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Lung Cancer Diagnosis

The following symptoms are the most common signs of lung cancer. But they can also be caused by other health issues that aren’t cancer. Some people with cancer don’t have any symptoms.

If you have these problems, make an appointment with your doctor as soon as possible:

  • Coughing or wheezing that won’t go away
  • Coughing or spitting up blood 
  • Pain in the chest, shoulder, or back that gets worse when taking a deep breath
  • Being short of breath
  • Unexplained weakness or weight loss
  • Frequent respiratory infections, including pneumonia

Your doctor might refer you to a surgeon, pulmonologist (lung specialist) or oncologist (cancer specialist). Or your doctor might order tests first. These tests confirm the presence of lung cancer, its type, and the stage — how advanced it is.

Tests might include:

  • Chest X-ray to look for a tumor in your lungs.
  • CT scan (computed tomography X-ray) of the chest to see more details.
  • Biopsy to take a sample of lung tissue.
  • Sputum cytology to look for cancer cells in your mucus.
  • Thoracentesis to look for cancer cells in the fluid around your lungs — which is removed by a thin needle or tube inserted in the chest wall.
  • Bronchoscopy to take a sample of the tissue in your airways, by using a tube inserted in your nose or mouth.

Stages of Lung Cancer

Staging measures the size of the tumor, whether it has spread to nearby lymph nodes, and whether it has spread (metastasized) to other parts of the body. Staging is done by examining the tissue and results from other tests. The stage will help determine the appropriate treatment and is an important part of the diagnostic process.

There are two general types of lung cancer, both named for how the cells look under a microscope. Non-small cell lung cancer is the most common type. Small cell lung cancer is fast growing, with cancer cells smaller than non-small cell cancer, as the name suggests.

Non-small cell lung cancer is staged from 0 to 4.

Stage 0

  • The cancer hasn’t spread outside the inner lining of the lung (also called carcinoma in situ). 

Stage 1

  • The cancer is small, limited to the lungs, and hasn’t spread to the lymph nodes.

Stage 2

  • The cancer has spread to some lymph nodes near the original tumor.

Stage 3

  • The cancer has spread to nearby tissue and lymph nodes farther away from the original tumor.

Stage 4

  • The cancer has spread to other parts of the body, such as the liver or bone.

Small cell lung cancer is divided into two stages.

  • Limited stage: The cancer is found in only one lung and may or may not have spread to nearby tissue.
  • Extensive stage: Cancer is in both lungs and has spread beyond the affected side of the chest.

After determining the stage, your oncology team will be able to recommend a treatment plan and discuss your options with you. Many people like to take some time to think about what the doctor recommends before starting treatment.

Your doctors and cancer care team at Kaiser Permanente medical offices can answer any questions that might come up before, during or after testing and diagnosis.