A bronchoscopy is a procedure that allows doctors or pulmonologists (lung specialists) to look inside your lungs. If necessary, they will take a lung tissue sample for laboratory testing. You may be asked to undergo a bronchoscopy if you have been having lung-related issues, such as trouble breathing or persistent coughing. If you have been diagnosed with lung cancer, your oncologist may request a bronchoscopy to find out more about the type of cancer you have or its stage. If you are hearing about a bronchoscopy for the first time, here’s what you need to know about this test, including how it is used, what it involves, and what it can tell your health care team.
During the procedure, a small, thin tube (called a bronchoscope) goes down your throat and into your lungs via your bronchi and bronchial passages (the airways). This tube has a light and a camera (in some cases, a video camera), which allow your doctor to see inside your airways and lungs.
If your doctor needs to take a sample of your pulmonary tissue (called a biopsy), the bronchoscope will also have the necessary equipment. This apparatus might vary based on the type of lung biopsy needed, the location being biopsied, as well as other factors.
Your doctor or oncology team may request a bronchoscopy for several reasons. In some cases, the procedure is used to diagnose lung cancer. In others, a bronchoscopy may be performed to move obstructions or tumors from the airways or lungs.
If a CT scan, chest X-ray, or MRI indicates something abnormal or unusual (such as a growth, or lesion), your doctor can use bronchoscopy to look at that section of your lungs and determine what the abnormality is.
If part of a tumor is blocking your airway, a bronchoscopy can help remove it. The bronchoscope can be used to guide a laser into your bronchi and destroy the section of the tumor causing problems. If your airway has a blockage or is in danger of closing or collapsing, a bronchoscopy can also be used to insert a small, rigid tube (called a stent) that will keep it open.
Your doctor may recommend a bronchoscopy to help reveal the causes of lung symptoms, such as trouble breathing, persistent coughing, shortness of breath, or chest pain. A bronchoscopy may also be used to diagnose the cause of an unexplained collapsed lung (pneumothorax) or other lung problems, including lung cancer, lung disease, and pulmonary infections.
If you have recently been diagnosed with lung cancer, your oncologist will want to determine whether it has metastasized (spread outside of your lungs). Doctors can use a particular kind of bronchoscopy, called an endobronchial ultrasound, to see if your lymph nodes are swollen or detect tumors outside your lungs. If they need to biopsy these areas, they can use a transbronchial needle aspiration, performed via bronchoscopy, to get the samples they need.
Depending on the type of bronchoscopy you have, your doctors will let you know what they find. The results may be based on what they see. In these cases, your health care team may let you know that your airways are clear or that they saw an abnormality or a growth that requires further investigation. If your doctor performs a procedure to help clear your airways or lungs, they will let you know if it was successful and what you can expect moving forward.
If doctors take a biopsy or biopsies during your bronchoscopy, they will send these for review. Experts will examine the tissue, compare it to healthy tissue, look for markers that indicate certain types of lung cancer (or other diseases), and, in some cases, perform tests for genetic markers. You will receive detailed results as soon as they are available.
These test results can indicate:
Some people feel anxious before undergoing medical procedures. This is normal. It can be helpful to know what to expect before going in and what you can do to ensure you have the best possible experience during your bronchoscopy.
Follow all of the instructions that you are given before your bronchoscopy. Most of the time, this includes not eating or drinking for at least six hours before the procedure. Your health care provider will let you know if you should stop taking certain medications several days before the test, such as blood thinners.
You will also want to make sure that you have transportation to and from the procedure. Because bronchoscopies are usually performed under sedation, you will need someone to help you get home.
Once you arrive at the location where the bronchoscopy will be performed, you will be called into a room. You will lie on your back on a table, where medical staff will connect you to monitors for blood pressure, heart rate, oxygen levels, and more.
Most of the time, bronchoscopies are performed under some sort of intravenous sedation or anesthetic. You may be put to sleep entirely (under general anesthesia), or you may simply receive medication that will help you relax and not remember much of the procedure.
Your doctor will make sure that your nose and throat are numb before they perform the procedure. This makes it easier to move the scope down your throat and decreases the chances that you will experience discomfort during the procedure.
Once you are comfortable and prepared for your bronchoscopy, your doctors will insert the bronchoscope into your lungs. They will move it slowly and carefully down your windpipe and past your vocal cords. The procedure should not cause you pain.
Your doctors will do the work that needs to be done in your lungs, whether that involves taking pictures or videos, obtaining tissue samples, or inserting a stent to help keep your lungs open. Then, they will remove the bronchoscope and wake you up slowly if you were asleep or given medication that may make you groggy.
Your medical team will monitor you after your bronchoscopy. Because of the numbing medication and the procedure, you will not have your usual ability to gag (gag reflex) for one to two hours. You will not be able to eat or drink until your gag reflex returns.
Once your throat is back to normal, you should start drinking sips of water. If you are able to take small sips, you can move to soft foods. If those go down as usual, you can return to your usual eating and drinking habits.
You may experience a sore or scratchy throat for a few days after your bronchoscopy. You may also experience hoarseness, and you may cough more than usual. You can use your normal methods of dealing with a sore throat to manage this discomfort once your gag reflex has returned.
Your doctors will let you know when to expect the results of your bronchoscopy. This will be based on the particulars of your procedure and typical lab turnaround times. You may schedule your follow-up visit at the time of your bronchoscopy.
If you or someone you love has been diagnosed with lung cancer or is in the process of receiving such a diagnosis, it’s easy to feel anxious and overwhelmed. MyLungCancerTeam is the online social network for people diagnosed with lung cancer, as well as those who love and care for them. Here, you can share your own story about lung cancer, ask questions, and join ongoing conversations. You’ll meet people who understand your journey and who will form your lung cancer team.
Have you undergone a bronchoscopy? Share your experience or tips in the comments below or by posting on MyLungCancerTeam.