# Tests magnetic resonance imaging (MRI) uses powerful magnets and radio waves to make modern computers detailed cross-sectional images. These images are similar to those produced with computed tomography, but are even more accurate in detecting spread of lung cancer to the brain or spinal cord.

# The positron emission tomography (PET): Using a sensitive tracer of low dose that accumulates in cancerous tissues. Bone scans require the injection of a small amount of radioactive substance into a vein. This substance accumulates in abnormal areas of bone that may arise from the spread of cancer.

# Sputum cytology: is examined under the microscope a sample of phlegm to see if it contains cancer cells. * Needle biopsy: A needle is inserted into the mass while the lungs are displayed on a computer tomograph. After removing a sample of the mass and is seen through a microscope for cancer cells.

# Bronchoscopy: It introduces a flexible, lighted tube through the mouth into the bronchi. This procedure can help find tumors located centrally or obstructions in the lungs. It can also be used to take biopsies or remove fluids to be examined with a microscope to see if they contain cancer cells.

# Mediastinoscopy: A small cut is made in the neck and a lighted tube is inserted behind the sternum. You can use special instruments that are managed through this tube to take a sample of tissue from the mediastinal lymph nodes (along the windpipe and the major areas of bronchial tubes). The observation of the samples under a microscope can show if cancer cells.

# Bone marrow biopsy: A needle is used to remove a cylindrical core of bone of approximately 1.5 millimeters wide and 2.5 inches long. Usually, the sample is taken from the back of the hip bone and studied under a microscope to see if cancer cells.

# Blood tests: often perform certain blood tests to help detect if lung cancer has spread to the liver or bones, as well as to diagnose certain paraneoplastic syndromes.

Because lung cancer symptoms often do not manifest until the disease is advanced, only 15 percent of cases are detected in its early stages. Many lung cancer cases are diagnosed in early stage by accident, which means that are detected as a result of medical tests carried out due to other unrelated health problem.

A lung biopsy was used to confirm or refute a possible diagnosis of cancer as well as provide valuable information to determine the appropriate treatment. If it is eventually detected lung cancer, additional tests are carried out to determine how far the disease has spread, including:

History and physical examination: The medical history is recorded risk factors and symptoms in the patient. The physical examination provides information about signs of lung cancer and other health problems.

Radiological studies: These studies use X-rays, magnetic fields, sound waves or radioactive substances to create images inside the body. Often using multiple imaging studies to detect lung cancer and determine the body part where you have spread. It performs a chest x-ray to see if there is any mass or spot on the lungs.

A computed tomography (CT): Gives more detailed information about the size, shape and position of a tumor and can help detect enlarged lymph nodes that may contain a cancer from the lung. CT scans are more sensitive than routine chest radiographs for detecting early-stage cancers.

Only 15 to 20% of lung cancers are detected in its early stages because the symptoms are delayed. In many cases the diagnosis is usually incidental, that is, by medical evidence that you had another purpose. When diagnosed with lung cancer, additional tests are performed to evaluate different tumor stage (if the initial or advanced) as well as lung capacity and general condition.

The prognosis and treatment depend on the size and the extent of having cancer (stage), and the histologic type of tumor. The surgery involves removing the lung area containing the tumor (lung lobe) and lymph nodes in the chest and is the treatment of choice in the early stages of the disease. Chemotherapy involves using drugs to kill cancer cells and radiation therapy using high energy X rays. These last two treatments are used in more advanced stages or in patients which can not be performed surgery.

How can detect early stage lung cancer?
An early-stage lung cancer can be diagnosed early by detecting a lung nodule in chest x-ray or a CT scan. Latter being much more sensitive and accurate. Lung nodules can be benign (infections, scars or benign) or represent an early stage lung cancer. The importance of early diagnosis is that surgery in early stages is the only treatment that can cure lung cancer.

Bronchoscopy

It is a procedure designed to look inside the airways of the lungs. It involves inserting a thin, flexible tube down the throat into the airways. The tube allows the doctor to look inside. Your doctor might also take samples of tissues and cells (biopsy) during bronchoscopy.

