Monday 24 November 2014

Lung Cancer - Diagnosis

Timely diagnosis of lung cancer is crucial for a sound prognosis. Here are the different ways by which a cancerous growth in the lung is diagnosed.
Cancer of the lung is not the easiest to diagnose in its early stages, primarily due to generic symptoms that could be mistaken for any other respiratory disease. Another hindrance in timely diagnosis is the patient himself/herself, who blames his/her own lifestyle for the 'side effects', and avoids timely diagnosis. However, it's not all bad news for lung cancer patients - early diagnosis can result in an effective treatment with cancer-free years ahead.
When Is Lung Cancer Suspected?
The initial diagnostic tool is a physical exam that may lead a doctor to suspect the disease. The following signs may point towards cancer in the lungs:
• Abnormal lung sounds
• Swollen lymph nodes over the collarbone
• Weakened breathing; face swelling
• Arm weakness
• Enlarged veins in chest, neck and arms
• Drooping eyelids, differently sized pupils
Based on the results from the physical examination, the doctor will ask the patient to undergo the following tests:
Imaging Tests
1. X-ray - An x-ray can show a large mass or nodules(s) in the lung.
2. CT scan or MRI - If the patient resents more severe symptoms, the doctor will directly order a CT scan or MRI of the chest to identify the problem. These tests create 3D images of the chest and are more detailed than an x-ray as they can reveal the size of the tumour along with the stage of cancer. They can also tell if the cancer has spread from the chest to the lymph nodes or other organs.
Tissue Or Fluid Studies
If the above tests reveal cancer-like mass in the lung, the doctor requires confirming diagnosis by studying the lung tissue from fluids. There are different tests for this purpose:
1. Sputum Cytology
Persistent cough brings up sputum, which can be looked at under the microscope as they may contain cancerous lung cells.
2. Bronchoscopy
A bronchoscope, which is a thin, flexible tube with a tiny, lighted camera at its tip, is inserted through the mouth down the windpipe and into the lung airways (bronchi). The patient is given a local anaesthetic that numbs the mouth and throat to relieve discomfort while the bronchoscope examines the lower airways and collects sample of suspected tumour growth.
3. Needle Biopsy
Needle biopsy is useful in cases when the tumour sits on the lung periphery, where a bronchoscope cannot reach. A fine needle is inserted through the chest wall to directly reach the tumour and collect tissue sample for analysis. A CT scan or X-ray may be used to direct the needle.
4. Thoracoscopy
This procedure is conducted under general anaesthesia. Two to three small incisions are made to allow a tube to pass into the chest, using which the doctor looks for cancerous growths and takes samples. Overnight hospital stay may be needed to drain out any remaining fluids from the lungs.
5. Mediastinoscopy
This procedure allows a careful examination of the mediastinum or the centre of the chest. The doctor makes a small incision at the bottom of the patient's neck to pass a thin tube into the chest. Fitted with a camera, this tube allows the doctor to look inside the chest and draw samples of suspicious growths in the lung and lymph nodes. This test is conducted under general anaesthesia and the patient may require hospital stay for couple of days.
Staging The Cancer
An important step in the diagnostic process is determining the stage of cancer, i.e. the extent of spread. Knowing which stage the cancer is at is useful in deciding the right treatment. Various tests that help determine the cancer stage are MRI, CT scans, positron emission tomography (PET) and scanning of bone. Based on these tests, cancer in the lung is divided into the following stages:
• Stage I - Limited to lungs; smaller than two inches.
• Stage II - Grown more than two inches or is smaller but spread to chest wall, diaphragm or lung lining, or lymph nodes.
• Stage III - Large tumour and other nearby organs involved, or small tumour but spread far from lungs.
• Stage IV - Cancer spread to other lung too and distant organs.
It is important for patients to take worsening lung symptoms seriously and consult the doctor at the earliest for timely lung cancer treatment. Find the list of top cancer hospital in mumbai and book doctor appointment online.

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