Lung Cancer Information - Lung cancer symptoms, diagnosis & treatment

Lung cancer is the leading cause of cancer related deaths for both men and women in the United States. More people die from lung cancer than breast, colon and prostate cancer combined. The good news is that lung cancer is one of the most preventable cancers.

Early diagnosis and treatment can make a difference in increasing length of life after diagnosis. Treatment of lung cancer depends on the health of the patient, type of lung cancer, and how advanced the lung cancer is.

Lung cancer forms in tissues of the lung, usually in the cells lining air passages. The two main types are small cell lung cancer and non-small cell lung cancer. These types are diagnosed based on how the cells look under a microscope.

Understanding Lung Cancer
Cancers that begin in the lungs are divided into two major types, non-small cell lung cancer and small cell lung cancer, depending on how the cells look under a microscope. Each type of lung cancer grows and spreads in different ways and is treated differently.  Non-small cell lung cancer is more common than small cell lung cancer, and it generally grows and spreads more slowly.

There are three main types of non-small cell lung cancer. They are named for the type of cells in which the cancer develops: squamous cell carcinoma (also called epidermoid carcinoma), adenocarcinoma, and large cell carcinoma.

Small cell lung cancer, sometimes called oat cell cancer, is less common than non-small cell lung cancer. This type of lung cancer grows more quickly and is more likely to spread to other organs in the body.

Lung Cancer: Who's at Risk?
Researchers have discovered several causes of lung cancer -- most are related to the use of tobacco.

Cigarettes: Smoking cigarettes causes lung cancer. Harmful substances, called carcinogens, in tobacco damage the cells in the lungs. Over time, the damaged cells may become cancerous. The likelihood that a smoker will develop lung cancer is affected by the age at which smoking began, how long the person has smoked, the number of cigarettes smoked per day, and how deeply the smoker inhales. Stopping smoking greatly reduces a person's risk for developing lung cancer.

Cigars and Pipes: Cigar and pipe smokers have a higher risk of lung cancer than nonsmokers. The number of years a person smokes, the number of pipes or cigars smoked per day, and how deeply the person inhales all affect the risk of developing lung cancer. Even cigar and pipe smokers who do not inhale are at increased risk for lung, mouth, and other types of cancer.

Environmental Tobacco Smoke: The chance of developing lung cancer is increased by exposure to environmental tobacco smoke (ETS), the smoke in the air when someone else smokes. Exposure to ETS, or secondhand smoke, is called involuntary or passive smoking.

Radon: Radon is an invisible, odorless, and tasteless radioactive gas that occurs naturally in soil and rocks. It can cause damage to the lungs that may lead to lung cancer. People who work in mines may be exposed to radon and, in some parts of the country, radon is found in houses. Smoking increases the risk of lung cancer even more for those already at risk because of exposure to radon. A kit available at most hardware stores allows homeowners to measure radon levels in their homes. The home radon test is relatively easy to use and inexpensive. Once a radon problem is corrected, the hazard is gone for good.

Asbestos: Asbestos is the name of a group of minerals that occur naturally as fibers and are used in certain industries. Asbestos fibers tend to break easily into particles that can float in the air and stick to clothes. When the particles are inhaled, they can lodge in the lungs, damaging cells and increasing the risk for lung cancer.

Studies have shown that workers who have been exposed to large amounts of asbestos have a risk of developing lung cancer that is 3 to 4 times greater than that for workers who have not been exposed to asbestos. This exposure has been observed in such industries as shipbuilding, asbestos mining and manufacturing, insulation work, and brake repair. The risk of lung cancer is even higher among asbestos workers who also smoke. Asbestos workers should use the protective equipment provided by their employers and follow recommended work practices and safety procedures.

Pollution: Researchers have found a link between lung cancer and exposure to certain air pollutants, such as by-products of the combustion of diesel and other fossil fuels. However, this relationship has not been clearly defined, and more research is being done.

Lung Diseases: Certain lung diseases, such as tuberculosis (TB), increase a person's chance of developing lung cancer. Lung cancer tends to develop in areas of the lung that are scarred from TB.

Personal History: A person who has had lung cancer once is more likely to develop a second lung cancer compared with a person who has never had lung cancer. Quitting smoking after lung cancer is diagnosed may prevent the development of a second lung cancer.

Diagnosing Lung Cancer
To help find the cause of symptoms, the doctor evaluates a person's medical history, smoking history, exposure to environmental and occupational substances, and family history of cancer. The doctor also performs a physical exam and may order a chest x-ray and other tests.

If lung cancer is suspected, sputum cytology (the microscopic examination of cells obtained from a deep-cough sample of mucus in the lungs) is a simple test that may be useful in detecting lung cancer. To confirm the presence of lung cancer, the doctor must examine tissue from the lung. A biopsy is the removal of a small sample of tissue for examination under a microscope by a pathologist. A biopsy can show whether a person has cancer. A number of procedures may be used to obtain this tissue:

Bronchoscopy: The doctor puts a bronchoscope (a thin, lighted tube) into the mouth or nose and down through the windpipe to look into the breathing passages. Through this tube, the doctor can collect cells or small samples of tissue.

Needle Aspiration: A needle is inserted through the chest into the tumor to remove a sample of tissue.

Thoracentisis: Using a needle, the doctor removes a sample of the fluid that surrounds the lungs to check for cancer cells.

Thoracotomy: Surgery to open the chest is sometimes needed to diagnose lung cancer. This procedure is a major operation performed in a hospital.

Treatment Options For Lung Cancer

Lung cancer treatments are based on the type and stage of the lung cancer, and the overall health of the patient.

Non-small cell lung cancers include adenocarcinoma, large cell carcinoma, and squamous cell carcinoma. All of these non-small cell carcinomas are usually treated with the same therapies. The most common type of lung cancer is adenocarcinoma and it is typically located on the outer surface of the lungs and may spread to the lymph glands, into the bloodstream and to other organs. Squamous cell carcinoma is usually found in the lining of the large air passages (large bronchi) or the periphery of the lungs. Large cell carcinoma typically occurs in the periphery of the lungs.

Stages of Non-small cell lung cancers

Stage 0 - Lung cancer in this stage is confined to the surface of the bronchus (called carcinoma in situ) and can be treated with surgery. Another treatment is to treat the affected area with a laser to kill cancer cells, called photodynamic therapy.

Stages 1 and 2 - Treatment options for lung cancer in these stages is usually surgery if possible. If surgery is not an option, then radition with or without chemo is recommended.

Stages 3A and 3B - Lung cancer patients with Stage 3A disease are usually treated with surgery with or without chemotherapy prior to the surgery. If the tumor can not be operated on, radiation of the chest and chemotherapy are usually the treatments. Stage 3B tumors are not candidates for surgery.

Stage 4 - Most of the treatment for Stage 4 lung cancer is chemotherapy. Radiation therapy may be an option to any small areas that cause pain. Lung cancer at this stage are not operable.

Small Cell Lung Cancers typically develop in the center of the lungs. It often spreads aggressively and occurs almost only in smokers. The treatments used for small cell lung cancer depends on the stage of the cancer. Usually, surgery is not an option unless in the very early stages.

Limited Stage - This stage typically requires treatments of both radiation and chemotherapy.  Sometimes radiation of the brain is required to prevent the cancer from spreading into the brain.

Extensive Stage - The most common form of treatment is chemotherapy. Some radiation can be given to small areas of pain, but not the chest.