Your lung specialist has picked up an abnormality in your chest. This needs urgent investigation to determine its cause. The abnormality is likely to have been detected on a recent CT scan.
This booklet describes some of the investigations you will need, and where they will take place. You can use the booklet to record the date of your appointments.
You will only need some of these investigations. We will let you know which ones you need, and arrange your appointments.
Investigations you are likely to need
We suggest these for most patients. The results help our lung specialists to decide if you need additional scans or procedures.
| Type of investigation | Where to go | Date booked |
|---|---|---|
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Lung function tests These are breathing tests that give us detailed information about how your lungs are working. We will call you with an appointment date (probably within the next 7 to 10 days). |
Kingston Hospital or Teddington Memorial Hospital At Kingston: Cardiac Investigations Unit (Level 3, near main outpatients entrance). At Teddington: Outpatients (?), xxx
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PET scan A PET scan is painless, and similar to a CT scan. (PET stands for Positron Emission Tomography.) Your healthcare professional injects you with dye which the PET scanner uses to identify areas of your body which need investigating. The Royal Marsden will contact you directly with an appointment date. |
Royal Marsden Hospital, Sutton
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| CT head scan or MRI head scan. For details, see CT scan or MRI scan (under 'Investigations you might need'). | Kingston Hospital, main outpatients reception. They will direct you to the relevant location. |
Investigations you might need
We suggest these for some of our patients. The results help our lung specialists to decide on the best treatment plan for you.
| Type of scan | Where to go | Date booked (if needed) |
|---|---|---|
| CT scan (even if you have already had one). A CT scan is a type of X-ray test that takes detailed pictures of your body’s organs. It is painless. | Kingston Hospital, main outpatients reception. They will direct you to the relevant location. | |
| MRI scan. An MRI scan uses magnetic fields and radio waves to produce detailed images of the inside of the your body. The MRI scanner is quite noisy, but the scan is painless. | Kingston Hospital, main outpatients reception. They will direct you to the relevant location. | |
| Echocardiogram. An echocardiogram is a painless scan that uses ultrasound (high frequency sound waves) to produce pictures of your heart. |
Kingston Hospital, Cardiac Investigations Unit (Level 3, near main outpatients entrance) |
Biopsy
A biopsy is a different kind of investigation.
A biopsy means we take a small sample of your body tissue from any area of your body that requires investigation. We do this to help us confirm a diagnosis.
After a biopsy, most patients go home on the same day.
We may refer you for one or more of the following types of biopsy.
| Type of biopsy | Where to go | Date booked (if needed) |
|---|---|---|
| Bronchoscopy. We pass a thin, flexible telescope through your nose or mouth and down your windpipe. If we can see an area that looks abnormal (unusual), we take a tissue sample. | Kingston Hospital, Esher Wing (Level 7) | |
| Navigation bronchoscopy. This is a way of using your CT scan (plus lung 'GPS-type' technology), to access hard-to-reach areas and create a 'roadmap' of your lungs. | Royal Brompton Hospital, Chelsea | |
| EBUS (endobronchial ultrasound). We pass a thin flexible tube through your mouth and into your windpipe. The tube has a tiny scanner at the end. This allows us to scan and take tissue samples of your chest lymph nodes. | Royal Brompton Hospital, Chelsea or St George's Hospital, Tooting | |
| CT-guided (or transthoracic) biopsy. We insert a needle into your body, using real-time CT scanner images for guidance. We do this using local anaesthetic. | Kingston Hospital, main outpatients reception. They will direct you to the relevant location. | |
| Ultrasound-guided biopsy. We insert a needle into your body, using real-time ultrasound images for guidance. We do this using local anaesthetic. | Kingston Hospital, main outpatients reception. They will direct you to the relevant location. | |
| Mediastinoscopy. We sometimes perform this instead of an EBUS. We insert a thin tube with a tiny camera at the end. This enables us to look at the area in the middle of your chest (the mediastinum) and nearby lymph nodes. We do it while you are under general anaesthetic (asleep). | St George's Hospital, Tooting | |
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Thoracoscopy. This is a keyhole procedure where we insert a tube, with a camera at the end, into your chest cavity. This enables us to look at the lining of your lungs (pleura) and take a biopsy. We can perform it in two ways:
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St George's Hospital, Tooting or Guy's and St Thomas' Hospital, Waterloo |
Important
We do not give investigation results over the telephone. We give all patients their results at a face-to-face clinic meeting.
After your investigations
When we have the results from your investigations, we will discuss them at our multi-disciplinary team (MDT) meeting. This MDT meeting takes place every Monday at Kingston Hospital.
MDT (multidisciplinary team) meeting
At the MDT, our team of healthcare professionals from different lung specialities will review your diagnosis and discuss the best treatment for you.
The MDT includes the following.
- Lung cancer CNS (clinical nurse specialists), who represent your views at the MDT.
- Respiratory doctors, who treat lung problems.
- Radiologists, who perform investigations including X-ray and ultrasound.
- Medical oncologists, who treat cancer with chemotherapy and other cancer drugs.
- Thoracic surgeons, who perform operations on the organs inside the chest (thorax), excluding the heart.
Immediately after our MDT, we will invite you to meet the team at our Respiratory-Oncology Clinic. This takes place every Monday afternoon. At the clinic, we will let you know your investigation results and discuss your treatment plan with you.
Every patient's treatment is different. We will refine our treatment plan as we uncover more information about the cause of your lung condition.
More information
Contact information
Kingston Hospital Lung Cancer clinical nurse specialist (CNS) team
Monday to Friday, 8.30am to 5pm
Email: krft.lungcns@nhs.net
Faster Diagnosis Lung Line