NCCN Guidelines for Patients® | Non-Small Cell Lung Cancer - page 28

28
NCCN Guidelines for Patients
®
: Non-Small Cell Lung Cancer
Version 1.2014
Part 4: Lung cancer staging
4.1 Clinical staging tests
Staging tests
Pathologic review
Medical history and physical exam
CT scans of chest and belly area
CBC (
c
omplete
b
lood
c
ount)
Blood chemistry test
Pathologic review
A pathologist is a doctor who’s an expert in testing cells
to find disease. If the pathologist finds cancer cells, more
tests are done on the biopsy samples or surgical tissue.
All of the test results are recorded in a pathology report.
It’s a good idea to get a copy of your pathology report
since it’s used to plan treatment.
The parts of the cells will be studied to classify the
disease. This is called histologic typing. The pathology
report will state if the cancer started in the lung or
elsewhere. If the cancer started in the lung, the report
will also list the type of lung cancer. Histologic subtypes
of non-small cell lung cancer include squamous cell
carcinoma, adenocarcinoma, large-cell lung carcinoma,
and other rare types. Squamous cells are thin and flat
and line the airways of the lung. Adenocarcinoma is a
cancer of epithelial cells that make fluids to keep the
lungs moist. Large-cell lung carcinomas lack features to
classify them as any other carcinoma.
Medical history and physical exam
Your medical history includes any health events in your
life and any medications you’ve taken. Your doctor will
ask about symptoms that may be related to lung cancer.
Such symptoms include cough, trouble breathing, chest
pain, and weight loss. Knowing which symptoms you
have can help your doctors stage the cancer. Since some
health problems run in families, your doctor may also ask
about the medical history of your blood relatives.
Doctors often give a physical exam along with taking a
medical history. A physical exam is a review of your body
for signs of disease. During this exam, your doctor will
listen to your lungs, heart, and gut. Parts of your body will
likely be felt to see if organs are of normal size, are soft
or hard, or cause pain when touched. Your lymph nodes
may feel large if the cancer has spread to them.
CT scans
In addition to a CT of the chest, a CT scan of your
upper abdomen is needed. The CT scan of your upper
abdomen may show if the cancer has spread to the
adrenal glands, liver, or other sites. Lung cancer often
spreads to the adrenal glands, liver, or both if not treated.
These scans should use standard doses of radiation
instead of low doses used for screening. CT scans used
for screening are described in Part 2.3.
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