There are two broad types of lung cancer - non-small cell lung cancer and small-cell lung cancer. About 80 percent of lung cancer cases are non-small cell lung cancer. Of those cases that are classified as small-cell lung cancers, the vast majority are tied to smoking.
The cancer type will greatly affect how you are treated, as some cancers can be operated on and some cannot. To accurately diagnose your lung cancer, your WellStar physician will perform one of several diagnostic procedures, including:
- superDimension® is designed to extend the reach of the conventional bronchoscope, providing minimally invasive access to lesions deep in the lungs as well as mediastinal lymph nodes. Using GPS-like navigation, superDimension® enables physicians to make early diagnoses of benign and malignant lung lesions, enhancing treatment options and avoiding the need for higher risk procedures superDimension® is a type of Electromagnetic navigational bronchoscopy (EMN or ENB). EMN/ENB is like having a GPS attached to the bronchoscope, but without the satellite. The patient's CT scan images are loaded onto a CD-ROM disc and are fed into a computer. The computer generates a three-dimensional (3-D) CT and "virtual" image of the patient's actual lung anatomy.
- Bronchoscopy is used to look inside the lungs' airways, called the bronchi and bronchioles. The airways carry air from the trachea, or windpipe, to the lungs. In this procedure, your doctor passes a thin, flexible tube called a bronchoscope through your nose (or sometimes your mouth), down your throat, and into your airways. The bronchoscope has a light and small camera that allows your doctor to see your windpipe and airways and take pictures. You'll be given medicine to make you relaxed and sleepy during the procedure.
- Endobronchial ultrasound (EBUS): A relatively new procedure used in the diagnosis of lung cancer, infections, and other diseases causing enlarged lymph nodes in the chest. In 2007, WellStar started using EBUS, which allows physicians to biopsy lymph nodes in the chest while minimizing complications.
Sometimes, surgery must be performed to obtain tissue from the mass. Usually this diagnostic surgery is done minimally invasively using the VATS, or video assisted, technique. The tissue sample will be sent to a pathologist to review, and then your WellStar physician will recommend a treatment plan that may involve a combination of surgery, radiation or chemotherapy.
Lung Cancer Stages
When lung cancer is diagnosed, your WellStar physician will categorize it by the current stage. .Each stage describes the progression of the disease and whether the cancer has spread to other parts of the body. You should talk to your WellStar physician to understand each stage, and what it means for your treatment plan.
Determining the Stage
When a diagnosis of lung cancer is confirmed, determining the stage or extent of spread of the cancer is essential in order to understand treatment options. Important areas to screen for cancer include lungs, liver, bone and brain. Determining the stage of lung cancer may require many tests, which often include the following:
- Mediastinoscopy: A mediastinoscopy is a procedure that can indicate whether the cancer has spread to the lymph nodes in the chest. During a mediastinoscopy, a surgeon inserts a mediastinoscope (lighted tube) through a small incision in the neck while a patient is under general anesthesia. This mediastinoscope allows the surgeon to examine the center of the chest and nearby lymph nodes, as well as remove a tissue sample.
- Endobronchial ultrasound (EBUS): A relatively new procedure used in the diagnosis of lung cancer, infections, and other diseases causing enlarged lymph nodes in the chest. In 2007, WellStar started using EBUS, which allows physicians to biopsy while minimizing complications.
- Computed Tomography or CT Scan: A CT scan is a technique for imaging body tissues and organs, during which X-ray transmissions are converted to detailed images, using a computer to synthesize X-ray data. A CT scan is conducted with a scanner that rotates around the body to capture detailed images of the organs and tissues inside the body. This method is more sensitive and precise than the chest X-ray. (WellStar is participating in a global study of the CT scan as an effective tool in evaluating early stage lung cancer. This study, the International Early Lung Cancer Action Program, commonly referred to as I-ELCAP, started in the mid-1990s.)
- Magnetic Resonance Imagery or MRI: During MRI, a powerful magnet linked to a computer makes detailed pictures of areas inside the body.
- Positron emission tomography (PET): Positron emission tomography (PET) scanning has been used to improve the detection of cancer. PET scanning plays an important role in determining whether cancer has spread outside the lung prior to removing part of the lung.
- Bone Scan: A bone scan is used to determine whether cancer has spread to the bones. With the development of PET scanning, bone scans are used less often.