Lung Cancer Diagnosis Guide
What is the diagnosis of lung cancer ? Lung cancer doctors use a variety of diagnostic procedures and lung cancer tests to diagnose lung cancer. Some of lung cancer diagnosis (diagnóstico de cáncer de pulmón, La diagnosi di cancro al polmone, lungenkrebs diagnose, diagnóstico de cáncer de pulmón) are :
Physical and history examination
The history and physical examination may reveal the presence of symptoms and signs that, with suspected lung cancer. In addition, to inquire into the causes and risk factors for cancer such as smoking, doctors can detect signs of respiratory distress, airway obstruction or lung infection. Cyanosis, a bluish color of the skin and mucous membranes due to lack of oxygen in the blood, suggesting compromise of lung function. In addition, changes in the tissues of the nail, known as clubs, can also indicate lung disease.
Chest X-ray
Using Chest X-Ray is the most common first diagnostic step, when new lung cancer symptoms are present. Chest X-ray procedure often includes a view from the back of the front of the chest as well as the view from the outside. Like any X-ray procedure, chest X-rays expose patients below the minimum amount of radiation. In the chest X-rays can detect suspicious areas in the lungs, but can not determine if these areas are cancerous. In particular, calcified nodules in the lungs or benign tumors called hamartomas can be identified by chest radiography and simulate a lung cancer.
CT-Scan (computed tomography scan, or computed tomography)
Computed Tomography Scan, better know as CT-Scan can be performed in the chest, abdomen and / or to study the brains of primary and metastatic tumors. The CT scan may be ordered when a chest X-rays showed no abnormalities or does not provide sufficient information or the location of the tumor. CT X-ray procedures is to combine several images using a computer to produce cross-section view of the body. Photos taken large donut-shaped X-ray machine at various angles around the body. One advantage of CT is more sensitive than standard chest x-ray ray in detecting lung nodules. Sometimes intravenous contrast agent is given before the procedure helps to identify the bodies and their positions. CT exposes the patient to a minimal amount of radiation. The most common side effect is an adverse reaction to contrast material intravenously, which can be given before the procedure. There may be a result of itching, a rash, which usually disappear fairly quickly. Severe anaphylactic reactions (life-threatening allergic reactions with shortness of breath), in contrast to the material are rare. Abdominal CT scan can detect liver metastases or adrenal glands, and computed tomography of the head may be required to identify the presence and extent of metastatic brain cancer.
A technique called low-dose spiral CT (computed tomography or spiral)
CT Spiral, or computed tomography spiral is sometimes used for screening of lung cancer. This procedure requires a special type of scanner and shown to be an effective tool to identify lung cancer in smokers and former smokers. However, there has not been demonstrated that the use of this method actually saves lives and reduces the risk of death from lung cancer. Increased sensitivity of this method is actually one of the sources of its weaknesses, as it is easy nodules require further evaluation will be considered in approximately 20% of people with this technique. Nodules identified low-dose spiral transformer test, 90% not cancerous, but require up to two years of expensive and often difficult monitoring and verification. Trials conducted in order to determine more precisely the utility of spiral CT screening for lung cancer.
Magnetic resonance imaging (MRI)
Using MRI may be appropriate if the precise details on the whereabouts of the tumor is not necessary. Appliances Magnetic Resonance Imaging (MRI) uses magnetism, radio waves and a computer to produce images of body structures. Like CT, the patient is in bed furniture, which is inserted into the MRI. There are no known side effects of MRI, and no exposure. And the resolution of the image produced by MRI in detail and can detect small changes in the structure within the body. Persons with pacemakers, metal implants, artificial heart valves and other structures surgically implanted can not be scanned with MRI because of the risk that the magnet may move the metal parts of these structures.
Positron Emission Tomography (PET)
PET, or positron emission tomography is a specialized imaging technique that uses radioactive drugs short-term three-dimensional color images of these substances in the tissues in the body. Although CT and MRI to examine the anatomical structures and measure the metabolic activity of PET and functioning of tissues. PET can determine if the tumor tissue is actively growing and can help determine the type of tumor cells determined. In PET, the patient receives an average cut of radioactive drugs and about the amount of radiation in two chest X-ray. Drug discharges particles called positrons from wherever they are accepted and used in the body. As the positrons encounter electrons in the body, the reaction of gamma ray production occurs. The scanner records these gamma rays and map the area where radioactive drugs. For example, the combination of glucose (a common source of energy in the body) with radioactive materials will be displayed quickly when glucose is used, for example, the growing tumor.
