What is lung cancer?

Cancer refers to malignant (life-threatening), uncontrolled growth of body tissues. In lung cancer, these growths start in the lungs. This document describes mainly bronchial carcinoma, the more common type of lung cancer.

People who currently smoke or have smoked previously account for more than 85% of people with lung cancer. Lung cancer causes more cancer deaths in the U.S. than any other type of cancer.

Problems associated with this disease can include blocked breathing tubes and infection. In addition, cancer in a lung often spreads (metastasizes) to other parts of the body. Common sites of spread are the brain, the other lung, the liver, lymph nodes, and bone.

How does it occur?

Most lung cancers are related to smoking. In other, less common types of lung cancer, the cause is less well understood.

People who are most likely to develop lung cancer are those who:

• smoke cigarettes or marijuana

• have been exposed to large amounts of secondhand cigarette smoke

• have been exposed to radon gas or asbestos

• have been exposed to potential toxins, such as chemical byproducts like bis-chloromethylether or byproducts from the petroleum refining industry; asbestos; arsenic; and radiation from coal and iron mining.

What are the symptoms?

Lung cancer may grow for a long time without producing any symptoms. The cancer may be quite advanced by the time you have symptoms. Symptoms of lung cancer include:

• a persistent cough

• coughing up blood, sometimes large amounts

• chest pain

• wheezing or shortness of breath, especially with activity or exertion

• repeated attacks of pneumonia or asthma

• weight loss.

If the cancer spreads to other parts of the body, the symptoms depend on the area affected. For example, spread to the brain may cause headaches, and spread to bone may cause bone pain.

How is it diagnosed?

Your doctor will review your symptoms and examine you. One or more of the following tests will be done:

• chest x-rays

• CT (computed tomography) scans of the chest or chest tomograms, which are special x-rays that show layers of lung tissue

• CT or other scans to look for spread of the disease to other parts of the body.

Your doctor may also order the following routine tests:

• complete blood count (CBC)

• liver function blood tests

• kidney function blood tests

• sputum test.

If x-rays or scans show a suspicious area, it may be possible to take a sample of tissue from the area for testing (a biopsy). Biopsies can be done by:

• hollow needle biopsy, after local anesthesia, through the chest wall, to remove a piece of tissue

• bronchoscopy, which is passage of a lighted, flexible telescope into the affected bronchial tube (an airway to the lung) to see and sample abnormal areas

• surgery (open biopsy), with complete removal of the abnormal tissue.

How is it treated?

The treatment for lung cancer depends on the type of cancer, its size, and the location, as well as your general health. Possible treatments include surgery, radiation, and chemotherapy (anticancer drugs). Your doctor may use a combination of these treatments.

If you have a single tumor with little or no spread into nearby tissues, surgery is likely to be the best treatment. Radiation and chemotherapy may not be necessary.

More advanced cancers are more likely to require a combination of surgery, radiation, and chemotherapy. The treatment depends on the tumor type and how much the cancer has spread.

In certain cases surgery may not be recommended. The treatment may be limited to radiation and/or chemotherapy.

How can I take care of myself?

Follow your doctor's recommended treatment and keep all your follow-up appointments. To help take care of yourself during your treatment and recovery, follow these guidelines:

• Stop smoking, if you smoke.

• Exercise according to your doctor's recommendations.

• Eat regular, nutritious meals, as recommended by your doctor or dietitian.

• Get plenty of rest.

• Drink plenty of fluids to keep your lung secretions moist and fluid.

• Reduce the amount of alcohol and caffeine in your diet.

• Develop a support system of people you can talk to comfortably. Ask for help at home or work when the load is too great to handle.

• Use methods to reduce stress that work for you, such as participating in recreational activities and hobbies, listening to music, or doing relaxation and deep breathing exercises.

• Try to develop and maintain a positive attitude.

• Get professional help. Discuss with a doctor or therapist the events in your life that make you anxious. Ask for help in developing positive ways to cope with these events.

Call your doctor if any symptoms recur. Your doctor will also discuss with you what new signs and symptoms to watch for and when to call or make an appointment.

What can be done to help prevent lung cancer?

Not all of the causes of lung cancer are known, but following these guidelines can help reduce the risk of some of the more common kinds of lung cancer:

• Stop smoking and stay away from other people's smoke.

• Stay away from environmental hazards, such as radon, and asbestos, and, when possible, severe air pollution. Use on-the-job protective equipment when it's recommended.

• To help early detection of lung cancer, especially if you have a history of cigarette smoking, see your doctor if you have symptoms such as coughing up blood, a prolonged cough, repeated attacks of pneumonia or asthma, and weight loss. The risk of lung cancer continues for 10 to 15 years after you stop smoking.