Tests after diagnosis – staging lung cancer

You may have more tests after your diagnosis to find out:

• How large is the cancer?
• Where exactly is the cancer?
• Has the cancer spread to any other parts of your body?

This is called staging. Some of these tests may also be done when diagnosing and to check your response to treatment.

For most lung cancers, doctors don't use a specific grading system, although they may give it a grade number from 1-4.

Staging tests for lung cancer include:

Bronchoscopy

A small tube with a camera on the end is passed into your lungs to take pictures of your lungs.

Endobronchial ultrasound scan (EBUS)

A type of bronchoscopy that uses an ultrasound probe to look at the lungs and surrounding lymph nodes. Biopsy (tissue) samples from the lung or lymph nodes can be taken by passing a needle through the tube. This is called a transbronchial needle aspiration (TBNA).

Endoscopic ultrasound scan (EUS)

Similar to an EBUS, but the probe goes down your oesophagus (gullet) to give images of the area around the heart and lungs, to show if any of the lymph nodes in the centre of the chest are enlarged.

Mediastinoscopy

Putting a tube with a light and a camera into the centre of your chest area, through a small cut in the front of your lower neck. It can see if there are any abnormal areas.

Thoracoscopy

A flexible tube with a light and camera put into your chest through a cut between your ribs. It can see if the membranes that line the lungs (pleura) look normal. 

Bone scan

A radioactive injection that can show areas of abnormal bone on a scan, which may be caused by cancer.

Lung function tests

Your doctor will organise a range of breathing tests to see how well your lungs are working. The main type of breathing test is a pulmonary function test. This is where you blow into a mouthpiece on a machine to see how well your lungs work. The test is not painful and takes about 20 minutes.

MRI scan

A scan that uses magnetic energy to create a picture of the tissues inside your body. During the scan you will lie inside a tunnel-like machine.

CT scan

A type of X-ray that gives a detailed picture of the tissues inside your body.

PET - CT scan

A radioactive injection that will show up any cancer spread to other parts of your body on a CT scan picture.