Laboratory investigations for ap environmental science

Laboratory Investigations

Via: depositphotos.com

In the laboratory, examined different things.

First of all, in the laboratory, the blood is examined. It can be a lot of information about the general condition are derived, but also information about possible metastases.

laboratory investigations for ap environmental science

In addition, tissue examined which has been removed during bronchoscopy or puncture in order to determine whether there are cancer cells in the tissue are indeed. Then the type of lung cancer can be determined. The results of blood and tissue research are generally known within one week.

With certain types of non-small cell lung cancer tissue in the laboratory, this is examined to see if there are variations (mutations) in the cells can be found. An EGFR mutation determination is done in this way. Because it's a complicated laboratory, it often takes longer than a week before the doctor the results of this research. Yet the outcome of interest because an established EGFR mutation certain medications (EGFR-TKIs) an appropriate treatment option forms.

Photos and Scans

Photos and Scans

The pulmonologist may by means of X-rays and scans a lot of different kinds of information gathering:

On a chest x-ray, is a tumor in the lung can be seen.

By means of a CT scan of the chest and upper abdomen, the exact location of the tumor should be established. Also, any metastases to the liver and adrenal glands to see.

Sometimes there is a PET scan. This allows metastases in other parts of the body are better seen.

When bronchoscopy is a flexible telescope into the airways examined. The doctor may also remove small pieces of tissue for further examination. This fabric is used to check whether there is lung cancer. Addition can be viewed for any kind of cancer it is and what the characteristics of lung cancer are.

When a bronchoscopy is not possible, it may be obtained by other methods tissue. For example, with a lung puncture cells are to be removed that can be investigated.

Lung Cancer Diagnostic

 Studies - Lung Cancer Diagnostic

A pulmonologist will determine whether there is actually from lung cancer and whether it has spread.

The conversation with the patient is actually a first examination. Then we look at the physical condition of the patient, blood is taken and there are photos and scans to see where the tumor is.

Normally, cells will also always be removed in order to establish which type of lung cancer is concerned. Examining the removed cells is done by a pathologist. Also because certain properties of the lung cancer cell of interest for the determination of the treatment are also often present in patients with metastases examined for the presence of an abnormality in the EGF receptor, the so-called EGFR mutation assay.

What is an EGFR mutation?

What is an EGFR mutation?

An EGFR mutation is a mutation of the EGF-receptor. The EGF receptor is a recipient cell. This receiver is sensitive to stimulating growth factors. Growth factors are hormone-like substances that are normally in the blood and play an important role in the growth and development of cells. A lung cell receives the EGF receptor signal to multiply. This allows old, less well-functioning cells are replaced by new ones. This is a normal and beneficial process in the body.

Sometimes there is an error in the EGF-receptor of cells in the lung. This is caused by a change (mutation) in the genetic material (DNA) of these cells. Some mutations are activating mutations, by this change indicates the EGF-receptor, too much growth signals and these cells continue to proliferate. Because these cells but keep sharing and long live cancer arises. As long as this signal is passed on growth, the tumor continues to grow. In the animation "The genesis of lung cancer, this process is also explained.

For patients with an activating EGFR mutation has been established, there are specific treatments with known TKIs.

Responding to symptoms

Responding to symptoms

People with lung cancer often have very long inconspicuous symptoms. Moreover, the complaints often initially seen as appropriate to the age, such as cough, shortness of breath and weight loss. Thus there is often only (too) late to the doctor and is diagnosed with lung cancer (too) late set. However, there are symptoms that may indicate cancer. Do you have some of these symptoms, and you have many and / or long smoked, leave your lungs then checked by the doctor. This kind of complaints can of course also a very different cause. It is better to be safe than sorry. If the cancer is found to be over the sooner it is detected, the greater the chance that it can be treated well.

