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What Is Lung Cancer?

Lung cancer is one of the most common cancers among men and women. More than 200,000 new cases are diagnosed yearly in the United States.

Almost 90% of lung cancers start in the lining of air passages or air sacs. Air passages are tubes called bronchi (main tubes) and bronchioles (smaller tubes). Air sacs (alveoli) are at the ends of the tubes.

For treatment purposes, lung cancer is usually divided into two types: non–small-cell and small-cell. Non-small cell lung cancer can be further subdivided by specific cell type and in stages I, II, III, or IV. Therapy differs for each.

What Causes Lung Cancer?

Use of cigarettes, cigars, and pipes is the main cause. Others include exposure to asbestos radon, radiation, and second-hand smoke.

What Are the Symptoms of Lung Cancer?

Some people may have no symptoms until cancer is advanced. Others have long-lasting cough, coughing up bloody phlegm, shortness of breath, wheezing, recurrent pneumonia, loss of appetite, and weight loss. Swelling of the face and neck (superior vena cava syndrome) and pain in shoulders, arms, and hands (Pancoast tumor) can occur in some cases.

How Is Lung Cancer Diagnosed?

Early diagnosis can be hard because some people may have no symptoms until cancer is advanced. Low-dose CT scan of the chest can be used to look for lung cancer in people over age 50 who are smokers or have a significant history of smoking. If an abnormality is noted additional tests can be done. The only sure way to diagnose lung cancer is to take and study samples of lung fluid or tissue (biopsy). The doctor gets these by bronchoscopy (inserting a lighted, thin, flexible tube into the lungs), needle aspiration (passing a needle through the chest), or surgery.

How Is Lung Cancer Treated?

After diagnosis, staging is done to find out whether the cancer spread. Early detection is important because only early lung cancers, before spread (metastasis) occurs, can be cured.

For non-small-cell cancer, computed tomography (CT) of the chest and abdomen helps find spread of cancer to other body parts, such as lymph nodes (glands) and liver. A radiology test called positron emission tomography (PET) can also do this. Breathing tests (pulmonary function tests) are done before surgery to help find out whether removal of part of the lung will be tolerated. Surgery for localized cancer offers the best hope for cure. For more advanced disease or people who cannot have surgery, radiation therapy alone or radiation and chemotherapy (drugs) are tried.

For small–cell cancer, CT of the chest, abdomen, and head; PET; and bone marrow biopsy are usually done to look for spread into the brain or bone marrow. Surgery usually cannot cure small-cell lung cancer, so chemotherapy and chemotherapy with radiation therapy are options.

All treatments have complications, including pain and shortness of breath (surgery), tiredness and shortness of breath (radiation); and easy bruising and bleeding, nausea, vomiting, and hair loss (chemotherapy).

DOs and DON’Ts in Managing Lung Cancer:

  • DO understand the effects of smoking and its major role in lung cancer.
  • DO see an oncologist (cancer specialist) about therapy.
  • DO understand the importance of nutrition before and after treatment. Eat a healthy diet, including fruits and vegetables.
  • DON’T smoke—the most important lifestyle change.
  • DON’T be afraid to ask questions or ask for a second opinion. Therapy is complicated, and many decisions have to be made before you feel comfortable with the type of treatment you receive.
  • DON’T be afraid to ask about support groups.

Contact the following sources:

  • American Lung Association
    Tel: (212) 315-8700, (800) 586-4872
  • American Cancer Society
    Tel: (800) ACS-2345 (227-2345)

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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