Lung Cancer Diagnosis and Staging

Diagnosis and Staging

Diagnosis. Lung cancer can only be conclusively diagnosed through a biopsy, which is removing a tissue sample from the affected area. These samples can be taken through several techniques: sputum cytology, bronchoscopy, EBUS, mediastinoscopy, transthoracic needle biopsy, thoracentesis or video thoracoscopy.

Sputum cytology. If the patient has a persistent cough that is producing sputum (mucus or phlegm mixed with saliva), viewing the mucus under a microscope can often reveal the presence of lung cancer cells.
Bronchoscopy. With this test, a flexible tube called a bronchoscope is passed into the airway. The bronchoscope allows the physician to look inside the lungs as well as to take a tissue sample for examination in the lab.
Endobronchial Ultrasound (EBUS). The latest advancement in lung cancer diagnosis and staging. A more advanced extension of the bronchoscopy, EBUS is a minimally invasive, non-surgical procedure. EBUS uses a tiny ultrasound on the end of a flexible, lighted bronchoscope that angles through the mouth into the bronchial tube allowing access to the lymph nodes. A tissue sample may be taken with a small needle for a biopsy. EBUS uses a Doppler to detect blood vessels and is ultrasound-guided, making it much safer and more accurate. The EBUS complements the endoscopic ultrasound (EUS) procedures performed at Saint Mary's. With EBUS and EUS we now have precision access to the entire chest area for cancer screening and staging.
Mediastinoscopy. Here, an instrument is passed through a small incision at the base of the neck, which allows the physician to take a biopsy of lymph nodes in the chest.
Transthoracic Needle Biopsy. Using an X-ray or a CT Scan for guidance, the doctor inserts a small needle into the mass and removes a small piece for study.
Thoracentesis. If the patient has fluid buildup in the chest cavity, the physician can extract a sample for testing by inserting a thin needle in through the chest between the ribs.
Video Thoracoscopy. This biopsy technique involves the insertion of a thoracoscope (a narrow tube with camera and instrument attachments) through a small incision between the ribs. The physician partially collapses a lung and then introduces the instrument into the nodule or mass. The biopsy can be viewed on a screen as it is being performed. The lung will re-expand soon after the procedure is completed.
Robotic Assisted Thoracoscopic Surgery. We use the da Vinci robot to perform a multitude of operative procedures including lung biopsy, segmentectomy, and lobectomy. This approach uses three small incisions between the ribs, each measuring one to two centimeters. The physician partially collapses the effected lung and introduces the robotic camera and the robotic arms through these incisions and performs the operation from a remote consol. This procedure is minimally invasive. The lung will re-expand soon. The hospital stay is significantly less then the standard approach, and the patient pain is minimal

Staging. Staging is a classification system based on where cancer is located and to what extent it has spread, and is essential to determining the most effective course of treatment for each patient. Lung cancer is staged according to its two most common forms—Small Cell and Non-small Cell cancer. In the staging process The Lacks Cancer Center uses only the most state-of-the-art technologies, including Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET) and Endobronchial Ultrasound (EBUS).

Small Cell Lung Cancer Staging. This form of lung cancer is staged as either limited or extensive cancer. Limited small cell cancer is found in only one lung and/or its adjoining lymph nodes. Extensive small cell cancer spreads beyond the one lung and nearby lymph nodes, and invades both lungs, or distant lymph nodes and other organs.

Non-Small Cell Lung Cancer Staging. Non-small cell lung cancer is staged according to the size of the tumor, the number of lymph nodes involved and the extent to which the cancer has spread. Stages of non-small cell lung cancer range from Stage O, in which tumors haven’t yet invaded lung tissue, to Stage IV in which the cancer has spread to other organs of the body.

To schedule a diagnostic procedure, or to join our Multidisciplinary Lung Clinic, ask your primary care physician for a referral or make a self-referral by calling 1-877-LACKS-MI or 616-685-LACK(S).