can be uncomfortable, it's typically performed under local anesthesia.
- Needle Biopsy - A needle biopsy is used for tumors that are on the edge of the lungs and cannot be seen in a bronchoscopy. During this procedure, a needle is inserted through the chest wall and guided to the tumor by x-ray or CT. A sample of tissue is removed and sent to the lab for analysis. A variation of a needle biopsy is a thoracentisis, in which a sample of fluid surrounding the lung is obtained and examined for the presence of cancer cells.
- Thoracotomy - When a tumor cannot be reached via bronchoscopy, surgery can be the only way to obtain a sample. During surgery, as much of the tumor as possible is removed and sent to the lab for analysis. A thoracotomy is a major surgical procedure that requires several days in the hospital and weeks or months of recovery.
- Mediastinoscopy - In addition to determining if cancer has spread to the lymph nodes, this surgery is also useful for examining the outside surface of the large tubes of the airways (such as the trachea) and evaluating tumors or masses in the middle chest. A small incision is made under local anesthesia and an instrument is inserted behind the breastbone to remove a sample from the lymph nodes or masses located between the lungs.
- Other Tests - A CT, MRI or bone scan may also be used to determine if lung cancer has spread to other parts of the body.