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Seeing your GP Usually you begin by seeing your family doctor who will ask you about your general health and examine you. Your GP will then refer you to hospital for any X-rays or other tests you may need. You will be asked to go for a chest X-ray to check for anything that looks abnormal in your lungs.You may have some routine blood tests. Your GP may ask you to take to the hospital some samples of phlegm that you have brought up so it can be examined for cancer cells.You may have some routine blood tests. Your GP may ask you to take to the hospital some samples of phlegm that you have brought up so it can be examined for cancer cells. At the Hospital At the hospital the doctor will ask about your medical history and your symptoms. They will then probably arrange for you to have some tests, which may include any of the following. Bronchoscopy This test looks at the inside of the airways. A narrow, flexible tube called a bronchoscope is put down your throat and into the airway. The tube has an eye piece so that the doctor can see inside.You usually have this test as an outpatient under local anaesthetic. This means you are awake for the test, but your throat has been numbed. But you may have it with a general anaesthetic or after an injection of a sedative into a vein. If you have an anaesthetic, you may need to stay in hospital overnight. This depends on the time of day the test is carried out and your general health.If you are going to have sedation or an anaesthetic, your doctor will ask you not to eat or drink anything on the morning of the test. When you arrive at the outpatient department, a nurse may ask you to change into a gown or you may be able to stay in your own clothes. Then your nurse will show you into the test room. Once you are lying on the couch, you will have a sedative to help you relax. Just before the test, the doctor will spray a local anaesthetic onto the back of your throat. The doctor puts a long, thin, bendy tube (bronchoscope) either down your nose, or into your mouth and down the airway. This will be a bit uncomfortable, but it doesn't last long. The doctor then looks for anything abnormal and can takes tissue samples (biopsies) for testing. They can take photographs of the inside of your airways if necessary. After the bronchoscopy, you will not be able to eat or drink anything until the local anaesthetic has worn off (about an hour) as your throat will be too numb to swallow safely. You should not drive until the day after the test because of the sedative. Someone should collect you from the hospital and see that you get home safely. You may have a sore throat for a couple of days after the test because of the tube, but it will soon go. PET-CT Scan This is a combination of a PET scan and a CT scan. A PET-CT scan takes CT pictures of the structures of your body. At the same time, a mildly radioactive drug shows up areas of your body where the cells are more active than normal. The scanner combines both of these types of information. This allows your doctor to see any changes in the activity of cells and know exactly where the changes are happening. You may have a PET-CT scan before having a bronchoscopy or biopsy. The scan can show the area where the cancer is. You will have an injection of dye before the scan to help show up abnormalities. There is detailed information about PET-CT scans in the cancer tests section. PET-CT scans are not available in every hospital so you may need to travel to have one. Tumour Biopsy This type of biopsy is called a percutaneous lung biopsy. The doctor puts a thin needle through the skin and muscle of your chest to take samples of cells from the lung tumour to examine under the microscope. The area of the test will depend on where in the lung the abnormal area is. The test can be uncomfortable but only takes a few minutes. You usually have this test as an outpatient in the X-ray department. You have a local anaesthetic injection into the area where the needle is to be put in. The doctor will ask you to hold your breath for a minute while they put the needle through the skin into the lung. Once the needle is in, the doctor uses X-ray, CT scan or ultrasound to make sure the needle is in the tumour. The doctor then sucks out a sample of cells with a syringe. These are sent off to be examined under a microscope. If it is difficult to get enough tissue under local anaesthetic, the doctor can do an 'open' lung biopsy under general anaesthetic in a similar way to mediastinoscopy. Or you may have a thoracoscopy to get a biopsy. Source: http://www.cancerhelp.org