About Lung Cancer

What is Lung Cancer?

 

Lung cancer develops when a group of cells in the lungs begin to divide and grow uncontrollably. Uncontrolled cell growth is dangerous because it can form clumps that can block the lungs, cause the lungs to fill with fluid, or even cause the lungs to collapse. Cancerous clumps of cells can also spread to other parts of the body, thereby causing blockages and upsetting the chemical balances in the body.

There are two predominant types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Carcinoid is a third, rare type of lung cancer.

  • Small cell lung cancer (SCLC) – About 15%-20% of lung cancers are considered small cell lung cancer (SCLC). It is a faster-growing, more-invasive type of cancer that tends to cause larger tumors. It usually starts in the bronchi, the tubes that carry air throughout the lungs. SCLC is nearly always linked to cigarette smoking. There are two types of SCLC, including small cell carcinoma and combined small cell carcinoma, also known as small cell/large cell lung cancer.

  • Non-small cell lung cancer (NSCLC) – Non-small cell lung cancer (SCLC) makes up the other 80% of lung cancers and is slower and less invasive. There are three types of NSCLC, including adenocarcinoma, which is often found in the outer regions of the lungs, squamous cell carcinoma, which is often found in the center of the lung near the bronchi, and large cell carcinoma, which can be found in any area of the lung.

 

Lung cancer is the number-one cause of cancer-related deaths in the United States and the second most common form of cancer in the world (skin cancer is the first). Smoking is the biggest risk factor for lung cancer—smoking is responsible for about 90% of cases—although other environmental conditions such as pollution and radiation can cause cancer as well. See below[LJ1]  for more information about lung cancer causes.

Some smokers never develop cancer. However, studies show that men and women who smoke are about 13%-23% more likely to develop cancer than those who have never smoked.

Additional facts about lung cancer:

  • Smoking causes small cell lung cancer and non-small cell lung cancer and contributes to 80% of lung cancer deaths among women and 90% of lung cancer deaths among men.

  • The age-adjusted death rate for lung cancer is higher for men than it is for women. The death rate for men is 46.7 per 100,000 persons, while for women, it’s 31.9 per 100,000.

  • Lung cancer is more prevalent among older populations. In 2015, 86% of individuals living with lung cancer were 60-years old or older.

  • The age-adjusted lung cancer incidence rate among black men is roughly 30% higher than it is for white men, even though black men’s exposure to cigarette smoke is lower. Black men and women are more likely than those of any other racial or ethnic group to develop and die from lung cancer.

  • Lung cancer’s five-year survival rate is 56% when the lung cancer is still localized to the lungs. When lung cancer has spread to other organs, the five-year survival rate is only 5%. More than 50% of lung cancer patients die within one year of their diagnosis.

  • Early detection of lung cancer by low-dose CT screening may decrease lung cancer fatalities by 20% among high-risk populations.

  • Nonsmokers exposed to secondhand smoke have a 20% to 30% greater chance of developing lung cancer.

  • Radon exposure is estimated to be the second leading cause of lung cancer, and can also be caused by occupational exposures, such as asbestos and uranium.

 

Do you think that you might be at risk for lung cancer? State-of-the-art treatments such as those offered at The START Center for Cancer Care are helping to detect and treat lung cancer more effectively. For more details on cutting-edge treatments visit The START Center services page or keep reading to the section on this page about treatments specifically for lung cancer.

Additional resources:

Anatomical description of the lungs

What Causes Lung Cancer?

 

Lung cancer is caused by breathing in small toxic particles. A carcinogen is anything that causes cancer. There are many kinds of carcinogens. Some carcinogens occur naturally (such as radon or arsenic), while others are man-made (such as asbestos or tar). Carcinogens cause cancer by penetrating your body’s cells, where they might induce the following effects:

  • Damaging DNA, which controls the way cells replicate and divide. Damaged DNA can cause cells to divide uncontrollably

  • Damaging the body’s natural DNA repair systems (the DNA doesn’t get fixed, as a result)

  • Damaging the body’s system for cleaning out toxins (so they build up over time)

  • Causing inflammation, which is the body’s response to injury. Inflammation can sometimes be good and is how your body protects itself. At other times, the body doesn’t calm down afterwards, which can cause DNA damage that leads to cancer.

