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Lung Cancer

 

What is Lung Cancer?

Lung cancer is a disease caused by uncontrolled cell division in your lungs. It is generally described as small cell or non-small cell type. The risk for lung cancer increases by the amount someone smokes and how many years they have smoked.

Non-small cell lung cancer is the most common type of lung cancer and almost always occurs in those who smoke or have smoked in the past. Small cell lung cancer grows more quickly and is harder to treat than non-small cell lung cancer. Small cell lung cancer is often found as a small lung tumor that has already spread to other parts of the body.

Stages of Lung Cancer

Early diagnosis is important for treatment of lung cancer. Cancer is typically staged based on the size of the tumor, how far deep into the surrounding tissue it goes, and whether it has spread to other parts of the body. The general staging for lung cancer includes:

  • Stage I – the cancer is confined to one part of the lung and has not spread to any other parts of the body.
  • Stage II – the cancer is in one lung and lymph nodes in the same lobe of the lung.
  • Stage III – the cancer has spread to lymph nodes along the same side of the chest as the cancer or has spread to the lymph nodes on the opposite side of the chest of the cancer.
  • Stage IV – the cancer is found in the other lung and/or other organs within your body and lymph nodes beyond your lungs.

Once your cancer has been identified at a certain stage, it may be described as either limited or extensive range. This will be based on whether the area can be treated with a single radiation field:

  • Limited range – confined to one lung and can sometimes be in the lymph nodes in the middle of the chest or above the collar bone on the same side.
  • Extensive range – widespread throughout one lung or has spread to the other lung, lymph nodes on the opposite side of the lung, or other parts of the body.

Symptoms of Lung Cancer

For most people, they don’t experience symptoms until the disease is advanced, but some people experience symptoms in the early stages. Cancer can grow in your body for years before you know it is there. For those who notice symptoms, they may experience any of the following:

  • A cough that doesn’t go away or gets worse over time.
  • Trouble breathing or shortness of breath.
  • Chest pain or discomfort.
  • Wheezing
  • Coughing up blood.
  • Hoarseness.
  • Loss of appetite.
  • Unexplained weight loss.
  • Unexplained fatigue.
  • Shoulder pain.
  • Swelling in the face, neck, arms or upper chest.

While a persistent cough or pneumonia that keeps coming back after treatment can be an early sign of lung cancer, it is not automatically thought of that it may be cancer. Depending on what stage and range your lung cancer starts, the first signs you may see include a worsening cough, shortness of breath, chest pain and unexplained weight loss. If you have medical history involving your lungs or have family members who have had lung cancer or disease, paying attention to these signs is important to potentially catch it in the early stages.

Causes and Risk Factors of Lung Cancer

Lung cancer is caused by cells uncontrolled cell division in your lungs. While cell division is normal, all cells have a limit of division that keeps them from dividing into more cells or causes them to die when necessary. The “off switch” is triggered when a cell has divided too many times or has too many changes. Cancer cells lack this “off switch” and do not stop multiplying. These cells interfere with your normal cells and can enter into your bloodstream or lymph nodes or other parts of your body.

Smoking is the leading cause for lung cancer, including vapes, tobacco products, cigarettes, cigars or pipes. It is estimated that 80% of lung cancer deaths are smoking-related. Other risk factors can include:

  • Being exposed to secondhand smoke.
  • Being exposed to harmful pollutants like air pollution, radon, silica, coal products and more.
  • Having previous radiation treatments to your chest.
  • Having a family history of lung cancer.

Diagnosing Lung Cancer

If you experience any of the first signs of lung cancer, it is important to talk to your provider right away, especially if you are at higher risk. Diagnosing lung cancer can be a long and multi-step process. Your provider will perform a physical examination and review your medical history. Since lung cancer symptoms can be similar to those of other common diseases, blood tests and a chest X-ray may be needed to help in the diagnosis.

If you are suspected to have lung cancer, further testing will be needed. A CT scan will be able to show potential tumors in your lungs, especially at earlier stages. It can also help to determine whether the cancer has spread to other parts of your body. A biopsy of the lungs will be able to tell what kind of tumor it is, either malignant or benign. 

