Chapter 5

Diagnostic Approach to Lung Cancer

Jack Kastelik

Abstract

Lung cancer is a common neoplasm. Diagnosis of lung cancer at an early stage is associated with the best prognosis. Therefore, early recognition of symptoms through increased awareness, systematic investigations and rapid diagnosis of lung cancer is of importance. Patients investigated for lung cancer would require a chest radiograph, computed tomography and Positron Emission Tomography. Imaging can provide a non-invasive approach to staging lung cancer. However, in a number of patients, more invasive methods may be required for accurate staging. Endobronchial ultrasound (EBUS) and Endoscopic ultrasound are techniques, which in conjunction with mediastinoscopy, form important techniques for mediastinal lymph node staging as well as sampling for histological diagnosis. Patients with more peripheral lesions may need biopsy using CT guidance or newer approaches such as radial EBUS or navigational bronchoscopy. Many patients with lung cancer would also require complex physiological fitness assessment, including lung function and exercise testing. A proportion of patients with lung cancer may develop pleural effusion, which would require careful assessment based on the use of systematic diagnostic protocols and understanding of the best interventional and therapeutic strategies. Therefore, investigations and management of patients with lung cancer have become complex and should be undertaken through the multidisciplinary team approach.

Total Pages: 85-113 (29)

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