pretreatment staging for patients with lung cancer

Introduction

All patients:

• complete history & physical examination
  • determination of performance status & weight loss
  • ear, nose & throat examination
• complete blood count
• serum chemistries: chem 7, Ca+2, phosphorous, LFTs
• electrocardiogram
• skin test for tuberculosis
• chest X-ray
• computed tomography (CT) of brain, thorax, abdomen
• radionuclide bone scan if CT suggests metastatic lesions
• X-rays of suspicious bone lesions
• barium swallow if esophageal symptoms are present
• pulmonary function studies including arterial blood gas (ABG) of signs or symptoms of respiratory insufficiency are present
• biopsy of accessible lesions
  • no tissue diagnosis has been made
  • treatment of staging dependent upon whether or not accessible lesion is malignant

Non-small cell carcinoma

• fiberoptic bronchoscopy with washing, brushings & biopsy of suspicious areas
• coagulation studies
• diagnostic & therapeutic thoracentesis if pleural effusion is present
• transthoracic fine needle biopsy of peripheral lesions if material from fiberoptic bronchoscopy is non diagnostic

More general terms

• staging of lung cancer

Additional terms

• lung cancer