 

How does smoking cause these reactions in your body? Cigarette smoke contains 60 well-established carcinogens, which is why up to 90% of cases of lung cancer are due to smoking.

Additional resources:

A list of carcinogens in tobacco smoke

How do I know if I Have Lung Cancer?

 

Lung cancer can be hard to detect in its earlier stages, unfortunately, because symptoms don’t often appear until the cancer has advanced. If you’re a high-risk patient, your doctor might recommend regular lung cancer screening using a low-dose CT scan. In between screenings, it’s important to watch for symptoms of the disease. Some symptoms of lung cancer include:

  • Persistent cough, especially one that worsens over time

  • Constant chest pain

  • Coughing up blood or reddish mucus

  • Shortness, wheeziness, or hoarseness of breath

  • Recurring pneumonia and bronchitis

  • Face and neck swelling

  • Loss of appetite

  • Trouble swallowing

  • Weight loss

  • Fatigue

 

Keep in mind that other problems besides lung cancer could cause the above symptoms. A doctor can review your symptoms with you and help you determine options for testing. Some of the tests that might be used include:

  • Imaging tests: Imaging tests, such as a CT scan or X-ray, may be used to detect abnormal cell growth.

  • Biopsy: A tissue sample may be taken to test for cancerous cells.

  • Sputum cytology: Your sputum, or mucus, may be examined to see if lung cancer cells are present.

 

If you are diagnosed with lung cancer, the next step will be pinpointing the stage of your cancer, or how far it’s advanced. Various tests, or a combination of tests, can be used to stage your cancer, such as MRI, PET, and CT scans. In stage I, the cancer has not spread outside of the lung, while by stage IV, the cancer has spread to both lungs and to distant organs.

If you have any symptoms or if you believe you are high-risk for lung cancer, see a doctor for screening options, diagnosis, and treatment. Use this online form to request an appointment at The START Center.

What Is the Best Way to Treat Lung Cancer?

 

Treatment will vary from person to person, depending on your type and stage of lung cancer and other factors, such as your medical history. Your medical team – which will likely include a lung specialist, medical oncologist, radiation oncologist, and surgeon – will discuss the best treatment options for you.

Here are some of the leading treatments for lung cancer, which are available at The START Center for Cancer Care:

  • Surgery –START surgeons have extensive experience with lung cancer procedures such as:

    • Wedge/segment removal – extracting a small part of the lung

    • Segmental resection surgery – removing a section of the lobe of the lung

    • Lobectomy – the removal of one of the lobes of the lung

    • Pneumonectomy – the removal of an entire lung

 

  • Anti-cancer drugs – Most lung cancer treatments involve taking prescription medication. The START Center for Cancer Care provides comprehensive on-site pharmacy services, including medication pick-up, counseling, financial aid, prior authorization processing for insurance claims, and home delivery.

 

The START Center Oncologists are leaders in international cancer research and conduct the world’s largest oncology program in Phase I clinical trials for anti-cancer medications. (Phase I trials consist of the first round of research trials for new drugs with a select group of participants.)   The researchers at START have access to the very latest promising new anti-cancer medications. If you’d like to learn more make sure to talk with your doctor to see if this is something they believe makes sense for you.

 

Generally, a patient uses a combination of different medications, including the following:

 

  • Chemotherapy – Chemotherapy drugs target quickly dividing cells (like cancer cells) and destroy them. This therapy is particularly useful when treating cancer in later stages because it can kill cancer cells throughout the whole body. More than half of cancer treatments involve some degree of chemotherapy to completely remove the cancer or to slow symptoms. You might have heard of chemotherapy side effects such as hair loss, nausea, or damage to the skin and or bones. These side effects occur because the tissue in your hair, intestines, skin, and bones are all fast-growing cells and thus might potentially be attacked by chemotherapy drugs.

  • Targeted therapy – Targeted drug therapy is a type of chemotherapy designed to specifically attack a cancer cell itself or other molecules that help cancer cells grow. In some cases, targeted therapies cause fewer side effects than other treatments because they are better at addressing cancer cells and leaving healthy cells alone.