Possible complaints (not exhaustive):

1.      Changed cough pattern
2.      Persistent coughing
3.      Blood in the mucus coughed
4.      hoarseness
5.      Wheezing
6.      More mucus in the lungs
7.      Nagging pain in the chest
8.      Deteriorating condition
9.      Lack of appetite
10.      fatigue
11.      Recurrent respiratory infections
12.      Fever for no apparent reason
13.      increasing breathlessness
14.      emaciation

Stop Smoking

Stop Smoking

Lung cancer occurs in 90% of cases by smoking. If you have cancer or you have smoked, this is annoying to hear. You now have once smoked, and you can not undo. What else you can do is encourage people around you to stop smoking. You now know what the consequences are, and you are the right person to that of your partner, children, family, friends and colleagues across.

If you do not have cancer, you then consider this:

• One in four smokers dies prematurely (between the 35th and 69th year of life) on the effects of smoking. This is like a gun to your head, which one of the four chambers loaded.
• Every year, more than 9,000 new cases of lung cancer, and nearly 9,000 people die from lung cancer. In comparison, the number of fatalities per year over 1000.
• Substances in tobacco smoke affect a gene that protects the body against cancer. In this way, smoke causes cancer.
• Smoking is now even more dangerous than before. Light cigarettes do people smoke more and inhale deeply. The amount of inhaled carcinogens is therefore greater.

It is very difficult to quit smoking. Smoking is a real addiction, and it's understandable if you can not stop love. Despite all the tough stories, succeed only three of the 100 people without help to quit smoking.

Do you want to quit smoking, but it will not work, seek help. Nowadays, there is fortunately much more help available to quit smoking.

Is cancer hereditary?

Is cancer hereditary?

Is cancer hereditary? The simple answer to this question is no. You can see that lung cancer is more common in some families, but that does not mean that the parents of children has passed. It can be caused for example by preventing certain habits within the family, such as smoking.

This has been scientifically proven comparative case study of monozygotic twins and tweeëiige by the National Cancer Institute in Maryland (USA) showed that in the development of lung cancer hereditary factors play no role.

The main cause for the development of lung cancer is smoking, especially cigarette smoking. (NR info, 1/95 from: Berliner Morgenpost August 14, 1994)

What is non-small cell lung cancer?

What is non-small cell lung cancer?

The non-small cell type of lung cancer is characterized by relatively large cells. 

These cells also have a certain arrangement in the tissue. Based on a number of characteristics of the cell and the arrangement can be distinguished: squamous cell carcinoma (of overlying cells originating from the airways), adenocarcinoma (cell assuming the lung tissue) and grootcelligcarcinoom (also assuming the lung tissue but larger cells and without known structures ). 

The growth rate of these forms is different: the squamous cell grows the slowest and the fastest large cell tumor. In comparison with small cell lung cancer, sow these cell types relatively slowly from the body (through the lymph vessels to the lymph nodes and via the bloodstream to various organs). 

At what stage of tumor growth exactly this happens is not clear but it seems likely that this happens before the tumor symptoms. This is because the tumor has long been grown in the body before they can be discovered. In the period between the occurrence of the tumor and the time when the tumor is detected are sometimes many years. 

During that period, the tumor spread through the body.

Treatment for Mesothelioma

Treatment for Mesothelioma

For mesothelioma is no curative treatment. In establishing the diagnosis, the disease is already so extensive that cure is no longer possible.

In the past, surgical treatment has been tried. These were very large operations with a high risk of death after surgery. At present, surgery is not seen as a real possibility of treatment.

The mesothelioma is not sensitive to radiotherapy. Moreover, the area concerned (the half chest) very large. Sometimes, radiation therapy given to try to counter the pain and to prevent the tumor through the insertion openings, so that attempts have been made to arrive at a diagnosis, there is growing.

