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Lung Cancer Diagnosis

Successful lung cancer treatment starts with a robust diagnosis. Just like people, no two lung cancers are the same. At the Abramson Cancer Center, lung cancer specialists provide exhaustive information about the tumors they analyze. Using the latest methods, they can unlock the tumor’s DNA, so your care team can match the right treatments to you.

Lung Cancer Diagnosis: The Penn Medicine Advantage

We bring decades of experience to your lung cancer diagnosis. This expertise means our patients receive accurate and detailed diagnoses that help create effective short- and long-term treatment plans. You can also expect:

  • Rapid diagnosis: We aim to have all the information needed to make a diagnosis within three days of your first contact with our program. Your lung cancer navigator uses specialized training and extensive experience to coordinate the appointments and tests you need to make this possible. Meet the oncology nurse navigators.
  • Dedicated pulmonary pathologists: Pathologists are doctors who examine and analyze microscopic tumor tissue. Our pathologists subspecialize in lung diseases. They have a deep understanding of lung biology, which means they see details that others may miss. They also use the latest diagnostic tests. We are the only hospital in Philadelphia with multiple pulmonary pathologists on our lung cancer team.
  • Dedicated thoracic radiologists: Radiologists specialize in reading medical images to diagnose and treat diseases. In most hospitals, radiologists look at scans of the entire body. Our thoracic radiologists concentrate on the lungs and chest. Because they're examining all types of lung cancers every day, they make more sophisticated diagnoses that lead to better outlooks.
  • Advanced diagnostic tools: We use the latest versions of standard tools, along with innovative new ones, to catch hidden cancers. Navigational bronchoscopy allows doctors to find and classify tumors located in hard-to-reach branches in the lungs. We also constantly upgrade our imaging machines to ensure the highest possible image quality.
  • Personalized treatments: We fully characterize tumors by analyzing the cancer cells. Once we understand the genetics of the cancer, we can make sure the treatment is matched to the patient and the tumor. Knowing the cancer’s biomarkers also lets us know the likelihood that you will respond to certain treatments, such as immunotherapy and targeted therapy.

Liquid Biopsy at the Abramson Cancer Center

Targeted therapies are revolutionizing today's lung cancer treatments. Also known as precision or personalized medicine, these treatments are matched to a specific cancer to stop its growth. Typically, these drugs come in pill form and are taken at home while you live life normally.

To see if you are a candidate for targeted therapy, doctors need to analyze the genetic makeup of cancerous lung nodules. Traditionally, this analysis happens after doctors remove a tumor sample during a biopsy. Pathologists then examine the tissue in a process called tumor sequencing, which normally takes around two to six weeks.

At the Abramson Cancer Center, we have developed a faster, less invasive option to get this information through our Center for Personalized Diagnostics. Analysis of circulating tumor DNA, or liquid biopsy, is a blood test we use to identify the genetic changes that make a cancerous tumor grow out of control. The results of your liquid biopsy usually take a week to come back and can quickly match you to the appropriate targeted therapy.

Learn more about targeted therapy for lung cancer

What Tests Are Done to Check for Lung Cancer?

To diagnose lung cancer, your doctor will first do a physical exam and history. Your doctor checks your body for general signs of health and asks about your health habits, past jobs, illnesses and treatments. Then, you may undergo tests and procedures that include:

Imaging

  • Chest X-ray: Chest X-rays use energy beams that go through the body to make a picture of the organs and bones inside the chest.
  • CT scan (CAT scan): CT scans take detailed pictures of areas inside the body, such as the chest, from different angles. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly.
  • PET scan (positron emission tomography scan): PET scans find cancerous (malignant) tumor cells in the body using a radioactive glucose (sugar) injected into a vein. The PET scanner rotates around the body to make a picture of where glucose is being used in the body.
  • MRI (magnetic resonance imaging): MRIs use powerful magnets and radio waves to take detailed pictures inside the body.

Procedures

  • Fine-needle aspiration (FNA) biopsy: During FNA, doctors remove tissue or fluid from the lung with a thin needle. A pathologist views the sample under a microscope to look for cancer cells. Our interventional pulmonologists use a new minimally invasive technology, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), as a less invasive way to stage lung cancer.
  • Thoracentesis: Doctors use a needle to remove fluid from the space between the lining of the chest and the lungs. A pathologist views the fluid under a microscope to look for cancer cells.
  • Bronchoscopy: During bronchoscopy, doctors look inside the trachea and large airways in the lungs for abnormalities. They insert a thin, tube-like instrument with a light and a lens for viewing (bronchoscope) through the nose or mouth into the area.
  • Thoracoscopy: This surgical procedure looks at the organs inside the chest to check for abnormal areas using a thoracoscope. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing.
  • Thoracotomy: If certain tissues, organs or lymph nodes can't be reached during a thoracoscopy, doctors may do a thoracotomy. In this procedure, doctors make a larger incision between the ribs to access the chest.