Lung Cancer: Symptoms and Diagnosis
It is difficult to catch lung cancer while still in its early stages. There are few outward symptoms that appear serious enough to warrant seeing a doctor. Symptoms often do not become apparent or troubling until after metastasis has occurred and cancer has spread to and infected other organs, including the liver, the brain and the bones. When early symptoms are apparent, they often take the following forms:
- A stubborn cough that will not quit, sometimes accompanied by a hoarse throat
- Wheezing breathing
- Pain in the chest, shoulders or back
- Diminished appetite
- Unintentional weight loss
- Respiratory infections
- Shortness of breath with only moderate exertion
As the cancer worsens and spreads the patient may experience:
- Difficulty concentrating
- Severe coughing which produces blood
- Feelings of weakness and fatigue
- Swellings in the face and/or neck
- Difficulty while swallowing
- Pain in the bones
- Numbness in the limbs
- Jaundice (yellow coloration of the skin and eyes)
- Odd lumps appearing on the body
Persons who experience one or more of these symptoms unexpectedly should strongly consider seeking immediate medical attention. While it is quite likely that something other than cancer may be causing the symptoms to occur, it is better to be on the safe side.
If your doctor believes you may have lung cancer, he or she will most likely order one or more of the following tests:
Chest X-Ray. Often the first test a doctor will perform when looking for lung cancer will be a chest x-ray. The x-ray picture is formed by passing radiation through your body and capturing the result on sensitive film. The resulting image shows some detail of the structures within your body based on how those structures deflected or passed the x-ray radiation. The x-ray pictures give your doctor a preliminary idea of whether you might have cancerous tissues and the general locations of the cancer if it exists. In the event of a positive finding on the x-ray (that cancerous tissue appears to exist), the doctor will likely order further tests to try to get a more detailed look Your doctor may opt to do interval x-rays 6 months or 1 year later to evaluate any changes in the size of the mass. If the mass remains stable, no further work-up may be necessary.
CT Scan. A CT or computed tomography scan is basically similar to an x-ray. However, where a normal x-ray procedure involves only taking a small set of images, the CT scan procedure involves making many pictures of the body, and then using a computer to assemble them into an extensively detailed image of your body. In some cases, the radiologist performing the CT scan procedure can increase the resolution of the CT scan by injecting the patient with a special dye that causes certain features of the body to stand out in the resulting image. Some patients experience a warming sensation similar to a hot flash when this dye is injected, but the sensation does not last long. CT scans are very helpful in determining the size, shape and location of tumors, and can also be helpful in locating areas of metastasized cancer.
MRI. MRI stands for magnetic resonance imaging, a method of creating images of body structures using magnetism rather than radiation. During an MRI high powered magnets are used to create a cross section image of the body which often has greater resolution than CT or x-ray images. MRIs are generally used to determine if the cancer has spread to the brain or spinal cord; areas of soft tissue which MRIs excel at imaging. The MRI procedure requires that you be placed into an open-ended tube containing enormous magnets, and then lie motionless inside this tube while the machine clacks and clanks around you for up to an hour. Being inside the machine bothers some individuals who have a fear of confined spaces. Luckily, new MRI machines called 'Open MRIs' are now available that have a less confining design. Ask your doctor about options for Open MRI in your area if you think you will have a problem with the tight confines of the regular machine.
PET Scan. PET stands for positron emission tomography, an imaging technique that can be used to make movies of biological activity in the body. Tissues in the body burn sugar as food, and PET techniques are capable of making movies showing how much sugar different tissues in the body burn. In PET, the patient receives special radioactively-tagged sugars which then get taken up by the patient's various body tissues. The tagged sugars emit weak radiation which is then picked up by special movie cameras. Cancerous tissues are very metabolically active and so burn up more of the radioactive sugars than their non-cancerous neighbors. PET images thus enable doctors to see where cancers exist in the body by showing where there are areas of greater-than-normal sugar utilization. PET movies help verify whether or not an abnormality in a chest x-ray is actually cancer, and can also help identify cancers that have spread to other parts of the body.
Bone Scan. This test is often performed if doctors believe that lung cancer may have spread to the bones. In this test a radioactive substance is injected into the bloodstream. The radioactive substance is easily absorbed by cancer cells and a special camera is used to record areas of the bone where cancer is present. The patient will usually have to wait two to four hours for the radioactive substance to have sufficient time to be absorbed by the cancer. The actual scanning process lasts about an hour.
Bronchoscopy. Bronchoscopy is used to locate tumors or collect tissue samples from the trachea and upper bronchi. Before the test begins you will be given medicine that will help you relax and remain comfortable. In this test a doctor places an instrument called a capula into your mouth which holds down your tongue. Next, an anesthetic is sprayed into your throat to numb it. A flexible metal tube is then inserted into the numbed throat and used to take tissue and fluid samples from your throat and bronchi. Some individuals feel the sensation of choking while the tube is in their throat, however there is no real danger of suffocation. Your throat may feel a bit scratchy for a few days after the procedure is performed.
Sputum Cytology. This tests calls for a sample of your spit (phlegm) to be analyzed under the microscope to look for cancer cells.