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Lung Cancer Diagnosis

If you have lung cancer, it is important to get an accurate diagnosis as early as possible and find out if the cancer has spread. This will help your doctors choose the best type of treatment.

MD Anderson has the most advanced and accurate equipment available to diagnose lung cancer and find out precisely the extent of the disease. This helps increase the likelihood that your treatment will be successful. Our staff includes pathologists, diagnostic radiologists and specially trained technicians who are highly skilled in diagnosing lung cancer.

If you have symptoms that may signal lung cancer, your doctor will ask you questions about your medical, smoking and family history and whether you have been around certain chemicals or substances.

Lung Cancer Diagnosis

If you have symptoms that may signal lung cancer, your doctor will examine you and ask you questions about your health; your lifestyle, including smoking habits; and your family history.

One or more of the following tests may be used to find out if you have lung cancer and if it has spread. These tests also may be used to find out if treatment is working.

The two main tests to find out if you have lung cancer are:

  • Chest X-rays: Photographs of the lungs to look for abnormal areas.
  • Sputum cytology: A sample of mucus or phlegm brought up by coughing is looked at under a microscope.

If chest X-rays show an abnormal area, one or more of these tests may be used to find out if you have lung cancer:

Bronchoscopy: A thin flexible tube with a tiny camera is inserted through the nose or mouth and down into the lungs. A bronchoscope also can be used to take a small tissue sample for biopsy.

Fine needle aspiration (FNA): A very small needle is placed into the tumor. Suction is used to remove a small amount of tissue, which is then looked at under a microscope.

Thoracentesis: Fluid from around the lungs is drawn out with a needle and looked at under a microscope.

Endobronchial Ultrasound (EBUS): Guided biopsy to check for lung cancer and find out if cancer has spread to nearby lymph nodes.

Video-Assisted thoracoscopic surgery (VATS) 

Imaging tests, which may include:

  • CT or CAT (computed axial tomography)
  • MRI (magnetic resonance imaging) scans
  • PET (positron emission tomography) scans

If you have been diagnosed with lung cancer, we’re here to help. Call 1-877-632-6789 to make an appointment or request an appointment online.

Why Choose MD Anderson?

  • Latest, most-advanced lung cancer treatments including delivery of chemotherapy by nanoparticles, minimally invasive surgical techniques, targeted therapies and gene therapies
  • Leading-edge radiotherapy approaches including proton therapy, intensity-modulated radiotherapy (IMRT) and stereotactic radiotherapy
  • Focus on saving lung function and reducing damage to healthy tissue
  • Nationally recognized lung cancer research program, range of clinical trials
  • Lung cancer is part of MD Anderson's Moon Shots Program: an ambitious effort to reduce cancer deaths through the rapid discovery of new treatments

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Lung Cancer Staging

If you are diagnosed with lung cancer, your doctor will determine the stage (or extent) of the disease. This is a way to classify the cancer by how far and to which parts of the body it has spread. Staging helps the doctor plan the best treatment for you. Once the staging classification is determined, it stays the same even if treatment works or the cancer spreads.

Staging is often the most important part of your treatment. If the cancer is staged improperly, you may not receive the right treatment.

Lung Cancer Stages

(source: National Cancer Institute)

Small-cell lung cancer stages

Limited stage: Cancer is in one lung and possibly in lymph nodes on the same side of the chest.

Extensive stage: Cancer has spread to the other lung, to lymph nodes on the other side of the chest, to the fluid around the lung or to other parts of the body.

Non-small cell lung cancer stages

Stage 0 through stage IB tumors in which cancer has not spread to the lymph nodes are considered early stage lung cancer.

Occult stage: Lung cancer cells are found in spit or in a sample of mucus (phlegm) taken during bronchoscopy, but a tumor cannot be seen in the lung by imaging or bronchoscopy, or a tumor is present but is too small to be biopsied.

Stage 0: Abnormal cells are found only in the innermost lining of the lung. The tumor has not grown through this lining. A stage 0 tumor is also called carcinoma in situ. The tumor is not an invasive cancer.

Stage IA: The lung tumor is an invasive cancer. It has grown through the innermost lining of the lung into deeper lung tissue. The tumor is no more than 3 centimeters across. It is surrounded by normal tissue and does not invade the bronchus. Lung cancer cells are not found in nearby lymph nodes.

Stage IB: The tumor is larger or has grown deeper, but lung cancer cells are not found in nearby lymph nodes. The lung tumor is one of the following:

  • More than 3 centimeters across
  • Grown into the main bronchus
  • Grown through the lung into the pleura

Stage IIA: The lung tumor is no more than 3 centimeters across. Lung cancer cells are found in nearby lymph nodes.

Stage IIB: The lung cancer is one of the following:

  • Not found in nearby lymph nodes but has invaded the chest wall, diaphragm, pleura, main bronchus or tissue that surrounds the heart
  • Cancer cells are found in nearby lymph nodes and the tumor in the lung is one of the following:
    • More than 3 centimeters across
    • Grown into the main bronchus
    • Grown through the lung into the pleura

Stage IIIA: The tumor may be any size. Lung cancer cells are found in the lymph nodes near the lungs and bronchi and in the lymph nodes between the lungs on the same side of the chest as the lung tumor.

Stage IIIB: The tumor may be any size. Lung cancer cells are found on the opposite side of the chest from the lung tumor or in the neck. The tumor may have invaded nearby organs, such as the heart, esophagus or trachea. More than one malignant growth may be found within the same lobe of the lung. Cancer cells may be found in the pleural fluid.

Stage IV: Tumors may be found in more than one lobe of the same lung or in the other lung. Lung cancer cells may be found in other parts of the body, such as the brain, adrenal gland, liver or bone.

Getting a Second Opinion at MD Anderson

The pathologists at MD Anderson are highly specialized in diagnosing and staging lung cancer of every type. We have advanced expertise in genetic issues, including cancers involving epidermal growth factor (EGFR) and K-Ras gene mutations. We welcome the opportunity to provide second opinions for lung cancer.

If you would like to get a second opinion at MD Anderson, call 1-877-632-6789 to make an appointment or request an appointment online.


© 2014 The University of Texas MD Anderson Cancer Center