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

30 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 Blood tests Blood tests are needed to plan treatment for all stages of lung cancer. They are used to look for signs of disease. For a blood test, a needle will be inserted into your vein to remove a sample of blood. The needle may bruise your skin and you may feel dizzy from the blood draw. Your blood sample will then be sent to a lab where a pathologist will test it. Complete blood count A CBC ( c omplete b lood c ount) measures the number of blood cells in a blood sample. It includes numbers of white blood cells, red blood cells, and platelets. Cancer and other health problems can cause low or high counts. Chemistry profile Another blood test is a chemistry profile. Chemicals in your blood come from your liver, bone, and other organs. A blood chemistry test assesses if the chemicals in your blood are too low or high. Abnormal levels can be caused by spread of cancer or by other health problems. Imaging tests Imaging tests make pictures (images) of the insides of your body. They can show which sites have cancer. This information helps your doctors stage the cancer and plan treatment. Your treatment team will tell you how to prepare for these tests. You may need to stop taking some medicines and stop eating and drinking for a few hours before the scan. Tell your doctors if you get nervous when in small spaces. You may be given a sedative to help you relax. Diagnostic CT Diagnostic CT of your chest and belly area (upper abdomen) is needed for clinical staging. Higher doses of radiation are used than for low-dose CT. As a result, the images show more details. Imaging of your chest and upper abdomen may show if the cancer has spread to your lymph nodes, adrenal glands, liver, or other sites. CT should be one of the first tests done in the treatment planning process. Your doctors will be better able to plan which sites to biopsy and which treatment is best. The CT scan used to assess if you can have surgery should not be older than 60 days. FDG PET/CT PET/CT is a common test used for planning treatment. Usually, the area between the base of the skull and the knees is scanned. Sometimes, the whole body is scanned. FDG ( f luoro d eoxy g lucose) is a radiotracer used for lung cancer. It is made of fluoride and a simple form of sugar called glucose. You must fast for 4 hours or more before the scan. If you haven’t had PET/CT, it is advised for clinical stages I, II, III, and sometimes IV. PET/CT may detect cancer in the lymph nodes or other sites that wasn’t found by CT. Thus, PET/CT results may change the clinical stage of the cancer and your treatment options. The PET/CT scan should not be older than 60 days when used to assess if you can have surgery. Cancer detected by PET/CT often needs to be confirmed. A biopsy and, in some cases, another imaging test can be done. For example, brain MRI ( m agnetic r esonance i maging) may be needed. A biopsy of the most distant site may help with diagnosis and staging. 4 Treatment planning Blood tests | Imaging tests