From the Research
Introduction to Initial Cancer Workup
The initial workup for suspected cancer involves a comprehensive evaluation to confirm the presence of cancer, determine the type and stage of the disease, and develop an appropriate treatment plan. This process typically begins with a primary care physician's referral to a specialist based on symptoms, signs, and laboratory tests [ 1 ].
Components of Initial Evaluation
The initial evaluation for suspected cancer includes:
- A thorough medical history to identify symptoms and risk factors
- A physical examination to detect signs of cancer
- Laboratory tests, such as blood work and imaging studies, to help diagnose and stage the disease [ 2 ]
- Consideration of paraneoplastic syndromes, which are conditions caused by the immune system's response to cancer [ 2 ]
Diagnostic Procedures for Lung Cancer
For suspected lung cancer, diagnostic procedures may include:
- Sputum cytology, which involves analyzing a sample of mucus to detect cancer cells
- Bronchoscopy, which involves inserting a flexible tube with a camera and light on the end to visualize the airways and collect tissue samples
- Transthoracic needle aspiration, which involves using a needle to collect a sample of tissue from a lung nodule or mass
- Resectional biopsy, which involves surgically removing a portion of the lung to diagnose and stage the disease [ 3 ]
Liquid Biopsy for Lung Cancer
Liquid biopsy, which involves analyzing a sample of blood or other bodily fluid to detect cancer cells or DNA, may also be used in the initial diagnostic workup for suspected lung cancer. This approach can provide faster molecular results and shorten the time to treatment [ 4 ].
Cancer Fast-Track Program
A cancer fast-track program, which streamlines the referral process and provides rapid access to specialist care, can help reduce the time from initial symptoms to diagnosis and treatment initiation [ 1 ].
Suspected Cancer Pathway
The Suspected Cancer (SCAN) pathway, which provides rapid CT scanning, laboratory testing, and clinic review within 2 weeks, can help diagnose and stage cancer in patients with non-specific symptoms [ 5 ].
Treatment and Management
Once a diagnosis of cancer is confirmed, treatment and management options will depend on the type and stage of the disease, as well as the patient's overall health and preferences. Treatment may include surgery, chemotherapy, radiation therapy, or a combination of these approaches.
Dosing and Duration
The dosing and duration of treatment will vary depending on the specific treatment plan and the patient's response to therapy.
Differential Diagnoses and Caveats
Differential diagnoses, which are alternative explanations for the patient's symptoms, should be considered and ruled out during the initial evaluation. Caveats, such as the potential for false-negative or false-positive test results, should also be taken into account when interpreting diagnostic findings [ 3 ].