If the doctor believes you have lung cancer your specialist may want to do some of the tests described below to confirm the diagnosis, see if the cancer has spread to other parts of your body and help evaluate your situation to decide the best type of treatment for you.

These include:

CT Scan, Spiral CT Scan, MRI, Mediastinoscopy, Lung Biopsy, PET Scan, Ultrasound Scan, Isotope Bone Scan, Lung Function Test. (link to each section below). 

CT (computerized tomography) Scan

A CT scan takes a series of x-rays that build up a three-dimensional picture of the inside of the body.

The scan is painless but takes longer than an x-ray (about 10-30 minutes). It may be used to find the exact site and size of the tumor, or to check for any spread of the disease.

You may be asked not to eat or drink anything for at least four hours before your appointment. Most people who have a CT scan are given a drink or injection about an hour before the scan, to allow particular areas to be seen more clearly. For a few minutes, this may make you feel hot all over. If you are allergic to iodine or have asthma, it is important to tell your doctor and the person doing the test before you have the injection or drink. It is usually still possible to have the injection, but you will be given treatment with steroids the day before and the day of the injection.

You will probably be able to go home as soon as the scan is over.

Spiral CT Scan

Some hospitals use low-dose spiral CT scans. A computerized tomography scanning machine rotates rapidly around the body, taking more than one hundred pictures in sequence. The scan can detect smaller lung tumors than a conventional CT scan and takes only a few minutes. Spiral CT scans are quite new and you may have to travel to a hospital that specializes in this procedure to have one done. They are not always necessary but you can discuss with your doctor whether one would be useful in your case.

MRI (magnetic resonance imaging) Scan

This test is similar to a CT scan but uses magnetism instead of x-rays to build up a detailed picture of areas of the body.

During the test you will be asked to lie very still on a bed inside a long tube for about 30 minutes. It is painless but can be slightly uncomfortable, and some people feel a bit claustrophobic during the scan. It is also noisy, but you will be given earplugs or headphones to wear. You can usually take someone with you into the room to keep you company.

Some people are given an injection of dye into a vein in the arm, but this usually does not cause any discomfort.

An MRI scan can often tell the difference between different types of body tissue more precisely than a CT scan, so in some situations it will give extra information.

Mediastinoscopy

This test allows the doctor to examine the area at the center of your chest and the lymph nodes close to the lungs. These are often the first places to which cancer spreads and so are usually checked for signs of cancer. The test is done under a general anesthetic and will mean a short stay in hospital.

A small cut is made in the skin at the base of the neck and a tube is passed into the chest. The tube has a light at the end and can magnify the areas it looks at. The doctor can see any abnormal areas and may also take samples of the cells and lymph nodes to examine under a microscope.

A similar test known as a Thoracoscopy involves making a small cut in the skin and inserting a telescope into another part of your chest to look directly at the cancer and take samples from it. 

Lung Biopsy

This test is usually done in the x-ray department, most commonly during a CT scan. A local anesthetic is used to numb the area. You will then be asked to hold your breath while a thin needle is passed through the skin into the lung. An x-ray is used to make sure that the needle is in the right position. A sample of cells is taken for examination under a microscope. The biopsy is sometimes slightly uncomfortable but it only takes a few minutes.

PET (positron emission tomography) Scan

A PET scan uses low-dose radioactive sugar to measure the activity of cells in different parts of the body. A very small amount of a mildly radioactive substance is injected into a vein, usually in your arm. A scan is then taken. Areas of cancer are usually more active than surrounding tissue so they take up more of the radioactive substance and show up on the scan.

PET scans are a new type of scan and you may have to travel to a specialist centre to have one. They are not often necessary but you can discuss with your doctor whether one would be useful in your case. PET scans can be used to find whether a lung cancer has spread beyond the lung, or to examine any lumps that remain after treatment to see whether they are scar tissue or whether cancer cells are still present.

Ultrasound Scan

Ultrasound uses sound waves to look at the liver and the other organs in the upper part of the abdomen. It is the same sort of scan that is used on pregnant women.

Once you are lying comfortably on your back, a gel is spread on to the area to be scanned. A small device like a microphone, which produces sound waves, is passed over the area. The sound waves are then converted into a picture by computer. The test only takes a few minutes.

Isotope Bone Scan

This is more sensitive than an x-ray and shows up any abnormal areas of bone more clearly. However, it is not always clear whether an abnormality is caused by cancer or other conditions such as arthritis.

A small amount of a mildly radioactive substance is injected into a vein, usually in your arm. Abnormal bone absorbs more radioactivity than normal bone so these areas are highlighted and picked up by the scanner as 'hot spots'. There is generally a wait of approximately 2-3 hours between having the injection and the scan taking place, so you may like to take a magazine or book to pass the time. The level of radioactivity used in the scan is very small and does not cause any harm.

Lung function tests

If your doctor wants to remove your lung cancer using surgery, he or she will first ask you to have breathing tests to see how well your lungs are working.

It will probably take several days for the results of your tests to be ready, and a follow-up appointment will be arranged for you before you go home. Obviously this waiting period will be an anxious time for you, and it may help to talk things over with a close friend or relative.