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Investigations: staging and operability of lung cancer

All tumours have to be staged before a final treatment plan can be agreed. This means measuring the tumour, defining its exact position and relation to other thoracic structures or organs and to find out if the tumour has spread into the regional lymph nodes or into other organs such as the lung, liver or brain .

Following your initial staging, you may be referred directly for an operation (lung resection) or for chemotherapy or/and radiotherapy.

Alternatively, your consultant may estimate that there is not enough information on your tumour and may want to obtain more tissue or a more accurate diagnosis in order to establish a therapeutic plan.

PET Scan In most instances, if the diagnosis of malignant tumour is proven, your consultant will refer you for a PET-CT (Positron Emission Tomography) before the operation. PET-CT is now widely used to rule out distant metastasis (cancer spread) and occult malignant disease (microscopic cancer) in the chest before you have an operation.

Alternatively, you may need to have a minimally invasive procedure done under IV sedation or general anaesthesia to stage your tumour before you have a curative procedure:

Videothoracoscopy (VATS) or Mediastinoscopy are the most commonly used diagnostic procedures to obtain tissue from your tumour or lymph nodes if all other techniques have failed to give a precise diagnosis. Most of these diagnostic procedures can be performed as day-case procedures, or may involve an overnight stay in hospital.

This procedure is performed under general anaesthetics, on this occasion, we will assess your lung function, your cardiac function, fitness for surgery and perform some routine blood tests.