Lung Cancer

Lung cancer - investigations

To help to diagnose lung cancer doctors recommend various investigations. Chest x-rays, sputum tests and blood tests are very common. Most people remembered other investigations such as bronchoscopy, lung biopsy, computer tomography (CT scan), positron emission tomography (PET) - CT (a PET scan combined with a CT scan), bone scan, and lung function tests. While some people felt anxious about tests, others found slides or pictures of their internal organs fascinating.

Bronchoscopy allows doctors to examine, photograph and where possible take a tiny sample (biopsy) of tissue from inside the airways. The procedure does not always provide a conclusive diagnosis. A bronchoscope is a narrow, flexible tube, which is passed either up the nose, or through the mouth and then down the throat. Occasionally doctors need to use a rigid tube to reach parts of the lung, which may be a bit painful. Sometimes patients have a general anaesthetic for this type of bronchoscopy.

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Before bronchoscopy many people felt frightened, but after it most said that the procedure did not hurt. Most were given a sedative that made them drowsy and a local anaesthetic, usually a throat spray, to make the procedure more comfortable.

A few people recalled bad experiences. One man, who chose not to have a sedative, described having a bronchoscopy via the throat as 'horrendous'. However, he said that the discomfort soon passed. 

A woman, who also had the procedure without a sedative, had local anaesthetic injected via a needle directly into her throat. Her discomfort followed a junior doctor's five attempts to inject the anaesthetic.

Some people had a different type of lung biopsy. A needle was passed through the back or chest wall into the lung or into the fluid round the lung. This was usually done during an ultrasound or CT scan. Normally local anaesthetic is used to make the procedure more comfortable; it can be painful if done without local anaesthetic. However, even with anaesthetic the procedure may be painful. Two women suffered a rare complication, a collapsed lung. (See also 'Pleural effusion and pleurodesis for lung cancer').

Almost everyone had a CT scan, which is done to see if the cancer has spread to other organs or blood vessels. Sometimes an injection or drink containing a dye is given to highlight other organs. This injection can cause a warm feeling in the genital area. CT scans are also done to help plan radiotherapy.

Many people had lung function tests to see how well their lungs were working. This simple test usually involves blowing into a mouth piece.

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A few people mentioned other investigations, such as bone scan, brain scan, and magnetic resonance imaging (MRI scan). One woman described feeling a bit claustrophobic when she had an MRI scan.

A few people described mediastinoscopy, a surgical procedure to examine the lymph nodes behind the lungs. One woman recalled a ventilation-perfusion scan (VQ scan). This studies air flow and blood flow in the lungs and is sometimes used to diagnose a pulmonary embolism (a clot in the lung). It can also help the surgeon to decide if the remaining lung will function well after surgery.

A man, who was later diagnosed with mesothelioma, described a thoracoscopy, which he had under a general anaesthetic. 

One other investigation, positron emission tomography (PET scan), is sometimes used in the assessment of patients before operation. It is now common to have a PET-CT scan, a combination of CT scan which is used to build up a three-dimensional picture and a PET scan where a low-dose of radiation is used to measure the activity of cells.

For more information sources see our Resources.

Last reviewed May 2016.

Last updated May 2016.


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