How does my doctor know I have lung cancer?

This information was provided by the Women's Cancer Network. www.wcn.org

Since it is known smoking tobacco causes most cases of lung cancer, women who smoke or have smoked are at the highest risk. If you are having symptoms, your doctor will ask you some questions regarding the following:

  • Medical History
  • Smoking History
  • Family history of cancer
  • Other risk factors the woman has been exposed to

Many early lung cancers are found as a result of tests that are done for other medical problems. But symptoms of lung cancer often do not appear until the disease is advanced. Only about 15 percent of lung cancer cases are found in the early stages or before the cancer has spread. Prompt attention to symptoms, leading to early diagnosis and treatment, can result in a cure for some patients. For others, prompt attention to symptoms can help people live longer and have better control of their symptoms.

To date, there is no standard screening process to find early stage lung cancer. Current available detection tests—chest x-rays and sputum tests—are not always accurate in finding early lung cancer. Women with high risk factors—especially smokers and former smokers—should still consider taking such detection tests. But, this is not a standard procedure. A woman should ask her doctor what she can do.

In order to determine why a woman is having lung cancer-like symptoms, the doctor will find out the woman’s medical history, smoking history, and family history of cancer, and other risk factors the woman has been exposed to. The doctor might also perform a physical exam, a chest x-ray, and other tests. If the doctor suspects the patient has lung cancer, he or she may perform a sputum cytology. In a sputum cytology, the doctor looks at cells from the mucus in the lungs. These exams may lead the doctor to decide that the woman doesn’t need any more tests, and that she does not have lung cancer.

The kinds of biopsies done to find lung cancer, and some details about what will happen during each, are listed below.

  • Bronchoscopy - The doctor places a thin, lighted tube called a bronchoscope into the patient’s mouth or nose to look into the breathing passages and to take a tissue sample.
  • Needle biopsy - The doctor inserts a needle through the chest wall into the tumor to remove some tissue. Often, a CAT scan is done at the same time to help guide the placement of the needle.
  • Thoracentesis - The doctor uses a needle to take some fluid from around the lungs, if fluid is present.
  • Thoracotomy - This biopsy requires surgery and is done in a hospital. In this procedure, the surgeon looks for lung cancer in the chest.

Once the biopsy is completed, a pathologist—a doctor who looks at tissue samples in a lab—looks at the tissue under a microscope to check for cancer cells. It usually takes several days for the results of a woman’s biopsy to come back. A biopsy is the only sure way to tell if a woman has cancer and what kind of cancer it is.

Reviewed By: Gail Wilkes, RN, MS, OCN
Oncology Nurse Specialist, Massachusetts General Hospital, Boston, Massachusetts.
Reviewed By: Graeme Fisher, M.D.
UMASS Medical Center, Worcester, MA
Reviewed By: Teresa Knoop, RN, MSN, AOCN
Cancer Information Nurse Specialist, Vanderbilt-Ingram Cancer Center, Nashville, TN