Chemotherapy was until recently little or not effective in the treatment of mesothelioma. Recently, new drug pemetrexed (Alimta ® tradename) available, certainly when given together with a platinum-containing drug has a clear effect on the tumor show. The studies showed that approximately 40% of the patients, a reduction of the tumor occurs, and that the survival of the treated group of patients, non-spring is longer than 2-4 months without this combination treatment. The agent is directly into the blood vessel by means of an infusion, which runs for 10 minutes. Treatment is repeated every three weeks. More detailed information on the mode of action and side effects of the drug pemetrexed can be found on the website under cytostatics: click here.

Other modes of treatment, such as administration of cell-killing drugs directly between the lung membranes (intrapleural) and more advanced treatments with tumor fabrics (such as interferon, etc.) and genetic therapy appear to currently more side effects than effect on mesothelioma and are therefore not recommended ..

Or in the future, a combination of a variety of treatments after the other, such as surgery followed by treatment with cell-killing drugs and external irradiation, that will feed in the treatment of patients with a particular stage (degree of expansion) of the disease is currently in research. This form of treatment requires a very accurate determination of the extent of the mesothelioma to know who this combination therapy is eligible ..

Studies in mesothelioma

Studies in mesothelioma

The doctor will first ask about the history and in particular whether there has in the past worked with asbestos. The occupations with the highest risk are workers in shipbuilding and in the heating industry. At the physical examination, a damping can be found on the lung as a result of the moisture. About this area of ​​attenuation is less breath sounds heard. Sometimes the tumor through the chest wall to grow out.

On chest radiography, moisture and thickening of the lung membranes seen. This is almost always unilateral. A CT scan of the chest gives better information on where the tumor is in the lung membranes. It is important pathological examination in order to determine whether this fluid or changes to the lung membranes actually based on a mesothelioma. Therefore, the moisture and a piece of the lung membranes investigated. This can be done by using a needle through the skin to suck up some moisture. Usually has fought a bloody respect. The piece is a blind pleural biopsy through the skin or done through keyhole surgery (thoracoscopy).

These studies done to diagnose mesothelioma ensure and to the extent of the tumor to determine because of possible treatment. After this, a tentative ruling on life expectancy. Because of the far reaching consequences of the mesothelioma diagnosis and the difficulties in the correct interpretation of the histological findings, a national body (the mesothelioma panel) that the obtained tissue also assesses and inconclusive about the likelihood of a mesothelioma. The definition of the extent of the tumor is done on the basis of the T (for tumor size and location), the N-(all of which are unaffected by or lymph nodes) and M (for spreading to other organs) status. On the basis of this, a classification into four stages.

Usual addition to the CT scan of the chest and upper abdomen an investigation into the condition of the skeleton to do through a skeletal scan (a study using a radioactive substance) or MRI scan of pelvis and spine and research or it has spread in the central nervous system by means of a CT scan of the brains. Through laboratory research any metastases detected and whether there are abnormalities in terms of the salt (sodium) content and lime (calcium) content. It is also important to measure the number of white blood cells (leukocytes) and platelets (thrombocytes) because of the possibility of treatment with cytostatics.

Which role plays the PET scan in the diagnosis of small cell lung cancer is currently unclear.

What are the symptoms

What are the symptoms

Between exposure to asbestos and the onset of mesothelioma is usually a period of about 20 years but can be over 40 years of sitting. 

This means that people with mesothelioma usually over 50 years. The first symptoms include chest pain or discomfort in the chest, shortness of breath and coughing. The shortness of breath is caused by the accumulation of fluid between the lung membranes. 

Pain is mostly in the foreground as the tumor invade the chest wall and the nerves that run it are affected. Due to this ingrowth creates as it were an armor around the lung, which is therefore not able to function properly. This creates more breathlessness. This also leads to deformity of the chest. 

There has been a proliferation in 40% place to the local lymph nodes. Metastasis to other organs through the bloodstream usually plays no significant role. In a later phase occurs at slimming.

What is mesothelioma and how does it work?

The Mesothelioma

A (malignant) mesothelioma, also known as pleural cancer or cancer of the pleura, is a specific tumor, caused by the inhalation of asbestos. Asbestos fibers are inhaled and lodge in the lung membranes. There they stimulate the lining cells and they bring such changes, these cells into malignant tumor cells change.

