Bronchoscopy:

This test uses a "scope" (a flexible tube with the capacity to reflect and transfer images) which is passed directly down the trachea (windpipe) and into the various pathways of the bronchus (airway tubes leading into the lungs). The images seen by the bronchoscope are transferred to a screen, from which doctors can examine any areas of tumour growth, bleeding, dryness or excess fluid production. A biopsy may be taken using a very small, fine, scissor-like attachment found on the bronchoscope.

Prior to this examination, a local anaesthetic is sprayed on the back of the throat to allow the tube to be passed down without resistance from the patient. While this test is often uncomfortable, it is not painful.

Mediastinoscopy:

This test is done under general anaesthetic and requires the expertise of a specialist cardiac surgeon. A small cut is made in the front of the neck and a tube is passed down the outside of the trachea (windpipe) so that the area surrounding the lungs (the mediastinum space) can be examined. In particular, the lymph nodes in the chest area are inspected and a biopsy may be taken to check for abnormal cells. Images are also seen via mediastinoscopy, with pictures transferred to a video screen.

Surgical procedures:

There are several other procedures which enable doctors to look directly inside the body to inspect for signs of lung cancer and take tissue samples for testing. These include:

Video-assisted thoracoscopic surgery: This is similar to mediastinoscopy, except that small cuts are made in the chest (rather than one cut in the neck) so the doctor can view areas surrounding the lungs and the outside of the lung themselves.Thoracotomy: This is a major surgical procedure requiring a general anaesthetic. The chest wall is opened and a tumour may be removed during this procedure.