KEYTRUDA for non-small cell lung cancer (NSCLC)

Tests to diagnose lung cancer

If you have symptoms or risk factors for lung cancer, a physical examination, chest x-ray and blood tests are some of the initial investigations your doctor may decide on.

Here are some of the tests used in New Zealand to diagnose and investigate lung cancer:

Sputum cytology

If you have a long-term cough and are producing phlegm (also called sputum), looking at the phlegm under the microscope may reveal the presence of lung cancer cells.

Imaging tests

An X-ray image may reveal an abnormal mass or nodule in a lung. A CT scan can reveal small lesions that might not be seen on an X-ray.


A sample of lung tissue may be removed during a procedure called a biopsy. There are several ways to perform a biopsy:

  • Bronchoscopy - your doctor uses an instrument called a bronchoscope to see into your lung and take a sample of abnormal-looking tissue. This type of biopsy can be performed under local or general anaesthetic.
  • Mediastinoscopy - involves an incision at the base of your throat. The mediastinoscope is inserted under your sternum (breastplate) and moved into the area between your lungs. Tissue can be taken from lymph nodes this way. A mediastinoscopy biopsy requires a general anaesthetic.
  • Needle - after a local anaesthetic is given, a needle is guided through the chest wall into the suspicious area identified by CT scan to extract a tissue sample.

Your doctor will determine which tests you may need.

Treating lung cancer

Questions to ask your doctor about lung cancer

Who can you talk to?


KEYTRUDA (pembrolizumab) 50mg powder for infusion
KEYTRUDA is a Prescription Only Medicine Use: KEYTRUDA is used:
  • in the treatment of melanoma which cannot be removed by surgery alone or when it has spread to multiple sites in the body.
  • in the treatment of a kind of lung cancer called non-small cell lung cancer (NSCLC).
  • in the treatment of classical Hodgkin Lymphoma (cHL)
  • in the treatment of urothelial carcinoma, including bladder cancer
  • in the treatment of a kind of head and neck cancer called head and neck squamous cell carcinoma (HNSCC)

Side effects: Immune-mediated side effects including inflammation of the lungs, colon, liver, kidneys, pituitary gland, brain, eye, muscles, nervous system, pancreas, and heart, thyroid disorders, type 1 diabetes mellitus. Severe skin reactions including Steven-Johnson syndrome and toxic epidermal necrolysis. Severe infusion reactions including hypersensitivity and anaphylaxis. Transplant recipients: rejection of a transplanted organ, graft-versus-host-disease (in people with a bone marrow transplant using donor cells). Very common side effects include diarrhea, nausea, itching, rash, joint pain, back pain, feeling tired, cough, patches of discoloured skin, stomach pain, decreased levels of sodium in blood. Tiredness, nausea, vomiting, diarrhea, constipation, shortness of breath, rash, itching, headache, hair loss, and, infections of the upper respiratory tract were reported when given in combination with chemotherapy. You may experience more than one side effect at the same time.

All medicines have risks and benefits. Talk to your doctor to see if KEYTRUDA is right for you. KEYTRUDA is a funded medicine for melanoma patients– restrictions apply. KEYTRUDA is an unfunded medicine for NSCLC, HNSCC, cHL and urothelial carcinoma patients. Ask your health professional the cost of the medicine and any other medical fees that may apply. Use only as directed and if symptoms continue or you have side effects, see your doctor, pharmacist, or health professional.

Based on data sheet prepared 17 July 2018. Marketed by: Merck Sharp & Dohme (New Zealand) Limited, Newmarket, Auckland. . For additional product information, consult the Consumer Medicine Information (CMI), available on request, phone 0800 500 673 or refer to the Medsafe website

This site is intended for New Zealand residents.

References to support this are available on request.

MSD recommends people always seek the medical advice of their healthcare professional.

Copyright © 2018 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, New Jersey, USA. All rights reserved.

Copyright © 2018 Merck Sharp & Dohme (New Zealand) Limited. Level 3, 123 Carlton Gore Road, Newmarket, Auckland. All rights reserved.

ONCO-1273154-0000 First Issued November 2017 TAPS NA10076 essence MSD8360

Updated: October 2018