Lung Cancer

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General Information About Lung Cancer

Lung Cancer Week

What is Lung Cancer?

Lung cancer is the leading cause of cancer death in the United States; each year approximately 228,000 people are diagnosed with lung cancer, and nearly 160,000 die of the disease. Lung cancer takes more lives than breast, prostate and colon cancers combined, accounting for nearly 30% of all cancer deaths. Only cancers that begin in the lungs are called "lung cancer," but lung cancer cells can spread through the blood stream, invade nearby lymph nodes and metastasize to the brain, bones, liver and other sites.

Risk Factors

Anyone can get lung cancer, including people who never smoked. Those at highest risk are people who currently or used to smoke, people with a family history of lung cancer at any age and people with a family history of any cancer before age 50. Exposure to radon is the second leading cause of lung cancer, and air pollution is also a major cause. Additional risk factors include chronic obstructive pulmonary disease (COPD), prior infection with tuberculosis and exposure to chemicals such as asbestos, Agent Orange, etc. Genetic disposition may also play a role in lung cancer development. Ten to fifteen percent of new lung cancer cases in the U.S., and 25% worldwide, are in people who never smoked. The majority of people who get lung cancer who haven’t smoked are women.

Lung Cancer Screening

Recent guidelines from the US Preventive Services Task Force (USPSTF) recommend annual CT screening for “high-risk” individuals. This includes people 55-79 with a history of heavy smoking—at least “30-pack years,” which includes people who smoked one pack of cigarettes per day for 30 years, or people who smoked two packs a day for 15 years, etc. A recent study showed 20 percent fewer lung cancer deaths among people who received CT scans compared to those who had chest X-rays. However screening CT scans may also detect “false positive” findings, meaning a nodule may be detected that is not a cancer.  Thus, it is important to discuss the risks and benefits of screening with your provider.   

Symptoms

Because the symptoms in patients who present with lung cancer can be caused by many different conditions, it is important for people to see their doctor if they experience any of the symptoms of lung cancer, which include:

  • Blood when you cough or spit
  • Recurring respiratory infections
  • Enduring cough that is new or different
  • Ache or pain in shoulder, back or chest
  • Trouble breathing
  • Hoarseness or wheezing
  • Exhaustion, weakness or loss of appetite
  • Unintentional weight loss

Other symptoms may include swelling in the neck and face or difficulty swallowing.

Treatment

The most common treatments for lung cancer are surgery, radiation therapy and chemotherapy. Surgery is the primary treatment for early stage lung cancers and physically removes the cancer tumor and any lymph nodes that may contain cancerous cells. Radiation therapy (sometimes referred to as radiotherapy, x-ray therapy or irradiation) uses X-rays to damage cancer cells and stop them from growing or multiplying. Chemotherapy drugs are used to kill cancer cells. Unlike surgery and radiation, which are used to treat local disease, chemotherapy is usually systemic; it goes through the whole body and therefore should affect cancer cells anywhere they may be.

Some patients may be prescribed targeted therapy, which includes drugs that “target” specific changes in cancer cells. In normal cell growth, small chemicals called growth factors are produced by one cell and attach to proteins called receptors on that same or nearby cells - like a baseball fitting into a catcher’s glove.  By attaching to these receptors, the growth factors are able to “tell” the cell to multiply.  In cancer, there may be too many growth factors present, or the receptor may be mutated so that it “thinks” the growth factor is attached when it really isn’t.  Some drugs block these receptors to stop the cancer from growing and/or spreading, thereby “targeting” the cancer.

More options for treatment are available through clinical trials.  For example, immunotherapy agents have shown promise for certain lung cancer patients after chemotherapy, targeted therapy and other treatment methods have stopped working. Instead of attacking cancer cells directly, immunotherapy drugs help the body’s own immune system recognize and kill cancer cells. Immunotherapy options, along with many others, are available to patients through their participation in clinical trials.

Communication about Your Cancer Treatment and Care

It is important to understand the specific type of lung cancer you are diagnosed with. This information will help inform your decisions about the best treatment option for you.  Make a list of your questions to ask your health care provider.  Most lung cancer treatments have risks and benefits and the side effects may impact your quality of life.  Often a referral to palliative care service, which focuses on symptom management, coordination of care and medical decision making can be helpful for patients and caregivers.

Lung Cancer Survivorship

More and more people are surviving lung cancer as a result of the advancements in medical research.  A lung cancer survivorship plan documents the treatment you have received, symptoms to monitor, follow up care plans, and community resources.  Ask your provider for a copy of your survivorship plan.


Four Facts About Lung Cancer

  1. 1 in 14 people will be diagnosed with lung cancer in their lifetime.

  2. Lung cancer takes more lives than breast, prostate and colon cancers combined, accounting for nearly 30% of all cancer deaths. Each year in the US, approximately 228,000 people are diagnosed with lung cancer, and more than 159,000 die of the disease.

  3. Smoking is a major risk factor for lung cancer, but between 20,000 and 30,000 people who have never smoked are diagnosed with lung cancer in the US each year. Exposure to radon and air pollution is also a major cause of lung cancer.

  4. People with COPD and pulmonary fibrosis are at significantly increased risk of lung cancer.