Genetic testing – Like each person’s unique characteristics, cancer manifests itself differently. Thus, cancer treatment should also be personalized for a patient’s individual diagnosis. And since time is precious, it is critical to gain access to the most effective drug early on in the treatment process. The START Center for Cancer Care is the first provider in South Texas to offer genetic testing of tumors to help obtain the most effective medication as fast as possible.​

 

What is genetic testing? Each of your cells, including cancerous cells, contain a copy of your DNA. By sequencing the DNA found in a cancerous growth, the START cancer specialists can implement a series of tests and genetic markers to identify which anti-cancer drugs are most likely to be effective, saving weeks to months of treatment and unnecessary side effects. You can also be tested to detect hereditary diseases. Use our online form to request an appointment.

Radiation – Hitting cancer cells with high-energy particles can damage a cancer cell’s DNA, which can prevent the cancer from replicating and growing. For lung cancer cases, radiation is generally only used when a patient is too sick for surgery. It is also usually prescribed to relieve symptoms but not as a cure.  

 

The type of lung cancer determines the type of treatment a doctor recommends. For example:

  • Small cell lung cancer (SCLC) – Surgery is usually less effective for SCLC and tends to be used only in the earliest stages of SCLC development. Instead, chemotherapy and radiation are the typical treatment options for SCLC cases.

  • Non-small cell lung cancer (NSCLC) – Surgery is usually the first line of treatment for NSCLC. Chemotherapy and radiation might be added at later stages.

Additional resources:

Further explanation of the lymphatic system

Anatomical description of the lungs

Treatment for SCLC at various stages

Treatment for NSCLC at various stages

Chemotherapy

Targeted therapy

What Puts Me at Risk for Lung Cancer?

 

The risk factors for lung cancer include a mix of lifestyle, environmental, and genetic factors.

Lifestyle/Environmental risk factors

  • Smoking ­– Smoking accounts for nine of 10 cases of lung cancer in men and eight of 10 cases in women. The more cigarettes you smoke and the longer you have been smoking, the higher risk you have of developing cancer. Low tar and low nicotine cigarettes have not been found to reduce the risk of developing cancer.

  • Environmental pollutants – Small particles from gasoline, diesel exhaust, paints, preservatives, asbestos, tar, secondhand smoke, and many other sources are carcinogenic and can lead to cancer.

  • Radiation exposure – Common sources of radiation exposure include imaging tests, radiation therapy, atomic explosions, and exposure to metals such as radon and arsenic. Radiation can damage cell DNA and repair mechanisms, leading to cancer. Radon exposure causes 26% of all lung-cancer-related deaths.

 

Genetic risk factors

While lung cancer appears to be primarily related to environmental factors, such as smoking and radon exposure, there is evidence that genetics may play a role in the risk of developing lung cancer.  According to the American Cancer Society, for example, individuals who inherit certain DNA changes in chromosome 6 may be more likely to develop lung cancer, whether or not they smoke. Another study estimates that 8% of lung cancer cases are the result of a genetic predisposition for lung cancer.

Talk to your doctor about your family’s medical history to determine if screening for lung cancer may be recommended.

How Can I Prevent Lung Cancer?

 

Several lifestyle changes can decrease your likelihood of getting lung cancer:

  • Stop smoking – The longer you smoke, the higher your risk of lung cancer. However, if you do stop smoking, you can reduce your risk of lung cancer by 30-60% after 10 years.  Remember that low tar or low nicotine cigarettes have been shown to cause cancer at the same rate as standard cigarettes.

 

Smoking can be a difficult habit to give up, but it can be done with help. Need help to stop smoking? Here are some resources:

 

        Help! I Want to Stop Smoking!

        Quitting Smoking: Help for Cravings and Tough Situations

 

  • Avoid radiation as much as possible—Radiation can be absorbed through X-rays in clinics or at the airport, from certain metals, in laboratories, and at sites of atomic explosions.

  • Avoid spending time in polluted areas as much as possible – These areas include construction zones, rooms with fresh paint, laboratories, busy cities, or other locations where lots of small particles might be floating around.

How to Prepare for Your Appointment

 

Make an appointment with your family doctor if your symptoms aren’t concerning or causing problems in your daily life. They will refer you to a specialist if they suspect you might have lung cancer.

 

Since this can be a scary and overwhelming experience, you must prepare in advance so you know what you should do before the appointment and don’t forget to ask specific questions:

 

  • Write down all the questions you have for the doctor. There are no bad questions. Anything you may be thinking about or curious about is worth asking.