What is mesothelioma and how does it work?

A mesothelioma is a cancer of the serous membranes. Typically this involves the lungs and pleurae but occasionally the peritoneum (10%) or the pericardium (in less than 1% of cases). It is almost always caused by exposure to asbestos, and in particular to crocidolite. The asbestos fibers of this kind are long and very thin. Once inhaled, these fibers deep in the lung and are capable of coating the cells of the serous membranes (the mesothelial cells) so as to stimulate that genetic changes, and disturbances in cell division, which eventually degenerate into malignant cells. Under normal conditions, these cells die off. Due to the specific genetic changes and the resulting inflammatory response and stimulation of cell growth, these cells can however survive and become malignant. A virus may play a role in the development of mesothelioma. In the Netherlands, every year 400 new cases of mesothelioma. Only after 2018 will decrease the number of new cases. This decrease is due to the asbestos decision from 1991, making use of asbestos in the Netherlands is prohibited.

Based on histological characteristics distinguish four types of mesothelioma. The epithelial, sarcomatous it, it desmoplatische and mixed (epithelial and sarcomateus) type. The last type is the most common.

At present mesothelioma in the Netherlands seen as an occupational disease for which compensation can be received. The Asbestos Institute mediates herein.

The Treatment

The Treatment

The foregoing study is designed to determine whether there has been limited (limited disease) or extensive disease (extensive disease).

When there is a very small tumor without signs of metastasis following surgical treatment in which the tumor with surrounding tissue is removed, followed by chemotherapy. This happens to any very small metastases, which surveys are not available, to eradicate. Often the diagnosis of small cell lung cancer after the operation set.

Almost never is surgical removal of the tumor as possible, because too many metastases, and treatment with chemotherapy is the standard treatment. Typically this involves 5 ​​or 6 courses of a combination of different cell-killing drugs. If the disease is confined to the chest is often selected for a simultaneous treatment of chemotherapy with radiotherapy, sometimes first chemotherapy followed by radiotherapy (EBRT) in the tumor and lymph nodes in the chest and head. The latter is needed because drugs are not properly penetrate the brains and possibly present microscopic metastases do not be eradicated. (see also: Chemotherapy).

Information about Lung Cancer Treatment

Lung Cancer General

If you, or someone in your area, lung cancer, then a lot at you. Lung cancer is a serious disease, and the diagnosis often comes as a bolt from the blue. Usually there is little time to talk and make decisions, and should be quickly intervened.
 
How cancer arises

The main cause of lung cancer is cigarette smoking. The smoking of cigars and pipe increases the risk of getting lung cancer, just as the practice of certain professions. Due to the prolonged action of stimuli caused by harmful substances, creates changes in the genetic material of the cells in the lungs. Therefore, these cells eventually derail. The unrestricted cell growth at the expense of tissue in the surrounding area. Often it happens that these cells through the lymph nodes and the bloodstream to other parts of the body and there become metastases of lung cancer.

Types of lung cancer

Lung cancer is divided into small cell and non-small cell lung cancer. There is also the mesothelioma, which is cancer of the lung or pleura is.

The non-small cell type of lung cancer - the word says it all - is characterized by relatively large cells. The growth rate of these forms is different. Non-small cell lung cancer spreads out relatively slowly by the body. This tumor is usually long been grown in the body before it is detected. Between the origin of the tumor and the time it is discovered, are sometimes many years. During that period, the tumor has already spread throughout the body have.

Approximately 20% of cases of lung cancer are small cell. This form of cancer is characterized by tiny, fragile cells that divide very rapidly. This allows them rapidly through the body. Often it is, therefore, small cell lung cancer has already metastasized at the time of symptoms. The treatment of small cell lung cancer other than non-small cell lung cancer. In most cases there will not be surgically intervened, but is treated by chemotherapy and radiotherapy (radiation).