Treatment for Lung Cancer

Treatment for lung cancer will vary depending on the stage, how far is has spread and what range your cancer is in. Treatments for lung cancer are designed to help get rid of cancer in your body or slow it down. The most common lung cancer treatments include:

  • Surgery – cancer that has not spread to other parts of the body and is limited to a single tumor can be eligible for surgery. This may involve removing the tumor and a small amount of healthy tissue surrounding it to ensure that no cancerous cells are left behind. Sometimes, a full lung removal, also called a resection, is needed for the best chance preventing the cancer from returning.
  • Radiofrequency ablation – tumors that are near the outer edges of your lungs are sometimes treated with radiofrequency ablation. This procedure uses high-energy radio waves to heat and destroy the cancer cells.
  • Radiation therapy – radiation uses high energy beams to kill the cancer cells. It can be used by itself or after surgery to make it more effective, shrink tumors and relieve pain.
  • Chemotherapy – involves a combination of medications to stop cancer cells from growing. This treatment can be in addition to other treatments like surgery or immunotherapy. This treatment form can be highly effective but can cause side effects.
  • Immunotherapy – Cancer cells have a way of hiding from the immune system to keep from being destroyed. This treatment reveals the cancerous cells to your immune system so your body can fight the cancer. 
  • Targeted drug therapy – for some people, lung cancer cells have specific changes that help the cancer grow, also called mutations. Targeted drug therapy aims to target the mutations to slow down or destroy the cancer cells.

Side Effects of Treatment for Lung Cancer

Lung cancer treatment can come with many side effects that take a physical and emotion toll on the body. Your provider can recommend treatments to help manage the symptoms you experience from treatment, like pain and difficulty breathing. They can advise you on what side effects to expect and what complications to look out for throughout the duration of your treatment. Side effects may vary depending on the kind of treatment you receive:

Chemotherapy

  • Nausea and vomiting.
  • Diarrhea.
  • Hair loss.
  • Fatigue.
  • Mouth sores.
  • Loss of feeling, weakness or tingling.

Immunotherapy

  • Fatigue.
  • Itchy rash.
  • Diarrhea.
  • Nausea and vomiting.
  • Joint pain.

Radiation Therapy

  • Shortness of breath.
  • Cough.
  • Pain.
  • Fatigue.
  • Difficulty swallowing.
  • Dry, itchy and red skin.
  • Nausea and vomiting.

Surgery

  • Shortness of breath.
  • Chest wall pain.
  • Cough.
  • Fatigue.

Palliative care is a specialized form of care that provides symptom relief, comfort and support to people who are undergoing treatments for serious illnesses. Some palliative care lung cancer treatments are used to relieve symptoms and may include therapies to reduce or remove tumors that are blocking airways, remove fluid around your lungs and more.

Your provider can prescribe medications to help with the side effects of treatment, manage your pain and improve quality of life while you are in treatment. 

Preventing Lung Cancer

The biggest thing you can do for yourself to prevent lung cancer is to quit all forms of smoking. Although it is unclear what causes most cancers for certain, there are many preventative measures you can take to reduce your risk:

  • Don’t smoke or quit smoking if you do. You and your provider can work together to find the best methods to help you quit smoking. Your lung cancer risk comes down within five years of quitting smoking.
  • Avoid secondhand smoke or other pollutants.
  • Maintain a healthy diet and weight.
  • Get screened for lung cancer. Screening tests can help you catch cancer in the early stages and increase your chances of a successful outcome. You are eligible for lung cancer screening if:

Outlook for Lung Cancer

The outlook and life expectancy for those with lung cancer greatly depends on the stage you catch your cancer in and how well you respond to treatment. For some with early-stage cancer, removing the tumor and following up with screenings is the common form of treatment and has a high success rate. For others, it is a process of trial and error to determine what treatment is most effective.

Lung cancer can be cured, depending on certain factors. Some types of lung cancer can be considered “cured” if it is diagnosed before it has spread to other parts of the body and the tumor has been removed. This is most often referred to as “remission”. Though you may be in remission, there is always a small chance that the cancer cells can return, so it is important to continue to follow up with your provider in the years following your treatment.

It is important to take care of yourself during your cancer diagnosis and treatment process. A diagnosis of lung cancer is never easy on anyone, so some ways you can take care of yourself while receiving or recovering from treatment include:

  • Surrounding yourself with friends and family. Sometimes bringing a trusted friend or family member to appointments is helpful for support. They can help you keep track of information and options your provider gives you.
  • Plan in advance during your treatment. This may include having meals planned or making sure you have a light social schedule.
  • Drink plenty of fluids, get proper nutrition and get exercise as recommended by your provider.
  • Consider joining support groups to extra support.