  • Make a list of the medications you’re taking. That includes supplements and vitamins.

  • Write all symptoms you’ve been experiencing, even if they seem irrelevant or unrelated to lung cancer.

  • When you schedule the appointment, ask if there’s anything you should do to prepare, such as fasting or avoiding certain activities.

  • Include a detailed list of recent changes, such as stressors or major life changes like moving into a new home.

  • Ask your family about their medical history. Make a note if anyone had lung cancer.

  • Find someone to go to the appointment with you, even if they are only on Facetime or Zoom. You should not be alone during this difficult time in your life.

Contact Us

At The START Center for Cancer Care, we have more than 35 years of experience providing advanced treatment for prostate cancer patients. Our dedicated staff will assist you in choosing the best options and give you hope for the future. We know cancer is scary. You can depend on us to educate you on the process, provide compassionate support, and work hard to meet your expectations. To find out more about the services we offer, call us at (210) 593-5700 or fill out our online form.

References

 

Centers for Disease Control and Prevention (US); National Center for Chronic Disease Prevention and Health Promotion (US); Office on Smoking and Health (US). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2010. 5, Cancer. Available from: https://www.ncbi.nlm.nih.gov/books/NBK53010/.

Davis, C. P. (2018, June 29). Non-Small Cell Lung Cancer vs. Small Cell Lung Cancer Prognosis. Retrieved from https://www.medicinenet.com/non-small_cell_lung_cancer_vs_small_cell/article.htm.

How does smoking cause cancer? (2019, May 8). Retrieved from https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/how-does-smoking-cause-cancer.

How Tobacco Causes Cancer: Dana-Farber Cancer Institute. (2019, June 28). Retrieved from https://blog.dana-farber.org/insight/2016/12/how-does-cigarette-smoke-cause-lung-cancer/.

Kanwal, Madiha, Ding, Xiao-Ji, and Cao, Yi, Familial risk for lung cancer, Oncology Letters, 2017 Feb; 13(2): 535–542. Published online 2016 Dec 20. doi: 10.3892/ol.2016.5518. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5351216/#:~:text=Approximately%208%25%20of%20lung%20cancers,of%20genetic%20recombination%20(83).

Kovalchik, Stephanie A., Ph.D., Tammemagi, Martin, Ph.D., Berg, Christine D., M.D., Caporaso, Neil E., M.D., Riley, Tom L., B.Sc., Korch, Mary, M.Sc., Silvestri, Gerard A., M.D., Chaturvedi, Anil K., Ph.D., and Katki, Hormuzd A., Ph.D., Targeting of Low-Dose CT Screening According to the Risk of Lung-Cancer Death. N Engl J Med. 2013 Jul 18; 369(3): 245–254. doi: 10.1056/NEJMoa1301851. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783654/

Lung Cancer Fact Sheet, American Lung Association. Available at https://www.lung.org/lung-health-diseases/lung-disease-lookup/lung-cancer/resource-library/lung-cancer-fact-sheet.

Lung Cancer - Non-Small Cell - Symptoms and Signs. (2019, March 7). Retrieved from https://www.cancer.net/cancer-types/lung-cancer-non-small-cell/symptoms-and-signs.

Lung Cancer Prevention (PDQ®)–Patient Version. (2019, June 19). Retrieved from https://www.cancer.gov/types/lung/patient/lung-prevention-pdq#section/all.

Lung Cancer | Lung Cancer Symptoms. (2019, October 25). Retrieved from https://medlineplus.gov/lungcancer.html.

PDQ® Screening and Prevention Editorial Board. PDQ Lung Cancer Prevention. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/lung/patient/lung-prevention-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389497]

Small Cell Lung Cancer Treatment (PDQ®)–Patient Version. (2019, October 16). Retrieved from https://www.cancer.gov/types/lung/patient/small-cell-lung-treatment-pdq#_112.

U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke A Report of the Surgeon General. 2006. Available at https://www.ncbi.nlm.nih.gov/books/NBK44324/

U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. 2004. Available at https://pubmed.ncbi.nlm.nih.gov/20669512/

U.S. Environmental Protection Agency. Radon.  Retrieved from: https://www.epa.gov/radon.

What Causes Lung Cancer? Retrieved from https://www.cancer.org/cancer/lung-cancer/causes-risks-prevention/what-causes.html.