Mesothelioma, also called pleural cancer or cancer of the pleura, is a specific cancer, caused by the inhalation of asbestos. Asbestos fibers are inhaled and lodge in the lung membranes. Since they stimulate the lining cells and cause such a change, in that these cells are malignant tumor cells to change.

Symptoms of lung cancer

In lung cancer, you often see long time no symptoms. The symptoms of lung cancer as you will find below, are also quite common, and can be a lot of other causes. If you have any of these symptoms, you can do better just checked. Please make an appointment with your GP. Whatever it is, your doctor can help.

1.      A persistent irritating cough that persists longer than three weeks
2.      Sometimes a little blood in the mucus coughed
3.      Inflammation of the airways but no go, even with antibiotics
4.      More mucus
5.      Dyspnea
6.      Hoarseness without sore throat
7.      Chest pain
8.      Swelling of the face or neck

This is often accompanied by a worse condition. This allows you to notice:

•      Fatigue
•      Weight loss for no apparent reason
•       poor appetite

Prevention of lung cancer

Smoking in 90% of cases the cause of lung cancer. The more and the longer someone has smoked, the greater the risk of lung cancer. Quit smoking so! Every cigarette you smoke increases your risk of lung cancer, so every cigarette you smoke less, lowers your risk of lung cancer.

People often stay in smoky rooms, have a slightly higher chance of getting lung cancer. Other people at risk are people who come into contact with substances such as asbestos, coal tar or arsenic.
Related to Lung Cancer:

• Lungcancer.org is a program of CancerCare, which provides free, professional support services--including counseling, support groups, educational publications and ...(www.lungcancer.org)
• Lung cancer — Comprehensive overview covers symptoms, causes, treatment of non-small and small cell types.(www.mayoclinic.com)
• Lung cancer is the second-most commonly diagnosed cancer in both men and women. However it is still the most common cause of cancer death.(www.lung.org)

What tests happen to suspect the existence of lung cancer?

What tests happen to suspect the existence of lung cancer?

The studies that are done, his aim to establish whether there is real of lung cancer, the type of lung cancer, to determine whether there is metastasis of the tumor and whether or not the person has other restrictions, making certain treatments are not possible.

When these complaints on lung pointing to the doctor, it will have a number of questions to determine the cause of the symptoms to come. Also, the doctor will want to know how the overall health of the patient. In particular, the prevention of heart disease and any existing lung problems should be mapped. The doctor will examine the patient and hereby specifically check whether enlarged lymph nodes and an enlarged liver can be found. Blood tests are not directly help to establish a tumor but can say or in certain organs such as liver metastases and the skeleton.

Important studies are: a lung picture, which shows a possible tumor, a CT scan of the chest and upper abdomen, in which the exact location of the tumor can be determined and the relationship of the tumor to the surrounding tissues. Also possibly enlarged lymph nodes and any metastases to the liver and adrenal glands are seeing this. A bronchoscopy (the airway in the look with a flexible viewer) is also part of the investigation, whereby it is possible to obtain tissue for examination. Depending on the symptoms and the results of previous studies (physical examination and blood tests) may be done to further investigate the extent of the tumor and any metastases to detect.


Usual addition to the CT scan of the chest and upper abdomen an investigation into the condition of the skeleton to do through a skeletal scan (a study using a radioactive substance) or MRI scan of pelvis and spine and research or it has spread in the central nervous system by means of a CT scan of the brains. Through laboratory research any metastases detected and whether there are abnormalities in terms of the salt (sodium) content and lime (calcium) content. It is also important to measure the number of white blood cells (leukocytes) and platelets (thrombocytes) because of the possibility of treatment with cytostatics.

Which role plays the PET scan in the diagnosis of small cell lung cancer is currently unclear.

Small cell Lung Cancer

Small cell lung cancer

Lung cancer is divided into the small cell and non-small cell shape. This classification is based on the characteristics of the cells but also says something about the growth of the tumor and the speed with which this tumor spreads through the body. These characteristics have obvious consequences for the chosen treatment.

