Lung Cancer

What is lung cancer?

Lung cancer is an abnormal growth of cells that starts in the lungs. Lung cancer is one of the most common forms of cancer in the US and is the leading cause of cancer death.

When you breathe, the lungs bring oxygen into the body and take out carbon dioxide. Carbon dioxide is a waste product of the body's cells.

Lung cancer can spread (metastasize) to other parts of the body, most often to the liver, brain, bones, and other parts of the lungs, including the outer lining (called the pleura). Cancer from other parts of the body may also spread to the lungs, but it is different from cancer that starts in the lungs.

How does it occur?

Tobacco is linked to 85 to 90% of cases of lung cancer. In addition to smoking, factors that increase your risk for lung cancer include exposures to:

• other people's smoke (secondhand smoke, or passive smoking)
• air pollution
• radiation at your job or in your environment
• asbestos
• radon gas
• industrial chemicals such as the byproducts from petroleum refining.

What are the symptoms?

Lung cancer grows for a while without causing symptoms. Symptoms may include:

• cough
• coughing up blood
• shortness of breath
• wheezing
• hoarseness
• chest pain
• weight loss
• loss of appetite

If the cancer spreads to other parts of the body, signs and symptoms of the cancer will depend on the area it has spread to. For example, you may have bone pain if the cancer has spread to bone.

How is it diagnosed?

Your healthcare provider will review your symptoms and examine you. A sample of sputum may show if cancer cells are present. Some of the following tests also will be done:

• chest X-ray
• CT scan
• PET scan.

If X-rays or scans show an area in the lung that does not look normal, a sample of cells can be taken for testing (a biopsy). Biopsies can be done by:

• numbing the area and putting a thin needle through the chest wall
• passing a slim, flexible, lighted tube called a bronchoscope through your mouth and down into the lung to see and sample abnormal areas (a procedure called a bronchoscopy)
• doing surgery to remove some or all of the abnormal tissue.

There are different types of lung cancer, and they are treated differently. The most common types are named for how the lung cancer cells look under a microscope. The types are:

• non-small cell lung cancer
• small cell lung cancer

Small cell lung cancer tends to spread quickly. Most lung cancers are non-small cell lung cancer. They spread more slowly than small cell lung cancer.

How is it treated?

Treatment depends on the type, size, and stage of the cancer and your own general health.

Surgery is the single best way to cure lung cancer. It is the usual treatment if you have a single tumor and the cancer is non-small cell lung cancer with little or no spread to nearby tissues. A part of one lung or a whole lung may need to be removed. Chemotherapy with or without radiation therapy may be recommended before surgery. Chemotherapy uses anticancer drugs to kill cancer cells. Unless the cancer is very small, chemotherapy for about 2 months may be recommended after surgery.

In some cases, if surgery is not possible, and the tumor has not spread beyond the chest, chemotherapy and radiation therapy may be recommended to kill cancer cells in the lungs. If the cancer has spread outside the lung to the bones or brain, radiation therapy may be needed for those areas. If the cancer has spread to other parts of the body, chemotherapy alone or biologic (“targeted”) therapy is used.

If you have small cell lung cancer, you may have chemotherapy with or without radiation.

When lung cancer spreads to the outer lining of a lung, fluid may build up in the chest outside the lung and make it hard for the lung to take in air. The fluid can be removed with a needle so you can breathe more easily (a procedure called thoracentesis).

What are the chances of a cure?

Almost 1 of every 6 cases of lung cancer is cured with treatment, usually with surgery.

How can I take care of myself?

Follow your healthcare provider's recommended treatment and keep all of your follow-up appointments. To help take care of yourself during your treatment and recovery, follow these guidelines:

• Ask your healthcare provider if there is a clinical trial available for your condition.
• Don’t smoke, and stay away from others who are smoking.
• Exercise according to your healthcare provider's recommendations.
• Eat regular, healthy meals, as recommended by your provider or dietitian.
• Get plenty of rest.
• Drink lots of liquids to keep the mucus in your lung secretions thin.
• Spend time with people you can talk to comfortably. Ask for help at home or work when the load is too great to handle.
• Lower your stress in ways that work for you, such as taking part in hobbies and fun activities, listening to music, or doing relaxation and deep breathing exercises.
• Talk with your healthcare provider or a mental health professional about the things that make you anxious. Ask for help in finding ways to cope with these things.

Call your healthcare provider if any symptoms come back. Your provider will tell you what new signs and symptoms to watch for and when to call or make an appointment.

How can I help prevent lung cancer?

Not all of the causes of lung cancer are known, but there are some things you can do to help lower the risk of some of the more common kinds of lung cancer:

• Don’t smoke, and stay away from other people's smoke. Smokers who quit smoking start lowering their risk of lung cancer right away.
• Stay away from environmental hazards, such as radon and asbestos. Also stay away from severe air pollution if you can. Use protective equipment at work when it is recommended.

For more information on cancer, contact national and local organizations such as:

• American Cancer Society, Inc.
  Phone: 800-ACS-2345 (800-227-2345)
  Web site: http://www.cancer.org
• Cancer Information Service
  Phone: 800-4-CANCER (800-422-6237)
  Web site: http://www.cancer.gov/aboutnci/cis