Anil Vachani: Most commonly, doctors suspect somebody might have lung cancer when they see something on an imaging test such as a CT scan that looks like it could be a tumor.
A CT scan takes a series of images from the top to the bottom of the lungs. However, your story could be different. For example, your doctor may have suspected that you had lung cancer based on symptoms such as a cough that didn't go away, shortness of breath, or chest pain.
Lung cancer doesn't always cause symptoms in the early stages. Sometimes patients are referred to me who don't have any symptoms at all.
We look at each patient's personal history to determine if they should be screened for the disease. The only way to fully verify that you have lung cancer, and to understand what type it is, is to look at a tissue sample under a microscope. We perform what is called the biopsy in order to get the tissue sample.
For lung cancer, biopsies are often completed using a technique called bronchoscopy. With this technique, a thin, flexible, lighted tube with a small camera is inserted into your lungs through your mouth while you are asleep. With the camera, the doctor can see inside your lungs. This helps with diagnosis, and it also helps the doctor find the best location to remove a tissue sample.
For a needle biopsy, a long needle is inserted through the best wall to remove a sample of lung tissue. We opt for a needle biopsy if the abnormal lung tissue is located close to the best wall.
Once we have a tissue sample, a doctor called a pathologist looks at the cells and decides on your diagnosis.
Some things don't always go as planned. We expect that a given test should be able to confirm a diagnosis, but sometimes more tests are needed. Things change, and that is normal. When we decide we need new tests, or when patients have to wait for the results of tests, it can be really frustrating. Also, patients might feel worried about all the time that is passing without having their lung cancer treated. It is important to realize that your lung cancer has likely been developing for many years and so it is very unlikely to spread while waiting for your test results.
Lung cancer is a difficult disease with outcomes that, on average, are not as good as we would like, but we're doing all the better. Progress and treatments over the past 10 years or so offer some real hope for patients. Also, the opportunity to participate in clinical trials is a way for patients to have access to the very best care and to potentially improve treatment options.
At the same, outcomes vary greatly. Statistics describe average outcomes, but that means the statistics can't tell us how anyone patient will respond to treatment. Patients beat the odds all the time. Also, with new treatment options become available, statistics change. While it is important to be realistic, in my early conversations with patients, I also emphasize these options and the possibility of hope during a difficult time.
That being said, lung cancer is a very serious and difficult disease, and it is very important to be prepared for whatever the future might hold.
Page last updated: March 22, 2020