NCCN Guidelines for Patients® | Lung Cancer - Non-Small Cell Lung Cancer
32 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 Airway tests To assess your airways, your doctor will perform a bronchoscopy. It is very important for diagnosis and cancer staging. A tool, called a bronchoscope, will be used to see inside your lungs. It is also used to collect samples from lung tumors and lymph nodes. Common types of bronchoscopy are described below. Bronchoscopy is advised for clinical stages I, II, IIIA, and IIIB before treatment is started. A bronchoscopy is sometimes done for stage IIIC or IV disease. If your doctors strongly think a nodule is cancer, you might not need a bronchoscopy until the day of your surgery. It should be done right before the surgery as one procedure. Doing so reduces health risks and saves time and money. Standard bronchoscopy To perform this test, part of the bronchoscope will be inserted into your body. This part looks like a thin, long tube about as thick as a pencil. See Figure 9 . It has a light, camera, and open channel. The light and camera allow your doctor to guide the tube down your nose or mouth and into your lungs. A small brush, needle, or tongs can be inserted into the open channel to collect samples. Also, liquid may be sprayed into the airway and then sucked back up. There are two types of standard bronchoscopes. A rigid bronchoscope is straight and doesn’t bend. A flexible bronchoscope is thinner and longer and can bend. It can reach the smaller airways of the lung. General anesthesia is needed for a rigid bronchoscopy. Local anesthesia is used for a flexible bronchoscopy. After the biopsy, you may feel some swelling and sound hoarse. Radial EBUS bronchoscopy Radial EBUS ( e ndo b ronchial u ltra s ound) bronchoscopy uses a flexible bronchoscope that is fitted with an ultrasound device. Ultrasound uses high-frequency sound waves to make pictures of the insides of the body. Your doctor will move the device back and forth to see a 360-degree view of the area on a screen. The ultrasound device will then be removed so that the sampling tool can be inserted. Navigational bronchoscopy The airways of the lungs get smaller as they extend toward the sides of the body. Flexible bronchoscopes are often too large to travel through these small airways. A navigational bronchoscopy uses a flexible 4 Treatment planning Airway tests Figure 9 Bronchoscope A bronchoscope is a tool doctors use to see inside your lungs. Part of it looks like a thin tube. This part will be inserted down your nose or mouth into your airways.