Lung Cancer Diagnosis

Proper staging of your disease at the right time helps significantly with treatment as it indicates how much the disease has spread throughout the lung tissue, and whether it has impacted your lymph nodes and other organs. We pioneer advanced technologies and help develop the latest diagnostic protocols to diagnose your lung cancer completely, identifying your lung cancer’s type and sub-type. Then we go beyond that to analyze your cancer on a molecular level, determining exactly what is driving it so we can figure out how best to stop it. This is important because your cancer is as unique as you are. Winship’s nationally recognized lung cancer team is the largest and most experienced in Georgia, routinely treating all types of lung cancer.

There are two main types of lung cancer: small cell and non-small cell. Treatment differs depending on cancer type.

• Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and accounts for about 85% of lung cancer cases. There are three main subtypes of NSCLC — adenocarcinoma, squamous cell carcinoma and large cell (undifferentiated) carcinoma — which are categorized based on their similar treatment options and outcomes.
• Small cell lung cancer (SCLC) is less common, accounting for 10% to 15% of cases. This type generally grows more quickly and is more likely to spread to other parts of the body. It’s also more likely to return after remission than non-small cell lung cancer. SCLC has a different prognosis and is treated differently than NSCLC.

Other types of lung cancer are rare and account for only a small percentage of cases. These include lung carcinoid tumors and mesothelioma, a rare type of cancer most commonly linked to asbestos exposure.

If you have symptoms of lung cancer or receive abnormal results from a low-dose computed tomography (CT) screening, your team will order diagnostic testing to determine whether you have lung cancer and, if so, identify what type and stage. At Winship, we take a multi-stage approach to ensure a thorough and accurate lung cancer diagnosis. Because no two lung cancers are the same — even those in the same stage and location — your cancer will differ from every other person’s. And it’s imperative we understand your cancer to treat it properly. We know you’re anxious to move forward with treatment, but getting a full and precise lung cancer diagnosis is critical, and it won’t take long, we promise.

Diagnostic imaging. At Winship, we use low-dose CT to create 3-D images of the lungs to diagnose lung cancer, and positron emission tomography (PET) to determine whether and how far a cancer has spread.

Bronchoscopy. During this procedure, your physician can take a closer look at your tumor by inserting a scope into the large airways of the lungs. Tissue can also be obtained during bronchoscopy for lab testing.

Emory Healthcare is the first in Georgia to use a robotic-assisted endoluminal platform, known as ION, for minimally invasive peripheral lung biopsy. The mobile 3-D imaging system with a robotic-assisted bronchoscopy enables our care teams to diagnose lung cancers earlier and less invasively.

Interventional pulmonology. Winship interventional pulmonologists can obtain tissue from the lungs to test for cancer without surgery. With the help of a scope and ultrasound guidance, these physicians perform minimally invasive biopsies using only a needle.

Thoracic surgery. In some cases, surgery is needed to obtain lung tissue for sampling. When necessary, our team of dedicated lung surgeons is skilled in complex thoracic surgery that may be necessary to access tumors in difficult-to-reach places.

Molecular pathology. If your tumor is determined to be cancerous, our molecular pathologists will conduct genomic profiling to look at the DNA inside your tumor to identify any genetic mutations and biomarkers, or cell characteristics. Winship genomic- and tumor-sequencing experts will analyze what’s driving your particular lung cancer and then work with your oncologists to determine which types of treatment are most likely to work best against your specific cancer.