Diagnosis

At UCLA Health, we recognize that every patient and lung cancer are not the same. Our precision medicine approach to lung cancer treatment means we personalize treatment based on each tumor’s genetic and molecular characteristics. It all begins with an expert diagnosis and testing.

We use advanced imaging and minimally invasive procedures (which use small incisions) to accurately identify the type and stage of every lung cancer. But we don’t stop there.

For every patient diagnosed with lung cancer, we break down the biology of tumor cells to guide us in individualizing treatment. Learning everything about the type of cancer you have helps us determine the most effective care plan for you.

Lung cancer diagnosis: the UCLA Health advantage

Our specialized team works quickly to thoroughly diagnose and understand lung cancer. You can expect:

Advanced diagnostic tools: We use the newest nonsurgical techniques to diagnose conditions in the lungs and chest. These methods give you an accurate diagnosis and reduce your recovery time.

Dedicated pulmonary pathologists: Our pathologists (physicians who analyze your body tissues) are also experts in lung diseases. Their experience means they see every detail when they study lung tissue.

Focus on precision medicine: We look for genetic mutations (changes in your genes) and the specific features of the cancer to personalize your treatment. Learn more about UCLA’s Institute for Precision Health.

Supportive care: If you’re diagnosed with lung cancer, you’ll work with a specialized oncology (cancer) nurse navigator. They’ll explain the process, coordinate your appointments with the rest of your lung cancer team and answer your questions.

Molecular testing for lung cancer

Molecular testing (also called biomarker, genomic or tumor testing) looks for changes in the DNA of a tumor. The testing is done using liquid biopsy, a blood test used to analyze a tumor’s DNA and identify the genetic changes that make cancer cells grow out of control. The information we gather helps us prescribe the most effective treatment for the specific cancer you have.

At UCLA Health, we offer molecular testing for all patients diagnosed with lung cancer. If the tumor shows certain gene mutations, we consider treating it with targeted therapy. This procedure “targets” those gene changes to slow tumor growth or shrink the tumor.

We also test to see if the cancer will respond to immunotherapy, treatment that helps the body’s own immune system fight cancer. We measure biomarkers such as levels of a protein called PD-L1. This protein, found on the surface of some cancer cells, blocks the body’s immune system from destroying the cancer. Your PD-L1 level may predict whether you’re a candidate for immunotherapy treatment.

How we diagnose lung cancer

We look at your health from every angle to diagnose lung cancer. Your physician will ask about your lifestyle, review your medical history and perform a physical exam, which may include bloodwork. We’ll also assess images from your lung cancer screening.

To further examine a suspicious area of your lung, your team may need to do more tests. They’ll discuss the details of every procedure with you, including any medicine to prevent pain (anesthesia) so you stay comfortable.

Your diagnostic tests may include:

Imaging

Chest X-ray: This imaging uses radiation to produce pictures of the bones and organs in your chest area.

CT scan: A CT scan takes pictures of your lungs from various angles to show the size, shape and position of any tumors. This scan provides more detail than a traditional X-ray.

MRI: Using radio waves and magnets, these scans provide detailed images of soft tissues in the body.

Positron emission tomography (PET) scan and PET/CT scan: During a PET scan, a technician injects a radioactive substance into the blood that collects in cancer cells. A PET/CT scan combines detailed CT pictures with the visual created in a PET scan.

Procedures

Fine-needle aspiration (FNA) or core needle biopsy: We use a syringe with a thin, hollow needle to collect cells and small pieces of tissue. If the lung nodule is deeper and can’t be felt, we guide the needle using ultrasound or CT imaging. 

Bronchoscopy biopsy: A thin, lighted tube (called a bronchoscope) travels through your nose or mouth to your chest to provide a picture of the airways and collect tissue. To access hard-to-reach areas of your lung, we use navigational bronchoscopy, which relies on CT scans, or perform robotic bronchoscopy using a flexible, remote-controlled device.

Endobronchial ultrasound (EBUS): We look at the lymph nodes and area between your lungs with a bronchoscope fitted with a microphone. Sound waves and the echo they create form an image of the area.

Thoracentesis: If your provider finds fluid around your lungs, this procedure drains the fluid to check for cancer cells.

Thoracoscopy or video-assisted thoracoscopic surgery (VATS) or robotic biopsy: A surgeon removes a tissue sample from your lung with small instruments and special equipment.

Types of lung cancer

When we diagnose lung cancer, we determine the type of lung cancer, as well as the cancer stage. There are two main types of lung cancer, classified by the size of their cells:

Non-small cell lung cancer (NSCLC)

Non-small cell lung cancer (NSCLC) makes up about 80 to 85% of all lung cancers. There are several NSCLC subtypes, which begin from different types of lung cells. The most common include:

Adenocarcinoma occurs mainly in people who smoke or used to smoke. It’s also the most common lung cancer diagnosed in people who don’t smoke.

Squamous cell carcinoma, often linked to a history of smoking, is usually found in the central part of the lungs.

Large cell (undifferentiated) carcinoma occurs anywhere in the lungs, grows quickly, spreads quickly and is hard to treat. A type of large cell carcinoma, called large cell neuroendocrine carcinoma (LCNEC), is fast growing and similar to small cell lung cancer.

Small cell lung cancer (SCLC)

Small cell lung cancer (SCLC), which occurs in the lungs’ bronchial system (airways), makes up about 10 to 15% of all lung cancers. This type of cancer begins when the cells surrounding those airways (called neuroendocrine cells) become abnormal and grow uncontrollably.

SCLC grows and spreads quickly. For most people with SCLC, the cancer has already spread at the time of diagnosis. Learn more about UCLA Health’s Neuroendocrine Tumor (NET) program.

After your lung cancer diagnosis

If you receive a lung cancer diagnosis, we’ll connect you with a clinical navigator. They will guide you through the cancer care process and coordinate the next steps in your treatment.

You’ll meet with a cancer care team, either in-person or virtually. This means you’ll partner with lung cancer specialists from many areas of medicine, including:

• Thoracic (lung and chest) surgeons
• Medical oncologists (cancer physicians specializing in medicine)
• Radiation oncologists (cancer physicians specializing in radiation therapy)
• Pulmonologists (lung physicians)
• Radiologists (imaging specialists)

They’ll work with you to create a personalized care plan that fits your lifestyle and provides the most effective treatment possible.

Learn more about lung cancer treatment at UCLA Health.

Request an appointment

To schedule an appointment, call 310-267-9099 or fill out our appointment request form.