Bronchial biopsy

Bronchial biopsy is performed by inserting a bronchoscope through the larynx of the patient. The bronchoscope is a camera that allows the doctor to see as you enter the unit. The bronchoscope is also a small hole that allows to remove pieces of tissue. These tissues are then sent to the laboratory for analysis.

Mediastinoscopy

This is the procedure that examines the mediastinum. This area is located in the center of the chest, right in the middle of the lungs and contains the heart, blood vessels and lymph nodes.

Needle biopsy

For this procedure, the doctor uses a fine needle to take samples and examine cells under a microscope. This test can be uncomfortable, but only takes a few minutes. The doctor may also use X-rays, CT scan or ultrasound to guide a biopsy needle during outpatient. The biopsy can be performed during surgery.

Wedge biopsy

For this procedure the surgeon makes an incision through the skin and removes a wedge of tissue from the tumor and sent to a lab for analysis. For this procedure, the patient must be under general anesthesia. Sometimes you use this type of biopsy when other biopsy methods have not been able to confirm a diagnosis.

Thoracoscopy (video-assisted VAT)

The doctor may request this procedure to drain fluid from the sac (pleura) that surrounds the lungs, also known as pleural effusion. This procedure can also be used to take samples of lung tissue or lymph nodes in the mediastinum. A tube with a scope on the tip, allows the doctor to see inside your chest. This tube also allows the physician to take samples of fluids, and sent to the pathology laboratory for analysis.

Lung cancer tends to be very quiet, so that symptoms appear when the disease is at an advanced stage. These are:

* Chronic cough.
* Coughing up blood.
* Obstruction of the bronchi.

* Shortness of breath.
* Chest pain.
* Pale.
* A table held at the time, there may be weight loss poor appetite.

Diagnosis

The doctor does a complete physical examination. If there is productive cough, sputum can be analyzed to see if it contains cancer cells. However, the first test to detect abnormalities in the lung is usually the chest radiograph. In the case of suspicion of malignancy, the specialist can perform a bronchoscopy to look inside the bronchial tubes and lungs and at the same time, remove a sample of tissue for biopsy

Lung cancer often spreads to the brain or bones. Knowing the stage (stage) of the disease helps the doctor plan lung cancer treatment. Some of the tests used to determine whether the cancer has spread are:

CT scans or CT scan. A computer linked to an X-ray machine creates a series of detailed pictures of areas inside the body.

MRI (magnetic resonance imaging). A powerful magnet linked to a computer produces detailed pictures of areas inside the body.

Radionuclide studies. The scans with radionuclides (radioactive isotopes) can show whether cancer has spread to other organs including the liver. The patient swallows or receives an injection of a mildly radioactive substance. A machine (scanner) measures and records the level of radioactivity in certain organs to reveal abnormal areas.

Bone scans. The scanogram bone, a type of radionuclide study can show whether cancer has spread to the bones. Is injected into the vein a small amount of a radioactive substance that travels through the bloodstream and concentrates in the areas of abnormal bone growth. An instrument called a scanner measures the radioactivity levels in these areas and records them on x-ray film

Mediastinoscopy / mediastinotomy. A mediastinoscopy can help show whether cancer has spread to lymph nodes in the chest. Using a light optical instrument called an endoscope, the doctor examines the center of the chest (mediastinum) and nearby lymph nodes. At mediastinoscopy, the scope is inserted through a small incision in the neck in mediastinotomy, an incision is made in the chest. In either of the two procedures, the endoscope is also used to collect a tissue sample. The patient receives general anesthesia.

To help find the cause of the symptoms, the doctor evaluates the person’s medical history, your history of smoking, exposure to environmental substances or craft and family history of cancer. The doctor also performs a physical exam and may order chest x-rays and other tests. If lung cancer is suspected, sputum cytology (microscopic examination of cells in a sample of phlegm from the lungs that comes from a deep cough) is a simple test that can be useful for detecting lung cancer. To confirm the presence of lung cancer, the doctor needs to examine lung tissue. A biopsy is the removal of a small sample of tissue for examination under a microscope by a pathologist and can show if a person has cancer. Several procedures can be used to obtain this tissue.