Thoracentesis
Why thoracentesis can diagnose lung cancer? Sometimes lung cancer involving the lining of the lung tissue (pleura) and lead to accumulation of fluid in the space between the lungs and thorax (called pleural effusion). The desire of the fluid sample with a fine needle (thoracentesis) can detect cancer cells and to establish the diagnosis. As the needle biopsy, a small risk of pneumothorax associated with this procedure.
Bronchoscopy
Examination of bronchoscopy of the airways (Airways viewing through a thin fiber optic probe is inserted through the nose or mouth), can identify areas of tumor, which may be sampling ( biopsy) for diagnosis by the pathologist. A tumor in the central regions of mild or arising in connection with the large airways is available for sampling using this technique. Bronchoscopy can be performed with the fiber, rigid or flexible-optic bronchoscope and can be done in the office that day bronchoscopy suite, operating room or living room. The procedure can be uncomfortable and requires sedation or anesthesia. Although bronchoscopy is relatively secure, it must be done by lung specialists (pulmonologist or surgeon) with experience in this procedure. When the tumor is visualized and adequately sampled, accurate diagnosis of cancer, as a rule, is possible. Some patients may cough up blood, dark brown for a day or two after the procedure. The most serious complications, but rarely include more bleeding, reduced blood oxygen, and cardiac arrhythmia, and complications of sedation and anesthesia.
Sputum cytology
What is the sputum cytology? The lung-cancer diagnosis always requires confirmation of malignant cells pathologist, even when symptoms and X-ray studies with suspected lung cancer. The easiest way to establish the diagnosis of sputum examination under a microscope. If the tumor is located in the center and into the respiratory tract, this procedure is known as the examination of sputum cytology, may allow visualization of the tumor cells for diagnosis. This is the biggest risk diagnostic procedure for free and cheap material, but its value is limited because tumor cells can not always be present in sputum, even if cancer is present. Also, sometimes benign cells undergo changes in response to inflammation or trauma, which makes them look like cancer cells.
The Bone Scan
The bone scan is used to create images of bones on a film or computer screen. Doctors may order a bone scan to determine the lung cancer metastasis to bone. In the analysis of bones, a small amount of radioactive material is injected into the blood and accumulates in bones, especially in abnormal areas, such as those involved in the metastatic tumors. Radioactive material detected by the scanner and the image of the bones is recorded on special film for permanent display.
The needle biopsies
Fine needle aspiration (FNA) through the skin, most commonly performed with X-ray images for guidance, can be useful in extracting the cells for diagnosis of tumors of the lymph in the lungs. Needle biopsy is particularly useful for peripheral lung tumor in the lungs and is not accessible for sampling by bronchoscopy. A small amount of local anesthetic for the installation of a thin needle through the chest wall in the anomalous region in the lungs. The cells were sucked into the syringe and examined under the microscope of the tumor cells. This procedure is usually necessary when the tissue in the affected area is an adequate sample, but in some cases, the district or outside the field can easily be confused with the sample. Small risk (3% -5%) of air leaks in the lungs (called pneumothorax, which can be easily treated) accompanies the procedure.
The major surgical procedures
If none of these methods provides methods of diagnosis, surgery should be used to obtain tumor tissue for diagnosis. These may include mediastinoscopy (examination of the chest cavity between the lungs through a tube inserted into a surgical biopsy of tumor masses or lymph nodes that may contain metastases) or thoracotomy (surgical opening of the chest wall to remove or biopsy). At thoracotomy, is a rare opportunity to completely remove the lung, and both mediastinoscopy and thoracotomy entails risks of major surgical procedures (for complications such as bleeding, infection, and risks associated with anesthesia and drugs). These procedures are performed in the operating room and the patient should be hospitalized.
Blood tests
Although regular blood tests alone can not diagnose lung cancer can be identified biochemical and metabolic disorders in the body that accompany cancer. For example, elevated levels of calcium or alkaline phosphatase enzyme may accompany cancer, which is a bone metastasis. In addition, elevated levels of certain enzymes normally present in liver cells, including alanine aminotransferase (ALT or SGPT) and aspartate aminotransferase (AST or SGOT), signal liver damage, possibly due to the presence of metastases.