Lung Cancer
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Definition
Lung cancer is a disease in which cancer cells grow in the lungs. There are two types of lung cancers:

  • Non-small cell lung cancer—generally grows and spreads more slowly (more common form)
  • Small cell lung cancer—generally grows more quickly and is more likely to spread to other parts of the body
Lung cancer is the leading cause of cancer deaths in the United States for both men and women.

Lung Cancer

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Causes
Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.

The following can cause damage to the cells in the lungs, leading to lung cancer:

  • First- or second-hand smoke from cigarettes, cigars, or pipes
  • Exposure to asbestos (a type of mineral) or radon (radioactive gas)
Risk Factors
Factors that may increase your chance of lung cancer include:

  • Smoking
  • Using chewing tobacco
  • Being exposed to second-hand smoke
  • Being exposed to asbestos or radon
  • Having a lung disease, such as tuberculosis
  • Having a family or personal history of lung cancer
  • Being exposed to certain air pollutants
  • Being exposed to coal dust
  • Radiation therapy that was used to treat other cancers
  • HIV infection
Symptoms
Symptoms may include:

  • A cough that doesn't go away and worsens over time
  • Constant chest pain
  • Coughing up blood
  • Shortness of breath, wheezing, or hoarseness
  • Repeated problems with pneumonia or bronchitis
  • Swelling of the neck and face
  • Loss of appetite or weight loss
  • Fatigue
Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will also ask about:

  • Smoking history
  • Substances that you have been exposed to
  • Family history of cancer
Tests may include:

  • Sputum cytology—a test that examines of a sample of mucus from the lungs
  • Biopsy —removal of a sample of lung tissue to be tested for cancer cells.
Imaging tests evaluate the lungs and other structures. These may include:

The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, lung cancer is staged from I-IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.

Treatment
The goal of treatment is to eliminate the cancer and/or control the symptoms.

Surgery
Surgery involves removing the tumor and nearby tissue. Lymph nodes may also need to be removed. The type of surgery depends on the location of the tumor, such as:

  • Segmental or wedge resection—removal of only a small part of the lung
  • Lobectomy —removal of an entire lobe of the lung
  • Pneumonectomy—removal of an entire lung
Radiation Therapy
Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. This may also be used to relieve symptoms, such as shortness of breath. External radiation is usually used to treat lung cancer. With this treatment, radiation is directed at the tumor from a source outside of the body.

Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. This may be given in many forms, including pill, injection, and via a catheter. Chemotherapy is often used to kill lung cancer cells that have spread to other parts of the body.

Newer Treatments
Researchers continue to study ways to treat lung cancer. The National Cancer Institute considers these potential therapies:

  • Photodynamic therapy (PDT)—A type of laser therapy. A chemical is injected into the bloodstream. It is then absorbed by the cells of the body. The chemical rapidly leaves normal cells. It will remain in cancer cells for a longer time. A laser aimed at the cancer activates the chemical. This chemical then kills the cancer cells that have absorbed it. This treatment may also be used to reduce symptoms.
  • Cryosurgery—A treatment that freezes and destroys cancer tissue.
Other treatments that are being researched include:

  • Targeted therapy—involves using medications or substances to target certain molecules in the cancer cells
  • Immunotherapy—involves using medications or substances made by the body to increase or restore the body's natural defenses against cancer
Prevention
To help reduce your chance of getting lung cancer:

  • Do not start smoking. If you smoke, talk to your doctor about how to successfully quit .
  • Avoid places where people are smoking.
  • Test your home for radon gases and asbestos. Have these substances removed if they are in the home.
  • Try to avoid or limit occupational exposures, such as working with asbestos.
The American Lung Association and American Cancer Society both suggest that screening for lung cancer with a type of CT scan may be considered if you are a smoker (or former smoker), aged 55-74 years, and have a history of heavy smoking (such as one pack a day for 30 years).




RESOURCES:
American Cancer Society

American Lung Association

CANADIAN RESOURCES:
Canadian Cancer Society

The Canadian Lung Association

References:
Cancer immunotherapy. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003013-pdf.pdf. Accessed August 15, 2014.

Lung cancer (non-small cell) American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003115-pdf.pdf. Updated August 15, 2014.

Lung cancer CT screening: is it right for me? American Lung Association website. Available at: http://www.lung.org/lung-disease/lung-cancer/lung-cancer-screening-guidelines/lung-cancer-screening-for-patients.pdf. Accessed August 15, 2014.

Munden RF, Swisher SS, Stevens CW, Stewart DJ. Imaging of the patient with non-small cell lung cancer. Radiology. 2005;237(3).:803.

Non-small cell lung cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 30, 2014. Accessed August 15, 2014.

Non-small cell lung cancer treatment. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/non-small-cell-lung/patient. Updated June 30, 2014. Accessed August 15, 2014..

Targeted cancer therapies. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Therapy/targeted. Updated April 25, 2014. Accessed August 15, 2014.

11/12/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: National Cancer Institute. Lung cancer trial results show mortality benefit with low-dose CT. National Cancer Institute website. Available at: http://www.cancer.gov/newscenter/pressreleases/NLSTresultsRelease. Accessed August 15, 2014.

Last Reviewed August 2014



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