Bronchoscopy. The doctor puts a bronchoscope (a thin tube, light) by mouth or nose until you reach the windpipe to look into the airways. Through this tube, the doctor can collect cells or small tissue samples.

Needle aspiration. A needle is inserted into the tumor through the chest to remove a tissue sample.

Thoracentesis. Using a needle, the doctor removes a sample of fluid around the lungs for cancer cells.

Thoracotomy. Sometimes surgery is needed to open the chest to diagnose lung cancer. This procedure is a major operation that is performed in the hospital.

- Chest radiograph with which you can see any mass or spot on the lungs and reasonably set the probability of being a cancer. This test is performed in two projections, one front and one in profile. For more than 95% of cancer cases their results are abnormal.

- TAC: It consists of an X-ray emission from different perspectives and with that seen throughout the body. It is a simple test which usually lasts more than 15-30 minutes. This is more sensitive than radiography and it detects more early-stage cancer. It also serves to check for metastasis to other organs: liver, adrenal glands, brain and so on. It is the most widely used imaging test and profitable in the study of this disease. However, sometimes required to complete the study of CT with other more sensitive tests for specific sites of lung cancer: magnetic resonance imaging (MRI) brain or spine, liver ultrasound, bone scan and so on.

- Magnetic resonance imaging is used to make detailed cross-sectional images. This technique uses magnetic fields and spectra emitted by phosphorus in body tissues and becomes the image. With it you can see the tumor vasculature. They are more accurate images with which one can observe the spread of cancer to the brain or spinal cord. It is often not too useful for exploring the lungs.

- Positron emission tomography (PET): involves injecting a drug radio combined with glucose and this will be taken up by cancer cells, cancer exist, they consume more glucose. The radio will be located drug areas where the tumor. In the case of lung cancer, is sometimes used to clear any doubts sown by the TAC, but is not necessary most of the time.

- Sputum cytology: We analyzed the first sputum or phlegm in the morning with a microscope to see if it contains cancer cells. Is a simple and very cost effective in lung cancers located in the bronchi.

- Tissue biopsy will be needed to confirm the diagnosis of lung cancer. This test involves taking a sample of suspicious tissue and microscopic analysis. The biopsy can be done by inserting a tube, a bronchoscope through the nose to where mass is in the lung. If the patient’s characteristics can not be done this type of biopsy, there will be a small operation to remove the tissue. After analyzing it, we can now determine the tumor type and stage and establish the appropriate treatment. Biopsies can be performed to analyze tissue from other areas, such as the lymph nodes, if metastasis is suspected.

- Mediastinoscopy and mediastinostomy: Most of the time, the TAC will be insufficient to provide essential information on whether the nodes of the mediastinum, in the center of the chest are affected or not. If in doubt, mediastinoscopy is used. This exam is done under general anesthesia, introduced under the sternum through a small incision at the base of the neck, a tube and optical system equipped with biopsy forceps.

- Blood tests can determine whether some functional or organic values are altered because of the disease and also help to determine the functional face of the person to treatment.

Only 15% of lung cancer is diagnosed in early stages, this is because the symptoms do not appear until the disease is advanced. If no lymph node involvement at the time of surgery, the survival rate five years is 50%. Considering all cases globally, the survival rate is reduced to 14%.

There are various diagnostic tests that visualize the lung tumors at different stages.

The doctor will use a method to detect cancer if there is prior suspicion. The patient’s medical history is the first to be conducted to assess personal and family history. The doctor will ask about the existence of cancer and other diseases in the family, snuff consumption, environmental or occupational exposure to substances that produce lung cancer and respiratory disease or any other suffering the ill.

The physical examination will take into account the symptoms that the patient concerned, and with it, it can obtain data that can help diagnose any disease.

The blood test will show if there are any alterations in cellular levels of other organs such as liver.

Radiologic studies can be done through various techniques, if not well visualized with a test, or if there is any doubt in diagnosis. These tests give information on the stage where the cancer. They are also useful to check if the cancer has spread to other parts of the body.