Wednesday, November 4, 2009

What steps are necessary to diagnose lung cancer


What steps are necessary to diagnose lung cancer?
I have a friend whom says she has lung cancer. I actually don't believe her. She is only 42 yrs. old. She said she has the opinion of 3 doctors. My mom had lung cancer and she didn't know for sure till they did a biopsy. This friend hasn't had a biopsy. Is it possible to know you have lung cancer without a biopsy?
Cancer - 5 Answers
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1 :
Diagnosing Lung Cancer To help find the cause of symptoms, the doctor evaluates a person's medical history, smoking history, exposure to environmental and occupational substances, and family history of cancer. The doctor also performs a physical exam and may order a chest x-ray and other tests. If lung cancer is suspected, sputum cytology (the microscopic examination of cells obtained from a deep-cough sample of mucus in the lungs) is a simple test that may be useful in detecting lung cancer. To confirm the presence of lung cancer, the doctor must examine tissue from the lung. A biopsy -- the removal of a small sample of tissue for examination under a microscope by a pathologist -- can show whether a person has cancer. A number of procedures may be used to obtain this tissue: Bronchoscopy. The doctor puts a bronchoscope (a thin, lighted tube) into the mouth or nose and down through the windpipe to look into the breathing passages. Through this tube, the doctor can collect cells or small samples of tissue. Needle aspiration. A needle is inserted through the chest into the tumor to remove a sample of tissue. Thoracentesis. Using a needle, the doctor removes a sample of the fluid that surrounds the lungs to check for cancer cells. Thoracotomy. Surgery to open the chest is sometimes needed to diagnose lung cancer. This procedure is a major operation performed in a hospital. ..........Lung cancer is difficult to detect early because symptoms usually do not appear until the disease is advanced. Symptoms depend on the location of the tumor and can include persistent cough, hoarseness or wheezing, shortness of breath, sputum streaked with blood, recurring bronchitis or pneumonia, weight loss and loss of appetite, and chest pain. Physicians use several techniques to diagnose lung cancer, including the following: Imaging Tests Chest x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) help locate abnormal areas in the lung. Low-Dose Helical CT A technique called low-dose helical (or spiral) CT may offer a novel approach for diagnosing lung cancer by exposing the patient to less radiation than a conventional chest CT scan while allowing the doctor to see areas of the chest normally obscured in a standard x-ray. Memorial Sloan-Kettering is now studying the effectiveness of low-dose helical CT in a clinical trial. Outside of New York, the National Cancer Institute has begun a multi-center study of the technology. Combined PET/CT Scans Memorial Sloan-Kettering's radiology department includes the best combined PET/CT imaging technology available in the United States. This is particularly important in imaging lung cancer, which can be difficult to identify on a regular CT. To address this situation, a PET (positron emission tomography) scan, which picks up the metabolic signal of actively growing cancer cells in the body, is run simultaneously with the CT scan. This improved imaging capability provides for superior treatment planning because the details of the tumor are better defined. Bronchoscopy & Biopsies A sputum sample can be analyzed for the presence of cancerous cells. Doctors may perform a bronchoscopy, which allows them to examine the bronchial passages using an instrument called a bronchoscope. This is a small tube that is inserted through the nose or mouth, down the throat and into the bronchi. During the procedure physicians may remove some tissue for analysis. A modified form of bronchoscopy called autofluorescence bronchoscopy, which can detect early invasive cancers not seen with standard x-rays or white-light bronchoscopy, is being used to detect very early lung cancer. To examine areas of the lungs that are not accessible during a bronchoscopy, physicians may perform a needle biopsy ("fine needle aspiration" or FNA) to remove a small sample of tissue for analysis.
2 :
here are the tests in step as they are done, X-ray, CAT scan, MRI and biopsy. A biopsy is necessary to check what kind of T-cell growth it is and what kind of malignancy it is.
3 :
the doctor needs to schedule you for either a ct chest with and without contrast and then possibly an MRI or PET scan. If the results are positive, then a bronch with biopsy is necessary. then doctor will then send the specimen over tot he lab for the pathologist to do a frozen section and try to diagnose the tumor
4 :
Yes, you're right. You cannot diagnose for certain without a biopsy. You may have a PET or CT that suggests, but you really don't have a histologic diagnosis till you get a biopsy. Even if she has a spot on her lung, doesn't mean she has primary lung cancer. Could be calcification, or could be breast cancer spread to the lung.
5 :
If the patient’s doctor suspects lung cancer, he or she will take a detailed medical history to check all the symptoms and assess the risk factors. The assessment of the patient’s medical history will be followed by a complete physical examination. The doctor will examine the patient’s throat to rule out other possible causes of hoarseness or coughing, and listen to the patient’s breathing and the sounds made when the patient’s chest and upper back are tapped (percussed). The physical examination, however, is not conclusive. If the doctor has reason to suspect lung cancer— particularly if the patient has a history of heavy smoking or occupational exposure to substances that are known to irritate the lungs—he or she may order a chest x ray to see if there are any masses in the lungs. Special imaging techniques, such as CT scans or MRIs, may provide more precise information about the possibility, size, shape, and location of any tumors. Sputum analysis involves microscopic examination of the cells that are either coughed up from the lungs, or are collected through a special instrument called a bronchoscope. Sputum analyses can diagnose at least 30% of lung cancers, some of which do not show up even on chest x rays. In addition, the test can help detect cancer in its very early stages, before it spreads to other regions. The sputum test does not, however, provide any information about the location of the tumor and must be followed by other tests, such as bronchoscopy, where machines can detect cancerous cells without the need to open the chest. Lung biopsy is the most definitive diagnostic tool for cancer. It can be performed in several different ways. The doctor can perform a bronchoscopy, which involves the insertion of a slender, lighted tube, called a bronchoscope, down the patient’s throat and into the lungs. In addition to viewing the passageways of the lungs, the doctor can use the bronchoscope to obtain samples of the lung tissue. In another procedure known as a needle biopsy, the location of the tumor first is identified using a CT scan or MRI. The doctor then inserts a needle through the chest wall and collects a sample of tissue from the tumor. In the third procedure, known as surgical biopsy, the chest wall is opened up and a part of the tumor, or all of it, is removed. A doctor who specializes in the study of diseased tissue (a pathologist) examines the tumor samples to identify the cancer’s type and stage.



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Posted by lung cancer at 3:10 PM