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Is Lung Cancer Easily Identifiable on X-rays?

In the world of medical sciences, it’s always a top priority to detect diseases at a very early stage. It’s stakes are especially high when it comes to lung cancer detection, as it is one of the most occurring of cancers globally. 

We will explore the same possibilities about X-ray imaging in the early diagnosis of lung cancer.

1. Understanding Lung Cancer

Lung Cancer Text
By Anna Tarazevich / Pexels copyrights 2021

It’s very important to understand the stats of primary lung cancers in today’s healthcare scene. Lung cancer is one of the greatest foes of humanity accounting for an average of 1.8 million deaths annually.

Lung cancer is not a single disease; it has various types and different stages. The two major types are Non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Non-small cell lung cancer (NSCLC) is the most common type of lung cancer making up 85% of the total cases. On the other hand, small cell lung cancer (SCLC) is not so common but is very aggressive. As small-cell lung cancer grows quickly, it responds excellently to chemotherapy and radiotherapy.

So, early detection of cancer cells is very important for the fight against most cancers, especially most lung cancers. Its detection in the early stage increases the probability of successor therapy and survival chances.

1.1. Symptoms of Lung Cancer

Different people face different types of symptoms of lung cancer. Some only face symptoms related to their lungs, while others can face symptoms in other parts of their body. This can happen only if the primary lung cancer itself has spread to other parts. Some people just feel unwell when having cancer, whereas there are many reported incidents where cancer started but the patient didn’t face any symptoms before reaching the advanced stage. Some of the major symptoms are stated below:

  1. Coughing that doesn’t go away
  2. pain in the chest area
  3. shortness of breath
  4. blood coming out with a cough
  5. losing weight without any known reason
  6. wheezing
  7. feeling tired all the times

So, these are some of the symptoms of a possible primary lung cancer illness. Patients can also feel some changes in their health like frequent pneumonia, and swelling in lymph nodes. But it is important to note that you can face these symptoms in case of some other illness. So, it’s strongly advisable to consult a specialist before reaching any conclusion.

1.2. The Role of Chest X-Ray in lung cancers

a man and a woman looking at a chest x - ray
By CDC / Unsplash copyrights 2021

Chest X-rays provide a wide-angle view of the human thorax, which includes all the parts behind the chest wall like the lungs, heart, airways, bones, blood vessels, and other organs. Chest X-rays have traditionally been the first imaging technique used in situations of suspected lung or heart illness, providing doctors with a basic awareness of interior anatomy and soft tissues.

The focus now switches to whether chest X-rays can accurately reveal the delicate mysteries of cancer growth near lymph nodes, and lung tissue as we negotiate the complex maze of lung cancer detection.

1.3. Chest X-ray and Lung Cancer Screening

The very complex structure of lung cancer can only be diagnosed if there are detections of little lung tumors hidden within the complex web of lung anatomy. Usually, chest X-rays can easily detect large tumors or abnormal areas, but they fail to diagnose lung cancer in its early stage. This is because the size of the lung tumor is very small in the early stage. So, if the cancer is diagnosed through X-rays, that means it is already an advanced cancer, and the cancer cells have already spread in great amounts.

The main reason for the failure of chest X-rays in lung cancer screening is its technique of imaging. The X-rays produce a two-dimensional image of the lungs in observing the tumors is very difficult. Many small parts like bones come in between the image of a tumor and can fail the diagnosis. Therefore, it is better to go for low-dose CT scans for better diagnosis. The CT scanner is a good second choice for this.

2. Unraveling the Limitations of Chest x rays

a man in a white lab coat pointing to an x - ray
By National Cancer Institute / Unsplash copyrights 2021

Let’s look at the different limitations of chest x-ray machines in screening lung cancers.

2.1. Low-Resolution Images

One of the most obvious limitations of Chest x-ray is its resolution. The image produced through X-rays lacks granularity. As a result, it becomes very difficult to analyze smaller abnormalities like early-age lung cancer tumors or metastatic nodules.