What is small cell lung cancer?

Small cell lung cancer or non-small cell are. Approximately 15% of cases of lung cancer are small cell. This type of cancer is characterized by tiny, fragile cells that divide very rapidly. This allows them rapidly through the body. Often it is, therefore, small cell lung cancer has already metastasized at the time of symptoms. The treatment of small cell lung cancer is different than in non small cell lung cancer. In most cases there will not be surgically intervene, but is treated by means of radiation therapy (radiation therapy), and chemotherapy.

The Symptoms

The signs or symptoms of lung cancer are not only caused by the tumor itself, including the possible spread through the body and their influence on the functioning of other organs, can cause complaints.

Complaints as a direct result of the tumor arise include: coughing, vomiting blood in the phlegm, shortness of breath and sometimes wheezing and recurrent respiratory infections.
 

Also as a result of the metastases, various signs or symptoms occur. By enlarged lymph nodes can be a flattening of the hollow upper body vein occur (superior vena cava syndrome) is characterized by swollen veins in the neck, face and arms up and complaints of headache and pain and congestion in the head when bending over. Hoarseness can be a result of the destruction of the nerve that goes to the vocal cord by pressure of enlarged lymph nodes or by the tumor itself. Pain in the chest can occur by invasion of the chest wall. Difficulty swallowing can be caused by enlarged lymph nodes near the esophagus pressures.

Because this tumor rapidly spreads throughout the body, symptoms may also occur elsewhere in the body. Both bone pains in the back and in the arms or legs rest on metastases in the bone. Headache may be due to metastases in the brains. Metastasis in the liver can cause pain but also responsible for jaundice. Idem: even in non-small cell

The tumor cells can also secrete a type substances, or endocrine glands (glands that produce substances or certain issue) influence. This could be a low sodium level in the blood formation and calcium levels in the blood can be increased. There may also be symptoms that fit feminization of men such as breast development and loss of male pattern hair

What treatments?

What treatments?

How the non-small cell lung cancer is treated will depend on the type (squamous, adenorcarcinoom or large cell), and whether there is an EGFR mutation. The treatment options are: operation (surgery), wherein the tumor to the surrounding lung tissue is removed,irradiation (radiotherapy), in which the tumor and the adjacent lymph nodes are irradiated either in order to try to cure to achieve or to to reduce the complaints, treatment with cell-killing drugs (chemotherapy), when the disease has already spread, and combinations of treatment modalities such as chemotherapy followed by surgery, chemotherapy simultaneously with or followed by radiotherapy or surgery followed by radiotherapy. They can also opt for a targeted therapy when there is an EGFR mutation.


Which treatment is appropriate depends on the outcome of the investigations. Is there a local disease and lung and heart-reserves are sufficient, then surgery may be suggested. There are metastases of the tumor then opted for a different treatment. There is only of metastases in the regional lymph nodes than as treatment (partly this is still experimental) chemotherapy followed by surgery or radiotherapy proposed. There are distant metastases, chemotherapy is then proposed. If an EGFR mutation can be determined will be elected for a targeted therapy with a TKI.

Survival

When estimating survival is always based on averages. That says so much about how it will fare. If you like survival rates of NSCLC want to see, click here.

Non-small cell lung cancer

When estimating the survival, use is made of a median survival. This means that at that time, 50% of patients with cancer who are deceased or survival. Also, using the 5-year survival: ie what percentage of people with this cancer survive five years after diagnosis.

Lung cancer is not treated then the median survival of 6 months. After surgical treatment, the five-year survival was about 40%. This also depends on the extent of the tumor. (see also: Surgery) The five-year survival after radiotherapy is also 5-10% depending on the size of the tumor and any metastases. (see also: Radiotherapy) for chemotherapy is a five year survival less than 1%. (see also: Chemotherapy).

