Non-small-cell lung cancer
How is NSCLC diagnosed? Most patients with NSCLC are diagnosed after seeing their doctor to report symptoms such as a persistent cough, a chest infection that won’t go away, dyspnoea, wheezing, coughing blood, chest or shoulder pain that won’t go away, hoarseness or lowering of the voice, unexplained weight loss, loss of appetite or extreme fatigue. A diagnosis of lung cancer is based on the results of the following examinations and tests:
Clinical examination Your doctor will carry out a clinical examination. He/she will examine your chest and check the lymph nodes in your neck. If there is a suspicion of lung cancer, he/she may arrange for a chest x-ray, or possibly a CT scan, and refer you to a specialist for further testing.
Imaging
Imaging is used to confirm a suspected diagnosis of lung cancer, and to investigate how far the cancer has progressed
Different imaging techniques include: • Chest x-ray: A chest x-ray will enable the specialist to check your lungs for anything that looks abnormal. This is usually the first test that is carried out, based on your symptoms and the clinical examination. • CT scan of chest and upper abdomen: A series of images are taken, which build up a three-dimensional picture of the inside of your body. This allows the specialist to gather more information about the cancer such as the exact location of the tumour in your lungs, whether nearby lymph nodes are affected, and whether the cancer has spread to other areas of the lungs and/or parts of your body. It is a painless procedure and usually takes about 10–30 minutes. • CT scan or magnetic resonance imaging (MRI) scan of the brain: This test allows doctors to rule out or confirm whether the cancer has spread to your brain. An MRI scan uses powerful magnetism to build up detailed images. You may be given an injection of dye into a vein in your arm to help the images show up more clearly. The scan won’t hurt but may be slightly uncomfortable as you will need to lie still inside the scanning tube for about 30 minutes. You will be able to hear and speak to the person doing the scan.
14
