Lung Cancer

Lung Cancer Diagnosis

Appointment New Patient Appointment or 214-645-4673

Appointment New Patient Appointment or 214-645-4673

Lung cancer is often diagnosed in the late stages of the disease, largely because there are few or no symptoms in the early stages. Having an awareness of the risk and reducing it, plus early detection, can change everything. 

Lung Cancer Detection

At UT Southwestern Medical Center, cancer specialists in the Harold C. Simmons Comprehensive Cancer Center offer advanced detection and diagnosis for lung cancer. 

Imaging for Lung Cancer

Imaging tests can include:

Special Screening Test

UT Southwestern offers a CT screening test, possibly at no cost to patients, that can detect lung cancer early.

This screening program is for patients who:

  • Are 50 years of age or older
  • History of smoking one pack a day for 20 years
  • No other lung disease issues
  • Currently smoke or have quit within the past 15 years

If a patient qualifies for the screening, he or she will undergo a CT exam, which involves lying flat on the CT table while the scanner rotates around the patient, gathering images of the inside of the lungs. 

The CT images provide our radiologists with detailed information that can be used to detect and diagnose lung cancer or determine if someone is cancer free. The entire screening exam typically requires a single breath hold and is usually completed in less than 10 seconds. 

Also as part of the screening program, patients will need to provide a blood sample. 

A low-radiation dose computed tomography (LDCT) scan of the chest is recommended for specific people at high risk of developing lung cancer. Patients can check with a doctor to see if they qualify for LDCT screening. 

How Is Lung Cancer Diagnosed?

If imaging shows a suspicious area in the lungs, the next step is often a biopsy to confirm whether a nodule or mass is cancerous. Throughout this process, our lung cancer team works quickly and collaboratively to reduce delays and support each patient at every step.

In most cases, the follow-up process begins within a few days to a week after the imaging results are reviewed. Patients will meet with a lung specialist to discuss the findings.

Depending on the size, location, and appearance of the abnormality, the care team will recommend the best biopsy method.

Biopsy Options for Diagnosing Lung Cancer

Biopsies are obtained from lung nodules, lung masses, lymph nodes within the chest, and other lesions within or outside the chest. Our team performs biopsies using state-of-the-art, minimally invasive surgical, interventional radiology, and interventional pulmonary procedures. 

Examples include:

Bronchoscopy

During this minimally invasive procedure, the doctor inserts a thin, flexible tube with a light and camera through the patient’s nose or mouth, then guides it into the lungs to view or collect samples from the airways.

For patients with small or hard-to-reach lung nodules, we also offer robotic bronchoscopy. This approach uses a robotic system to guide an ultra-thin, flexible scope with greater stability and precision.

To improve accuracy, we may use advanced imaging tools such as endobronchial ultrasound (EBUS) and navigational guidance during either traditional or robotic bronchoscopy.

Thoracentesis and Pleuroscopy

These minimally invasive procedures assess fluid buildup around the lungs (pleural effusion) that may be linked to lung cancer. Thoracentesis removes fluid from around the lungs using a thin needle, while pleuroscopy uses a small camera inserted through the chest wall to look inside the chest cavity and collect tissue samples.

Mediastinoscopy

Mediastinoscopy is a minimally invasive procedure used to examine the area in the center of the chest, between the lungs (mediastinum). The doctor makes a small cut just above the breastbone and inserts a thin tube with a light and camera into the chest. This allows the doctor to see the lymph nodes and other structures and to take tissue samples for testing.

Robotic- and Video-Assisted Thoracic Surgery

These minimally invasive surgical approaches use small incisions and a camera to access lung tissue, offering a less invasive alternative to traditional open surgery.

Once the biopsy is performed, the sample is sent to a pathologist for review. Results are typically available within two to five business days, though this can vary depending on the type of testing needed.

What Are the Stages of Lung Cancer?

If lung cancer has been diagnosed, our team will perform additional tests to stage the cancer, or determine if the cancer has spread locally or outside the chest. We stage lung cancer using endobronchial or endoscopic ultrasound or ultrasound-guided needle biopsy, or by removing fluid from the chest cavity. 

Lung cancer stages are:

  • Stage 0 and Stage 1 lung tumors are generally small in size and have not spread to other areas of the body. These stages are often referred to as early-stage lung cancer. At these stages, the cancer treatment team might suggest surgery, such as robotic lobectomy, to completely remove the tumor.
  • Stage 2 lung tumors are somewhat larger and might have begun to spread to nearby lymph nodes. The cancer treatment team might recommend surgery alone or in combination with medical treatment or radiation treatments.
  • Stage 3 lung cancer has begun to spread, perhaps to the lymph nodes located in the center of the chest, or perhaps into nearby structures in the lung. At this stage, it’s less likely that surgery alone will be able to successfully treat the cancer, so the UT Southwestern team might recommend a combination of surgery, medical treatment, and/or radiation therapy.
  • Stage 4 is the most advanced stage of lung cancer. The cancer has spread to both lungs or another part of the body. While many medical centers don't treat stage 4 lung cancer, UT Southwestern offers advanced care at this stage. Surgery is unlikely to be effective, so our specialists typically recommend immunotherapy – drugs that help the immune system recognize and attack cancer cells.