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What is Lung Cancer?

Lung cancer is the growth of cancerous cells in the tissues of the lungs or airways. This is a serious form of cancer that is often not detected until later stages of the disease when treatment is less likely to be effective. Because of the absence of symptoms and the failure of early detection, nearly 90% of lung cancer is fatal.

Lung cancer is often categorized as a carcinoma [KAR-sihn-OH-muh]. Carcinomas are cancers that start in the tissues or the lining of the organs. There are two basic types of lung cancer:

  • Small Cell Lung Cancer (SCLC). This form of cancer is rarer than others. It begins in the chest or bronchi [BRONG-kee] and spreads quickly.
  • Non-Small Cell Lung Cancer (NSCLC). This form of cancer makes up 85-90% of lung cancer diagnoses. There are three main types of NSCLC: Adenocarcinoma [ah-DEE-no-KAR-sihn-OH-muh] (the most common type of lung cancer), squamous [SKWEY-muhs] cell carcinoma, and large cell carcinoma.

The stage of a cancer refers to how far the cancer has spread, the size of the tumor, whether the lymph [limf] nodes or other organs are affected. There are just two stages of small-cell lung cancer: limited and extensive. Limited small cell lung cancer is in only one lung and may or may not have spread to the lymph nodes. Extensive small cell lung cancer is in both lungs or has spread the surrounding area. NSCLC (non-small cell lung cancer) has several stages that are defined as the following:

  • Occult. In this stage, the mucus or fluid of the lungs contains cancer cells and there are no visible tumors.
  • Stage 0. Cancerous cells are in the air passages or bronchi but not in the tissues of the lungs.
  • Stage I. Cancer is in the tissue of one lung but has not spread to any other organs or lymph nodes.
  • Stage II. Cancer may have spread beyond the lung to surrounding tissues and lymph nodes.
  • Stage III. Cancer has spread beyond the lung to nearby organs and lymph nodes.
  • Stage IV. Cancer has spread to the other lung, fluid around the heart, or distant organs like the brain or liver.

Early detection plays a vital role in the better outcomes for lung cancer, and earlier stages of the disease respond well to treatment.

Symptoms

The symptoms of lung cancer often don’t show up until later stages of the disease and can be confused with problems that arise from smoking in general. They include the following:

  • Shortness of breath
  • Persistent cough
  • Chest pain
  • Coughing up blood
  • Repeated bouts of pneumonia [noo-MOHN-yuh] or bronchitis [brong-KAHY-tis]
  • Swelling in the neck and face
  • Weight loss
  • Fatigue

When to See a Doctor

If you are experiencing any of the symptoms above, especially if you are a smoker or have smoked previously, you should contact your doctor to get screened for lung cancer. While some of the symptoms can be signs of a common illness, prolonged cough and breathing problems may be a warning sign of a more serious condition.

Causes

Smokers over the age of 55 are at high risk, especially those who have smoked for 30 years or more. Estimates indicate 85% of lung cancer is caused by smoking. However, there are a few other risk factors that contribute to lung cancer, including exposure to the following:

  • Smoking, especially pipe and cigar smoke
  • Secondhand smoke
  • Radon
  • Asbestos [as-BES-tuhs]
  • Chemicals
  • Air pollution
  • Radiation therapy
  • Genetic (inherited) risk factors

Even if you are a smoker who has quit within the last 15 years, you may still be at risk if you smoked for 20 years or more, so discuss what additional screening is recommended with your doctor.

Diagnosis and Tests

Doctors estimate that nearly 80% of lung cancer might have gone into remission if it had been caught in the earlier stages of the disease. For those who are 55-80 years old and have smoked 20-30 years or have other risk factors, yearly screenings are recommended. If you are at risk for lung cancer, your doctor may recommend the following tests depending on your age, overall health, and medical and family history:

  • Physical exam
  • Blood tests
  • CT scan
  • MRI
  • Sputum cytology [SPYOO-tuhm sahy-TOL-uh-jee] test
  • X-ray
  • Bronchoscopy [brong-KOS-kuh-pee]
  • Needle biopsy [BY-op-see]
  • Thoracentesis [thawr-uh-sen-TEE-sis]
  • Thoracotomy [thawr-uh-KOT-uh-mee]

Based on the results of your tests, additional screening may be recommended by your doctor to determine the best treatment plan.

Treatments

Treatment for your cancer will depend upon the stage of cancer, your overall health, age, and preference. Your doctor will work with you and an oncologist [on-KAL-oh-jist] or treatment team to develop a plan to treat your lung cancer.

The goals of treatment for cancer include the following:

  • Remove or destroy the existing cancer cells and tumors
  • Stop the growth of additional cancer or tumors
  • Prevent the cancer from returning
  • Ease the symptoms of lung cancer

Treatments for lung cancer typically include some combination of the following:

  • Radiation
  • Chemotherapy [KEE-moh-THER-uh-pee]
  • Targeted therapy
  • Immunotherapy [ih-MYOO-noh-THER-uh-PEE]
  • Photodynamic [foh-toh-dahy-NAM-ik] therapy
  • Laser therapy
  • RFA (Radiofrequency Ablation) [rey-dee-oh-FREE-kwuhn-see a-BLEY-shuhn]
  • Supportive therapy

Talk with your doctor, oncologist, and treatment team about what approach or combination of treatments would be the best for you given your medical and family history.

Prevention

One of the most important things you can do to prevent lung cancer is not to smoke. And if you do smoke or have smoked in the past, regular screenings, especially if you are over 55, are highly recommended. To prevent lung cancer, you can also take the following steps.

  • Don’t smoke and limit your exposure to second-hand smoke.
  • Test your home for radon.
  • Limit your exposure to pollutants like asbestos and air pollution.
  • Eat a healthy diet.

If you have a family history of lung cancer, talk with your doctor about additional steps you might want to take to stay healthy.