Things to know about lung health check-ups or screening

Our lungs are vital organs of our body as its health affects our overall well-being. One way to check for lung health is by lung screening/check-up where abnormalities can be spotted early—often before we experience symptoms. Early detection may also make treatment easier and more effective. Lung diseases, including lung cancer, are among the most prevalent health problems in Singapore, affecting men, women and children alike. Lung diseases are also one of the country’s major causes of death. Lung screening should be taken into consideration given the existing statistics in the country.

Typical Lung Diagnostic Exams

There are various lung diagnostic exams or tests currently in use today. These diagnostic exams are used to measure a range of parameters needed by the doctor for correct diagnosis and appropriate treatments. Some tests may be used in measuring the lungs’ ability to hold, transport, and absorb oxygen. Others may be used to detect other irregularities or infections that can be connected to a certain lung disease or other health disorders.

The following are the typical categories of lung diagnostic exams used needed for lung check-ups:

  • Simple tests. 
    • Spirometry-the easiest and most typical lung test in use today. TThis will calculate how much air is exhaled. It could be used to spot lung conditions that has an effect how much air it can hold, like chronic obstructive pulmonary disease (COPD). Spirometry is also used to determine whether breathing has improved after receiving medicine for asthma, etc.
    • Challenge test-this exam is typically used for asthma diagnosis. In this diagnostic exam, the doctor will first perform spirometry, then request you to breathe in a spray of methacholine, which can irritate and narrow your airways. Your doctor will perform additional spirometry to determine how the spray affects your breathing. This will be repeated in small doses until you begin to wheeze or feel short of breath.
    • FeNO test-It is used with persons who have specific types of asthma to determine whether their lungs are inflamed and how effectively drugs are controlling inflammation. Specifically, it determines the amount of Nitric oxide is in the air you exhale (swelling of the lung airways is related to higher nitric oxide levels.)
    • Peak flow measurement-also a test used for people with asthma. You may be able to detect an asthma attack in advance from using this test
    • Pulse oximetry (pulse ox)-a test that gauges the amount of oxygen that your red blood cells are carrying (i.e., to see if your blood is well oxygenated).
  • Advanced Tests
    • Plethysmography-this is a more exact way to measure the amount of air the lungs can hold. This is helpful in gauging the extent of your asthma, or other lung conditions and if surgery will be required for treatment.
    • Diffusion capacity test-this assesses how well your lungs provide oxygen to your blood. This examination might reveal whether your blood flow is problematic or whether your lungs have been impacted.
  • Imaging Tests
    • Chest X-ray-this can be used to check for conditions including lung fibrosis, lung cancer, or pneumonia.
    • Computerized tomography (CT) and positron emission tomography (PET) scans-These are more sophisticated imaging procedures that can be used to detect issues like cancer that an X-ray would miss until they are more advanced.
      • Pulmonary angiogram-this particular CT scan type concentrates on the pulmonary arteries, which are the blood channels that link your heart and lungs. It’s used to detect a pulmonary embolism, a blood clot that can be fatal and develop in your lungs.
      • Chest ultrasound-this test is helpful in determining whether the lungs have any fluid accumulation
  • Invasive Tests
    • Bronchoscopy-medical examination that enables doctors to examine your airways and lungs. The test makes use of a thin tube with a tiny camera and light at the end. This test is used to look for signs of cancer
    • Mediastinoscopy-a minimally invasive procedure that enables a doctor to examine the area between the lungs called mediastinum. The purpose of this procedure is often to remove lymph nodes and check for evidence of lung cancer that has spread. T
    • Pleural biopsy-in this test, a sample of tissue lining the inside of the chest (called the pleura) is taken out and examined to look for signs of infection, cancer or other conditions.

Lung cancer screens

People who are considered to be at a high risk of developing lung cancer should have regular lung screenings done. Lung cancer is actually the second most common cancer type diagnosed in Singapore, according to reports. The following people groups should think about getting a lung screening:

  • Smokers who are at 50 years of age and older, both current and former
  • Heavy smokers for a long time (i.e. if you have smoked for 20 packs or more years in the past)
  • Those who smoked heavily for a long time before quitting within the last 15 years
  • Those who are generally healthy
  • Those who have already had lung cancer
  • Those with additional lung cancer risk factors

Most lung cancer cases are discovered after the onset of symptoms, by which time it may be too late to treat or cure. Thus, the objectives of screening are:

  • Detect cancer before symptoms appear
  • Early detection of cancer to makes it easier to treat and cure
  • Lower the risk of death from cancer

Screening lung cancer will involve the use of tests mentioned above. Among the commonly used tests are a combination of imaging tests and biopsies. Initial tests will involve a chest x-ray or CT Scans. The results of the imaging tests will prompt for additional diagnostic tests such as Bronchoscopy, etc. Stage of lung cancer will be determined through use of other  tests like PET scans, etc. Lung cancer treatment is based on the patient’s overall health and fitness as well as the type and stage of the cancer.

Generally, you should continue doing annual lung cancer screenings until you reach a point where you’re unlikely to benefit from them, such as when you develop other major medical issues that could render you too frail to get lung cancer therapy.

IP Lung Clinic

Interventional Pulmonology & lung Clinic

Mount Elizabeth Medical Centre, 3 Mount Elizabeth, #12-03, Singapore 228510

+65 9023 0158