Screening and Diagnosis

Sentara Cancer Network Lung Cancer Program

The key to beating lung cancer is diagnosing and treating it early. We are dedicated to providing patients the most innovative and comprehensive cancer care available. Our highly skilled physicians and expert specialists combine patient and family medical history with blood test results and advanced diagnosis tools to detect lung cancer as early as possible, when it’s most treatable. 

Screening Tests

  • CT Lung Cancer Screening
    This screening uses low-dose computed tomography (CT) imaging scans to detect lung cancer early, which can lead to a higher cure rate. The scan covers the entire chest and provides a more detailed look than a standard chest X-ray. Learn more about CT Lung Screening.
  • Endobronchial Ultrasound (EBUS)
    EBUS uses ultrasound guidance to detect cancerous cells in the lungs and lymph nodes, helping to diagnose and stage lung cancer. It can also be used as image guidance for collecting tissue samples without surgery.
  • Electromagnetic Navigational Bronchoscopy (ENB)
    ENB uses GPS-like technology to navigate through small airways deep inside the lungs. Doctors use the advanced technique to locate, biopsy and treat cancerous cells. The procedure can also be used to implant markers into lung tumors to precisely target them during radiation therapy.
  • Chest X-ray
    A chest X-ray uses electromagnetic radiation to take pictures of the chest. X-rays may reveal the presence of tumors or abnormal fluid.
  • Computed Tomography (CT) Scan
    Doctors often use CT scans to take pictures of tissue inside the chest. The technology uses special X-ray equipment linked to a computer to create detailed pictures. Sentara Cancer Network typically uses a spiral CT scanner, which rotates around a patient lying on a table. The pictures may show a tumor, abnormal fluid or swollen lymph nodes.
  • Positron Emission Tomography (PET) scan
    PET scans take pictures of organ and tissue function using nuclear medicine technology. PET scans are often combined with 3D images from CT Scans to detect cancer reoccurrence.

Tissue sampling

The only way to confirm lung cancer is for a pathologist to examine samples of cells or tissue under a microscope, possibly combined with other testing. There are many ways  physicians collect samples, including:

  • Sputum cytology
    Thick fluid called sputum is coughed up from the lungs. The lab checks samples of sputum for cancer cells.
  • Thoracentesis
    A doctor uses a long needle to remove pleural fluid from the chest, which is then checked for cancer cells.
  • Bronchoscopy
    The doctor inserts a thin, lighted tube called a bronchoscope through the nose or mouth into the lung. This allows the doctor to examine the lungs and air passages, and take a sample of cells with a needle, brush or other tool. The doctor also may wash the area with water to collect cells in the water.
  • Fine-needle aspiration
    The doctor uses a thin needle to remove tissue or fluid from the lung or lymph node. Sometimes, the doctor uses a CT scan or other imaging method to guide the needle to a lung tumor or lymph node.
  • Thoracoscopy
    The surgeon makes several small incisions in the patient’s chest and back, and then looks at the lungs and nearby tissues with a thin, lighted tube. If an abnormal area is seen, a biopsy to check for cancer cells may be needed.
  • Thoracotomy
    The surgeon opens the chest with a long incision. Lymph nodes and other tissue may be removed.
  • Mediastinoscopy
    The surgeon makes an incision at the top of the breastbone. Using a thin, lighted tube to see inside the chest, the surgeon may take tissue and lymph node samples.

Fast Track Thoracic Clinic

The Sentara Cancer Network has created a Fast Track Thoracic Clinic to ensure patients with suspicious lung findings are seen by a specialist within seven business days. This program consists of dedicated lung navigators who will partner with patients and physicians through the process.

Coordinated Process

Any imaging report with a suspicious finding will include a note to ordering provider to contact their local lung navigator at a dedicated number. The navigator will assist in communicating with Pulmonologist/Thoracic Surgeon participating in the Fast Track Thoracic Clinic to schedule an appointment within seven business days.

The Lung navigator is available to assist across the continuum of care to help address any barriers and provide support to patient, their family, and the care team.

Referral Process

Utilization of the program by the ordering provider is completely optional. The ordering provider is responsible for providing their preference for referral when discussing with the navigator. If the pulmonologist/thoracic surgeon they prefer is not part of the program, they are welcome to refer through their normal channels.


If you have any questions, please contact the Sentara Cancer Network at 1-888-220-22141-888-220-2214.