Lung cancer

Cancer types

What symptoms might need an urgent referral?

  • Prolonged cough
  • Coughing up blood
  • Weight loss
  • Increased shortness of breath
  • Change in voice or swallow
  • Persistent tiredness and/or unexplained weight loss

Lung Diagnostic Tests

These are the types of diagnostics tests that might be carried out:


A bronchoscope is a thin flexible tube, like a very fine telescope, with a light on the end. It is passed through the nose or mouth, down the trachea and into the bronchi. The doctor may be able to see the tumour and take a biopsy (a sample of tissue for examination under the microscope).

The procedure takes about 30 minutes. The patient will usually be admitted to hospital as a day case, and given a drug to make them relaxed and sleepy beforehand. A local anaesthetic will be sprayed onto the back of the throat. It is normal not to eat or drink for a few hours afterwards until the local anaesthetic wears off. This is to prevent any food or liquid going down the wrong way.

For further information about the Endoscopy Department, including patient information leaflets, visit our Endoscopy pages.

Chest X-ray

A chest X-ray is a scan which examines the lungs and heart. If a tumour is present, the size and position of it may be seen. Not all lung cancers show up on an X-ray and the doctor may ask that you have a CT scan.

Computerised Tomography (CT) Scan

A Computerised Tomography (CT) scan takes a series of pictures of any part of your body using X-rays to produce images that show cross-sections or slices of your body. A Radiographer (a University-trained health professional who works in Radiology to produce diagnostic images using a variety of different modalities) will perform your scan and may be assisted by an RDA (Radiology Department assistant). The data produced from the scanner is processed by a powerful computer to create the images and can be viewed on a screen to show very detailed images of the inside of your body.

Depending on your symptoms, you may have a CT scan prior to having an Outpatient appointment. This pathway is known as ‘straight to test’.

For further information about the Radiology Department, including patient information leaflets, visit our Radiology pages.

Computerised Tomography (CT) Guided Biopsy

Other tests you have had, such as a previous CT scan, have shown an area of abnormal tissue inside your body. A biopsy involves collecting a small sample of this tissue.

You will be given a local anaesthetic to make the area of the biopsy go numb. A small incision (cut) will be made into your skin and a tissue sample taken. This will be sent to the laboratory to be examined under a microscope by a pathologist.

The CT scanner is used to take images of the needle as the biopsy is collected to make sure the correct sample of tissue is taken.

Endobronchial Ultrasound (EBUS)

Endobronchial Ultrasound (EBUS) is a special type of bronchoscopy that allows the doctor to examine and take samples from tissue that lie just outside of the airways. Samples from some lymph glands in the chest can be taken during this procedure. The procedure is very similar to a bronchoscopy and is usually performed as a day case.


A Mediastinoscopy is carried out under a general anaesthetic by a surgeon. A small cut is made near the collar bone. The doctor can examine lymph glands in the chest through this incision and take samples of tissue (biopsies) at the same time.

This will usually involve an overnight stay in hospital. This test is not carried out at The ESHT and requires referral to a surgeon at another hospital such as Guy’s Hospital in London.

Positron Emission Tomography (PET) Scan

Positron Emission Tomography (PET) scans produce detailed three-dimensional images of the inside of the body. The images can clearly show the part of the body being investigated, including any abnormal areas, and can highlight how well certain functions of the body are working.

PET scanners work by detecting the radiation given off by a substance injected into your arm called a radiotracer as it collects in different parts of your body. In most PET scans a radiotracer called fluorodeoxyglucose (FDG) is used, which is similar to naturally occurring glucose (a type of sugar) so your body treats it in a similar way. By analysing the areas where the radiotracer does and does not build up, it’s possible to work out how certain body functions are working.

PET scans are performed on behalf of ESHT by Brighton and Sussex University Hospitals Trust and by Alliance Medical in Maidstone.

Sputum Cytology

Patients are sometimes asked to cough up a mixture of saliva and mucus (sputum) from the lungs, into a pot. This will be examined under the microscope for cancer cells.


A Thoracoscopy involves making a small cut in the skin for the surgeon to insert a tube, similar to a bronchoscope, into the chest to take tissue samples from it. This procedure is also carried out under a general anaesthetic and will require a short stay in hospital.

This test is not carried out at ESHT and requires referral to a surgeon at another hospital such as Guy’s Hospital in London.