Lung cancer is often diagnosed in the later stages of the disease because symptoms don’t typically occur until that time. However, lung cancer can be found in earlier stages through lung cancer screening. If you are high risk for lung cancer, and meet the screening guidelines, having yearly lung cancer screenings are the best way to find lung cancer early, when it’s most treatable.

If your healthcare team is concerned about how a lung nodule appears or has changed, they will order diagnostic tests to get a detailed view of your body and determine whether cancer is present and, if so, additional tests may be ordered to determine the exact type and stage of cancer.

Tests to diagnose lung cancer

Lung cancer can be diagnosed in different ways. Your healthcare team will choose the specific tests based on personal factors, like your medical history, symptoms, and findings from exams. These tests may include:

• Scans to give a detailed view of the body to see the areas affected by lung cancer.
• A biopsy to confirm whether cancer is present, and if so, what type.

During the diagnosis process, you will have different types of scans. These tests give your healthcare team more information about the sizeof the suspected cancer and where it is in your body. They are used to help make treatment decisions. There are several types of scans, and each has its own purpose. You may have one or more of the following types of scans.

CT scan

A CT scan uses a special type of x-ray that gives a very detailed picture of the inside of your body. It’s more detailed than a chest x-ray and is safe and painless. It’s typically the first step in diagnosing lung cancer if you have symptoms or if your lung cancer screening results show an area of concern. CT scans can find very small tumors in the lung and can show whether cancer has spread to other parts of the body. The results of a regular CT scan could lead to additional testing, such as a biopsy.

PET scan

A positron emission topography (PET) scan is a type of imaging that is used to tell if lung cancer has spread to other parts of the body. It uses a machine that rotates around your body to create a 3-D view of your body.

Before your scan, a member of your healthcare team will inject a small amount of radioactive tracer (solution) into your vein. This radioactive trace is attracted to areas in the body where cells or tissues are very active, like cancer, and “lights up” on the scan.

When preparing to have a PET scan, it is important to follow the instructions provided by the imaging center, including avoiding eating, drinking, or consuming sugar.

Magnetic resonance imaging (MRI) scan

A magnetic resonance imaging (MRI) scan is an imaging test that uses a large magnet and radio waves to produce detailed pictures of the body.

MRI is especially helpful in providing detailed pictures of the soft tissue of the brain, spinal cord, muscles, and blood vessels. It is most often used in the diagnostic work-up of lung cancer to see if there’s evidence of cancer in these areas.

Before or during the scan a member of your healthcare team may inject a small amount of contrast into a vein. This allows the radiologist to best see soft tissues and whether cancer is present.

MRIs take longer than CT scans to perform and people who have metal in their bodies cannot receive an MRI because of the strong magnets in the machine.

Biopsy procedure

A biopsy is a procedure that can confirm whether lung cancer is present and, if so, what kind. During a biopsy, small pieces of tissue or fluids are removed from the body and examined under a microscope. Biopsies are often done on a tumor in the lung, but tissue from the chest lining, lymph nodes and/or fluid in the chest cavity or lungs may also be collected for testing.

There are a few ways a biopsy is performed. It is typically determined by the size of cancer and where it is in the lungs.

Types of biopsies include:

• Needle biopsy: A hollow biopsy needle is inserted through the skin into the chest wall to draw out tissue or fluid for testing.
• Thoracentesis: A hollow needle is used to draw fluid that has collected between the lungs and the chest wall.
• Bronchoscopy: A thin, flexible tube (bronchoscope) is inserted into the lungs through the nose or mouth, and a small camera looks directly into the airways and the lungs.
  
  • Autofluorescence bronchoscopy: A bronchoscope is inserted into the lungs through the nose or mouth and a camera with a special light is used to capture live color video viewed on a monitor.
  • Robotic bronchoscopy: A bronchoscope is inserted into the lungs through the nose or mouth. A robotic controller, like in a video game, and a computer-assisted camera are used to create 3-D views of your lungs and take a tissue sample for biopsy.
  • Endobronchial ultrasound (EBUS): A type of ultrasound combined with a bronchoscope and inserted through the mouth.This procedure allows for better examination of the lymph nodes and other structures in the center of the chest to see if cancer has spread.
  • Electromagnetic navigation bronchoscopy (ENB): A bronchoscope is used to reach the lungs, and pictures from a CT scan use GPS-like technology to create a map and to locate the area to biopsy the lung.
• Mediastinoscopy: A surgical procedure in which a device with a camera is inserted into an incision made just above the breastbone to pass into the middle of the chest  (mediastinum) to see if cancer is present there and to check central lymph nodes for cancer.
• Thoracoscopy: A surgical procedure in which a device with a camera is inserted into an incision in the chest wall to explore the lungs and surrounding area.

Pulmonary function test

This simple breathing test shows how well both of your lungs are working. It tests the volume of air you can move in and out of your lungs. This information helps healthcare providers make personalized decisions about the best and safest treatment options.

Most tests take 15–30 minutes. You maybe asked to wear loose clothing and comfortable shoes and avoid eating a large meal before your procedure. During the test, you’ll sit in a chair with a soft clip on your nose to do all your breathing through your mouth.

Dealing with a lung cancer diagnosis

There’s no right way or wrong way to cope with lung cancer—and no one else can tell you how you should feel or react. Different people cope with a lung cancer diagnosis in different ways. Some people seek out all the information they can find. Others prefer to get their information from a few select sources. Some people seek emotional support, while others turn inward. You may also have practical matters to manage, including insurance coverage, access to care, and financial issues. 

As you begin to move forward after your diagnosis, remember that you are not alone. Talk to your healthcare team. Find empowerment through education and know what questions to ask. Try to maintain a healthy lifestyle.It is also important to practice self-care and be kind to yourself. 

Learn more about coping with diagnosis.

What to expect

If you or someone you love is diagnosed with lung cancer, you’ll work with your healthcare team to develop a treatment plan. Each person’s lung cancer is unique—so the frequency of your doctor visits, treatment options, and next steps may vary.

Remember, you are not alone. Our HelpLine team is ready to answer your questions, provide support and resources, help you understand treatment options, and more.  

Additional resources

Learn more about lung cancer, how it’s diagnosed, possible treatment options and more through our free educational materials.