Small cell lung cancer

The survival rates are determined by the extent of the disease, the general state of the patient, a number of blood provisions (lactic acid dehydrogenase (LDH), alkaline phosphatase, protein content and salt (sodium) content), and the response to the treatment.

The survival at 3 years is limited disease (limited disease) treated with chemotherapy and radiotherapy above 20%. Treated with chemotherapy alone is the 3 year survival rate is only 9%.

Survival in extensive disease (extensive disease) is bleaker: a 5-year survival of 1.6%. The average survival is approximately 8-9 months.

Mesothelioma

The median survival (ie 50% of the patients still alive) depends on the stage between 11 and 22 months.

What causes lung cancer?

Non-small cell lung cancer

Lung cancer is divided into the small cell and non-small cell shape. This classification is based on the characteristics of the cells but also says something about the growth of the tumor and the speed with which this tumor spreads through the body. These characteristics have obvious consequences for the chosen treatment.

What causes lung cancer?

The main cause of lung cancer is cigarette smoking. The smoking of cigars and pipe increases the risk of getting lung cancer as some occupations. Due to the increased impact of harmful substances caused by stimuli, changes occur in the genetic material of the cell, which eventually goes off the rails, also the mechanism for a deranged cell to clean is inhibited by the toxic substances in the smoke causing a resultant cancer cell can grow unhindered, instead of to be cleaned up.: the cell does not care of the normal connections to more and grows at the expense of co-pass unobstructed through tissue in the surrounding area. Moreover, these cells tend elsewhere in the body to settle and grow into metastases (= metastasis) of the tumor.

What are the symptoms of lung cancer?

The symptoms of lung cancer can be highly variable and are also dependent on the location and the size of the tumor and of any metastases. In the beginning, when the tumor is still relatively small, there need be no symptoms and the tumor is often found by chance. Afterwards there appear still sometimes more vague general symptoms, such as not feeling fully fit, loss of appetite and sometimes also slimming. Symptoms that are more in the direction of lung cancer modes are: occurrence of coughing, changed cough pattern, so differently coughing than usual as the smokers cough, coughing up blood, increased shortness of breath, frequent respiratory infections, chest pain, and pain elsewhere in the body depending on the possible metastasis.

What tests happen to suspect the existence of lung cancer?

The studies that are done, his aim to establish whether there is real of lung cancer, the type of lung cancer, to determine whether there is metastasis of the tumor and whether or not the person has other restrictions, making certain treatments are not possible.

When these complaints on lung pointing to the doctor, it will have a number of questions to determine the cause of the symptoms to come. Also, the doctor will want to know how the overall health of the patient. In particular, the prevention of heart disease and any existing lung problems should be mapped. The doctor will examine the patient and hereby specifically check whether enlarged lymph nodes and an enlarged liver can be found. Blood tests are not directly help to establish a tumor but can say or in certain organs such as liver metastases and the skeleton.

Important studies are: a lung picture, which shows a possible tumor, a CT scan of the chest and upper abdomen, in which the exact location of the tumor can be determined and the relationship of the tumor to the surrounding tissues. Also possibly enlarged lymph nodes and any metastases to the liver and adrenal glands are seeing this. A bronchoscopy (the airway in the look with a flexible viewer) is also part of the investigation, whereby it is possible to obtain tissue for examination. Depending on the symptoms and the results of previous studies (physical examination and blood tests) are complementary investigations.

The main additional research is a PET scan which one can get a better understanding or elsewhere in the body (the lymph nodes and other organs) are metastases. There is also a large tumor examined whether metastases in the brains with a CT scan or neurological examination (this is the PET scan is not suitable). On the basis of these results is in active nodes on the PET scan in the chest a mediastinoscopy performed (keyhole surgery behind the breastbone to pieces of the lymph nodes to remove) to be sure whether or not metastases in these glands. Furthermore, the doctor heart and lung function checked by a breath test and a heart film screening of heart disease. The condition of these bodies is important to assess what treatments are possible.