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Cancer Diagnosis & Staging

In conjunction with the Comprehensive Thoracic Oncology Program (CTOP) at Norris Cotton Cancer Center, D-H Thoracic Surgeons deliver multidisciplinary cancer care using the most advanced technologies and evidence-based options for diagnosis, staging and treating thoracic cancers.

Advanced Imaging to Determine the Best Treatment

Detailed diagnosis and staging is the first step in determining the best treatment plan for lung, esophageal or other thoracic malignancies. Advanced radiographic staging, through computed tomography (CT) or positron emission tomography (PET) scan and magnetic resonance imaging (MRI) scan of the brain, provides detailed information on the size and location of tumors and whether cancer has spread to surrounding lymph nodes or other organs.

Detailed radiographic imaging helps to determine the best approach and sites for biopsy, and also is used to guide minimally invasive biopsy procedures.

Surgical Biopsy for Comprehensive Diagnosis and Staging

In a biopsy, a small sample of the abnormal tissue or fluid is taken for testing in the laboratory to determine the type of cancer cells present. Additional molecular studies may also be conducted to determine the genetic make up of the cancer cells and whether there are effective targeted therapies available.

Biopsies in the thoracic cavity may be done using:

  • Fine-needle aspiration (FNA), in which a very thin needle is inserted in the chest to remove a small sample of the abnormal tissue or fluid.
  • A minimally invasive approach called a thoracoscopy, which inserts a camera and surgical tools through a small incision to look at and remove samples from the lungs for biopsy.
  • Esophagoscopy, which uses an endoscope inserted through the mouth or nose and into the esophagus for viewing and biopsy.
  • Imaging modalities such as ultrasound combined with minimally invasive approaches such as bronchoscopy (called endobronchial ultrasound or EBUS) in the airway, CT-guided transthoracic needle biopsy (TNB) of the lungs, pleura and mediastinum, or endoscopic ultrasound (EUS) combining endoscopy and ultrasound in the esophagus.
  • Navigational bronchoscopy, which acts like a GPS in the lungs to help your physician guide the bronchoscope and biopsy tools through small airway passages to locate and obtain a sample of the tumor for diagnosis.

Page reviewed on: Jun 26, 2015

Page reviewed by: Dr. David J. Finley

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