What tests do I need right after being diagnosed with Lung Cancer

Initial Tests After a Lung Cancer Diagnosis

After being diagnosed with lung cancer, your care team will order several important tests to understand your cancer and plan your treatment. Here's what to expect:

Blood Tests

According to NCCN Guidelines, your team will start with two key blood tests:

Complete Blood Count (CBC)

• Measures your white blood cells, red blood cells, and platelets
• Helps assess your overall health and whether cancer is affecting your blood

Chemistry Profile

• Checks natural salts in your body
• Evaluates how well your liver and kidneys are working
• Important because some treatments can affect these organs

Imaging Scans

Diagnostic CT Scan of Chest and Upper Abdomen

• Takes detailed 3D pictures from multiple angles
• Shows the size and location of the tumor
• Checks if cancer has spread to nearby areas like your adrenal glands
• Usually the first scan done to stage (determine the extent of) your cancer
• You'll receive contrast dye injected into your vein to make images clearer

FDG-PET/CT Scan

• Uses a radioactive sugar tracer to highlight areas where cancer may be present
• Can detect cancer that a CT scan alone might miss
• Scans your whole body or from your neck to mid-thigh
• The tracer passes out of your body in urine within about 2 days

Brain MRI

• May be ordered if your care team suspects cancer has spread to the brain

Cancer Cell Testing

Biomarker Tests These are crucial tests performed on tumor tissue (from biopsy or surgery) or sometimes blood samples. They look for specific features of your cancer that determine which treatments will work best for you. Common biomarkers tested include:

• PD-L1 levels - A protein on cancer cells that affects how your immune system responds
• EGFR mutations - Changes in a gene that can make cancer cells grow faster
• Other driver mutations - Genetic changes that "drive" cancer growth (found in about 1 in 3 people with certain lung cancer types)

According to NCCN Guidelines, broad molecular profiling of multiple mutations is strongly recommended because it helps many patients get the best treatment for their specific cancer.

Lung Function Tests

Pulmonary Function Tests

• Measure how well your lungs work
• Important for planning treatment and understanding your baseline health
• May include breathing tests and other assessments

Bronchoscopy (if needed)

• A procedure where a thin camera is guided down your windpipe to examine your lungs
• Allows your doctor to take tissue samples if needed

Performance Status Assessment

Your care team will also evaluate your performance status — your ability to do daily activities. This is one of the most important factors in planning your treatment, as it helps determine what treatments your body can handle.

Important Timeline Note

According to NCCN Guidelines, scans done more than 60 days before treatment decisions should not be used to plan your care, so timing matters.

Questions to Ask Your Care Team

1. Which biomarker tests will be done on my tumor, and when will results be available? (Results can take up to 3 weeks)
2. Do I need a brain MRI, and if so, why?
3. What do my blood test results tell you about my overall health?
4. Based on my imaging, what stage is my cancer, and what does that mean?
5. If there isn't enough tissue for biomarker testing, what's the plan?

Why All These Tests Matter

These tests serve three main purposes:

• Assess your health - Understanding your overall condition helps your team choose safe treatments
• Stage your cancer - Determining how far it has spread guides treatment decisions
• Profile your cancer - Biomarker testing identifies which specific treatments will work best for YOUR cancer

Not all lung cancers are alike, and these tests help your team create a personalized treatment plan just for you.

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.