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Lung Cancer Diagnosis & Treatment

At Virginia Mason Franciscan Health, you’ll have access to a nationally recognized and comprehensive lung cancer program that includes screening and prevention as well as lung cancer experts who specialize in diagnosis, treatment and follow-up care.

Lung cancer screening and diagnosis

Lung cancer screening

We offer a low-dose CT screening for lung cancer for people at higher risk of lung cancer. A referral from a provider is needed for the screening. If you think you may be at risk, take a lung cancer risk assessment, and ask your primary care provider for a referral. A national lung screening trial showed a 20 percent reduction in lung cancer deaths among those who received these screenings yearly for three years.

Lung nodule clinics

More people are being diagnosed with lung nodules, which are round or oval growths in the lungs. About 95 percent of lung nodules are noncancerous. When an abnormality is found, it may be discussed at a multidisciplinary tumor board. Pulmonologists, radiation oncologists, medical oncologists and thoracic surgeons determine the best plan of care. Depending on your individual situation, next steps could include observation, biopsy or surgery.

At Virginia Mason Franciscan Health, we’ve made it a priority that people at risk for developing lung nodules receive early diagnosis and treatment. To facilitate this, our team has developed an innovative approach: Lung nodule clinics, which allow for early detection and treatment of cancerous lung nodules; this is critical, because treatment is more successful when lung cancer is discovered in its early stages.

Lung cancer diagnosis

Virginia Mason Franciscan Health is a pioneer in the use of bronchoscopy in which doctors use ultrasound or an inserted bronchoscope to assess a patient's airways. The latter is called navigational bronchoscopy and because of our expertise, we have the busiest navigational center in the state.

Other tests that may be needed to make an accurate diagnosis include:

  • A simple chest X-ray may show a tumor in the lungs. If the tumor is small, however, it may not be seen. If a tumor is found or if lung cancer is suspected, a bronchoscopy and CT scan often will be scheduled.

  • A CT scan may be performed to determine the location of the tumor and whether cancer has spread to the lymph nodes. A CT scan uses X-rays and computer imaging to show 3D pictures of your organs.

  • A PET scan shows how organs and tissues metabolize sugar. Malignant tumors use sugar at a higher rate than benign tumors. For this procedure, you will be given an IV injection of a radioactive substance, called a radioisotope or tracer, which has been attached to a simple sugar. The procedure is performed in a nuclear imaging department.

  • This imaging device provides pictures of your skeleton to determine if lung cancer has spread to your bones. For this procedure, you’ll be given an IV injection of a radioactive substance called a radionuclide or radioisotope, also called a tracer. A special camera then records areas in the body with greater concentration of the radioactive material, such as tumors. The procedure will be done if you have pain in your bones or an abnormal blood test.

  • A bronchoscope is a lighted tube that is guided down your throat and into the bronchial tubes in your lungs. It allows your doctor to view these large airways and to take samples of tissue or secretions. This procedure is performed in the clinic under a local anesthetic (to numb your throat) and conscious sedation (medicines to make you sleepy), or in the operating room under a general anesthetic (to induce sleep). Your doctor may obtain samples of suspicious cells during this procedure.

  • During this procedure, your doctor will guide an endoscope through a small incision at the base of your neck and into the mediastinum, the area between your lungs in your chest cavity and behind the breastbone. He or she will then obtain a tissue sample of your lymph nodes. This procedure is performed under a general anesthetic in the operating room.

  • This procedure is performed to obtain a sample of pleural fluid from the pleural space, which is the space between the lungs and the chest wall. After first numbing the area with a local anesthetic, a needle is inserted through the skin, between the ribs and into the fluid that has collected outside of the lung. The fluid is then removed and tested for the presence of cancerous cells.

  • This procedure is performed after a tumor or nodule has been located. A biopsy may be obtained at the time of surgery, bronchoscopy or during a CT scan. Your doctor may use a needle or video-assisted instruments to obtain samples of the tumor.

Lung cancer treatment

Lung cancer is treated with surgery, chemotherapy, radiation therapy  or a combination of these therapies. Additionally, you may be eligible for a clinical trial that offers new approaches to treatment. Virginia Mason Franciscan Health takes part in many clinical trials, offering access to new treatments not available elsewhere.

Small cell lung cancer

In most cases, small cell lung cancer spreads to lymph nodes and other organs before symptoms develop. For this reason, surgery is rarely the best therapy. Usual treatment for this type of cancer, when it’s confined to the chest, is chemotherapy combined with radiation therapy. If the cancer has spread outside the chest, chemotherapy alone is generally the preferred treatment. This cancer responds well to these therapies. Most people see long-term responses to treatment, and some may be cured.

Malignant mesothelioma

If the tumor is located in one spot in the pleura (the lining of the lung), your doctor may remove it surgically. Our surgeons use the latest technology using small incisions and video- or robotic-assisted surgery to remove cancer. This approach results in faster recovery and return to normal life. If the cancer has spread within the pleura and is making pleural fluid, your doctor will help you consider controlling the symptoms with a procedure called pleural sclerosis. There may also be benefits from using chemotherapy drugs or radiation treatment.

Secondary lung cancer

Cancers from other parts of the body, such as the breast, can also spread to the lungs. When this occurs, the cancer that is in the lungs is not referred to as lung cancer. It’s called metastatic breast cancer to the lungs because the tumor contains breast cancer cells. These tumors are sometimes treated with radiation or surgery.

Cancer that reappears or spreads

In some people treated for lung cancer, the disease reappears in the lungs or elsewhere in the body. Small numbers of cells that survived the original treatment can multiply and cause cancer to recur. Your doctor will discuss treatment options with you that may be more effective for the recurrent cancer.

If initial exams and tests suggest a recurrence, a CT scan, MRI, bone scans and a biopsy may be performed. Depending on the location of a recurrent cancer, treatment may involve surgery, radiation therapy or chemotherapy, or treatment within an investigational clinical study.

Lung cancer second opinions

If you’ve been diagnosed with lung cancer, learn more about second opinions and how they may help you find all your available treatment options

Lung cancer research and clinical trials

Virginia Mason Franciscan Health is a leader in cancer research. Learn more about research and clinical trial options.

Lung cancer wellness and support

Cancer treatment includes more than just treating physical symptoms. Learn more about our comprehensive wellness and support services.

Lung cancer specialists

To learn more about lung cancer care or to make an appointment, find a specialist near you.