What is Lung Cancer?
More than 90,000 men and 79,000 women are diagnosed each year with cancer of the lungs and bronchi (the air tubes leading to the lungs). Lung cancer is presumably developed over a period of many years. There are two major types of lung cancer:
- Non-small Cell Lung Cancer: This type is the most common. It is usually associated with a history of smoking. Although it is the most common type, it is the less aggressive form of lung cancer.
- Small Cell Lung Cancer: Previously called "oat cell lung cancer", this type of cancer accounts for approximately 20 percent of lung cancers and is also sometimes associated with a history of smoking. Although this type of cancer occurs less frequently, it grows and spreads to other organs faster.
The American Cancer Society reports that:
- Lung cancer is the leading cause of cancer deaths in America.
- More people die of lung cancer than of colon, breast, and prostate cancers combined.
- The average age of people diagnosed with lung cancer is 70.
- Fewer than 3 percent of all cases are found in people under age 45.
Risk Factors
- Tobacco use: Lung cancer is usually generated by tobacco use - cigarette, pipe or cigar smoking. The best prevention of lung cancer is to quit smoking or never start.
- Environmental exposure: People with long-term exposure to second-hand smoke, asbestos, or radon may be more vulnerable to lung cancer.
- Lung diseases: Those with recurring inflammation in the lungs may be more inclined to developing lung cancer. Lung cancer tends to develop in areas of the lung that are scarred from tuberculosis (TB) and some types of pneumonia.
Common Symptoms
The earliest stages of lung cancer are most often not felt; however, as the disease progresses, symptoms begin to emerge.
Some of the most common warning signs include:
- Persistent cough that gets worse over time
- Coughing up blood
- Pain in the chest cavity or ribs
- Shortness of breath
- Wheezing or hoarseness
- Repeat bouts of pneumonia or bronchitis
- Bloody or rust-colored sputum or phlegm
- Fatigue
- Loss of appetite and/or weight loss
Screening and Diagnosis
Lung cancer is difficult to detect early because symptoms usually do not appear until the disease is advanced. Therefore, physical exams are essential for early detection and successful treatment. A doctor will conduct an exam if a patient is suspicious of lung cancer. Personal medical history, family history, tobacco use, exposure to environmental dangers, and potential symptoms will be reviewed during the examination. One or more of the following medical tests will additionally be received:
- Chest x-ray
- Computed Tomography (CT) scan (see description below)
- Sputum cytology: Phlegm (spit) cells are reviewed under a microscope.
- Needle biopsy: A surgical lung biopsy is performed under general anesthesia. A tissue sample is collected through a small incision in the chest and then sent to a pathologist for further study.
- Bronchoscopy: This is administered under local anesthetic. During the short outpatient procedure, a pulmonologist inserts a flexible tube into the lungs through the nose or mouth. A tiny camera at the end of the tube allows doctors to see into the lungs and collect a tissue sample.
Staging of Lung Cancer
Doctors conduct additional tests to stage the cancer if a diagnosis is made. They will also determine if the cancer has spread and how far. Staging helps doctors develop an appropriate treatment plan. Some of the most typical tests used to stage lung cancer include:
- Computed Tomography (CT) scan: A computer linked to an x-ray machine creates a series of detailed pictures of areas inside the body.
- Positron Emission Tomography (PET scan): PET is a powerful imaging technique that provides unique information about the body's chemistry, cell function and exact location of disease. It often detects cancerous cells at the molecular level and at the very early stages better than other diagnostic technologies.
- Magnetic Resonance Imaging (MRI): MRI uses radio waves and magnetic fields to obtain superbly detailed anatomical images of the body.
- Bone scan: This is usually used in patients with non-small cell lung cancer when doctors suspect the cancer has spread to the bones.
Common Treatment Options
Depending on the type and stage of the disease, lung cancer can be treated with surgery, chemotherapy, radiation therapy, or a combination of these treatments. The intent of treatment is to preserve healthy tissue while demolishing the tumor at its point of origin, as well as destroying any cancer cells that have invaded the rest of the body.
- Early-stage lung cancer: A widely used surgical procedure called lobectomy is often recommended for patients with early-stage lung cancer. Performed under general anesthesia, a thoracic surgeon removes all or part of the affected lung. If cancer is present in the nearby lymph nodes, they are removed as well.
- Middle-stage lung cancer: Treatment for patients with middle-stage lung cancer may involve surgery, chemotherapy, and radiation (radiotherapy)-either individually or in combination. Chemotherapy shrinks the tumor before surgery. Radiation may be administered after the tumor is removed to eliminate the last traces of disease.
- Late-stage lung cancer: Although surgery is not recommended for patients with late-stage lung cancer, chemotherapy and radiation are frequently used. The goal is to enhance quality of life, and minimize pain and discomfort.