Lung cancer presentations on a chest X-ray might include a wide range of appearances, such as lung nodules, masses, or shadows. While these symptoms may prompt additional research, they lack the specificity needed for a conclusive lung cancer diagnosis.

2.2. Obscure Images

When we try to look through the complicated structure of the lungs in its X-ray report, there can be some distortions. Bones are one of the main objects to come in between. Small tumors can hide behind these bones during X-rays resulting in failed diagnosis. This thing happens majorly in the upper part of the lung where bony structures like clavicle are present.

Chest X-rays give grayscale images, making it difficult to discern between normal levels in different tissues and abnormalities of cancer cells. An abnormal development in the lung can present in various ways, and while it may suggest cancer, it could also be a benign illness. Furthermore, lung tumors located high in the lungs or on the periphery are very difficult to detect with regular chest X-ray images.

2.3. False Report

A major source of concern is that chest X-rays miss a considerable proportion of lung cancer cases. According to studies, 20% to 23% of chest X-rays in people with lung cancer symptoms produce false-negative chest X-ray results, resulting in a high risk of missed lung cancer diagnoses. This delayed diagnosis can be fatal, as lung cancers can double in size in as little as 136 days.

3. Alternative Methods to Diagnose Lung Cancer

As we became aware of the limitations of chest X-rays in detecting lung cancer, it resulted in the incorporation of advanced methods.

3.1. CT Scans:

CT scanner
By OsloMetX from Pixabay copyrights 2018

Computed Tomography scans emerged as the best option for the early detection of lung cancer. CT scans provide three-dimensional detailed images that are greatly accurate in capturing little irregularities in the lung area in the presence of many obscuring structures like bines.

3.2. Bronchoscopy:

Bronchoscopy, an ultrasound scan that involves inserting a thin tube into the airways, allows for direct observation of lung tissue samples as well as the collection of samples for analysis.

3.3. Lung Biopsy:

Similarly, a full lung biopsy or surgical biopsy retrieves worrisome tissue samples for microscopic examination of cancer cells, which provides a conclusive diagnosis. PET scans provide a metabolic perspective, exposing areas of aberrant cellular activity and assisting in the staging of lung cancer.

3.4. Thoracentesis:

In this process, a long needle is used to collect fluid from between the spaces in the lungs. After that, that fluid is tested for cancer in labs.

3.5. PET Scan:

In a PET scan, you will be infected with a radioactive sugar-like injection. And that substance gets collected in cancer cells. The cells get highlighted after that and get detected in the scan.

4. The Shift Towards Diagnosing Lung Cancer

Despite their historical importance, chest X-rays have lost their status as an excellent standard to diagnose lung cancer. Due to the complex character of early-stage cancer, more sensitive methods have been created. Low-dose CT scans are emerging as a method for individuals with high risk.

People with a smoking history and ages between 50 and 80 should go for low-dose CT scans. This screening method provides detailed cross-sectional images and can lower the mortality rate in terms of possible lung cancer. However, the advantages of his diagnosis conflict with the dangers and increased risk factors of long-term radiation exposure.

5. Beyond Diagnosis of Lung Cancer

Cancer awareness ribbon
By Gustavo Fring / Pexels copyrights 2021

While the right lung cancer screening and treatment are important, it is also crucial to provide lung cancer patients with correct and insightful knowledge, support, and resources. Patients and caregivers related to lung cancer can join advocacy groups, support networks, and educational platforms.

From these platforms, they can be well aware of the diseases, cancer treatment options, and coping strategies. Not only this, but the main thing in which they will get help will be awareness against myths and misinformation. It’s greatly advised to all of us to quit smoking for a cancer-free life.

6. Final Words

The answer is a little yes with a little no. This is because cancer in advanced forms can be easily detected, while early-stage cancer can be detected through other methods. Those methods include PET scans, MRI, CT scans, and many others. Chest X-rays were useful in the past but now they share their spotlight with several other screening techniques available.

Last Updated on December 22, 2023 by