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What is Lung Cancer?

Lung cancer is the uncontrolled growth of abnormal cells in one or both lungs.  As they grow, the abnormal cells can form tumors and interfere with the functioning of the lung, which provides oxygen to the body via the blood.

Lung cancer is by far the leading cause of cancer death among both men and women, making up almost 25% of all cancer deaths.  Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined.

 

Lung Cancer Types

 Staging lung cancer is based on whether the cancer is local or has spread from the lungs to the lymph nodes or other organs.  Knowing the stage of your cancer helps your treatment team understand how advanced your lung cancer is, recommend treatment options that are likely to be most effective for you, and evaluate your response to treatment.

 

Non-small cell lung cancer (NSCLC) 

Non-small cell lung cancer accounts for about 85 percent of lung cancers and includes:

  • Adenocarcinoma, the most common form of lung cancer in the United States among both men and women;
  • Squamous cell carcinoma, which accounts for 25 percent of all lung cancers;
  • Large cell carcinoma, which accounts for about 10 percent of NSCLC tumors.

 

Stages of Non-Small Cell Lung Cancer

STAGE I

Stages of Non-Small Cell Lung Cancer

STAGE II

The cancer is in the lung and nearby lymph nodes.

STAGE III

Cancer is found in the lung and the lymph nodes in the middle of the chest, also described as a locally advanced disease. Stage III has two subtypes:

  • If the cancer has spread only to lymph nodes on the same side of the chest where the cancer started, it is called stage IIIA.
  • If the cancer has spread to the lymph nodes on the opposite side of the chest, or above the collar bone, it is called stage IIIB.

STAGE IV

This is the most advanced stage of lung cancer, and is also described as advanced disease. This is when the cancer has spread to both lungs, to fluid in the area around the lungs, or another part of the body, such as the liver or other organs.

 


 

Small cell lung cancer (SCLC)

Small cell lung cancer accounts for the remaining 15 percent of lung cancers in the United States.  They tend to grow more quickly than NSCLC tumors. Usually, SCLC is more responsive to chemotherapy than NSCLC.

Stages of Small Cell Lung Cancer

Limited Stage

In this stage, cancer is found on one side of the chest, involving just one part of the lung and nearby lymph nodes.

Extensive Stage

In this stage, cancer has spread to other regions of the chest or other parts of the body.

Symptoms

Most lung cancers do not cause any symptoms until they have spread. Because the lungs are large, tumors can grow in them for a long time before they are found.  Even when symptoms, such as coughing and fatigue, do occur, people think they are due to other causes. For this reason, early-stage lung cancer (stages I and II) is difficult to detect.  Like with all diseases though, not all patients are the same and some people with early lung cancer do experience symptoms.

The most common symptoms of lung cancer are:

  • Coughing that gets worse or does not go away
  • Chest pain
  • Shortness of breath
  • Wheezing
  • Coughing up blood
  • Feeling very tired all the time
  • Weight loss with no known cause

Because these symptoms may overlap with those of other conditions, it is important to get the correct diagnosis to find the right treatment.  Make an appointment with your primary care physician or pulmonologist if you are experiencing persistent signs and symptoms that concern you. 

Although smoking is the main cause of lung cancer, lung cancer risk also is increased by exposure to secondhand smoke; environmental exposures, such as radon, workplace toxins (e.g., asbestos, arsenic), and air pollution.  The risk of lung cancer can be reduced by quitting smoking and by eliminating or reducing exposure to secondhand smoke and environmental and workplace risk factors.

While lung cancer is the leading cause of cancer death among both men and women, the number of deaths from lung cancer continues to drop due to advances in early detection (screenings) and treatment.  As the number of people who smoke decreases, the numbers of new lung cancer cases and deaths decrease.

Screening

The main benefit of screening is a lower chance of dying from lung cancer.  The American Cancer Society recommends screening (low-dose CAT scan or CT scan) for:

  • People who are aged 55 to 74 years and are in relatively good health; and
  • Have at least a 20 pack-year smoking history. This is the number of packs of cigarettes per day multiplied by the number of years smoked. For example, someone who smoked 2 packs a day for 10 years (2 x 10 = 20) has 20 pack-years of smoking, as does a person who smoked 1 pack a day for 20 years (1 x 20 = 20) or
  • Have a 30-pack-year smoking history who quit within the past 15 years.

Alliance Cancer Care advocates screening for lung cancer and encourages patients to discuss low-dose CT scans with their physician to better understand the benefits and risks associated with the screening. 

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