Lung Cancer

What is lung cancer?
Lung cancer is a disease that begins in the cells of the lungs. There are two types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). The majority of lung cancers are NSCLC. There are three sub-types of NSCLC: squamous cell carcinoma, adenocarcinoma and large-cell undifferentiated carcinoma.

What are risk factors for lung cancer?
Risk factors for lung cancer include:
> Cigarette smoking – tobacco addiction is by far the most important risk factor in the development of lung cancer. Cigarette smoke contains more than 4,000 different chemicals, many of which are proven carcinogens (substances that cause cancer). Quitting smoking reduces the risk of lung cancer over time, but former smokers remain at a higher risk for developing lung cancer than someone who has never smoked;
> Exposure to radon (an invisible, odorless, tasteless gas that occurs naturally in soil and rocks);
> Exposure to second hand or passive smoke;
> Exposure to certain industrial and organic substances such as arsenic, asbestos, uranium, and diesel fuel;
> Family history of lung cancer;
> Previous lung disease.

What are prevention strategies for lung cancer?
While not all lung cancers can be prevented, the majority of lung cancers can be prevented by reducing risk factors.
> Cigarette smoking – Avoiding cigarette smoking and quitting if you currently smoke greatly reduces the risk of lung cancer.
> Second hand smoke – Avoiding second hand smoke from cigarettes reduces the risk of lung cancer.
> Exposure to chemicals – Avoiding exposure to cancer causing chemicals reduces the risk of lung cancer.
> Diet – Evidence supports that a diet high in fruits and vegetables may reduce the risk of lung cancer.

Is screening available?
Currently, there are no established national screening guidelines for lung cancer. If you are at risk for lung cancer, you should discuss this with your doctor.

What are the symptoms of lung cancer?
Although most lung cancers do not cause symptoms until they have spread, you should report any of the following to your doctor right away. Often, these problems are caused by something other than cancer. But if lung cancer is found, prompt treatment could extend your life and relieve symptoms.
> A cough that does not go away;
> Chest pain, often made worse by deep breathing;
> Hoarseness;
> Weight loss and loss of appetite;
> Bloody or rust-colored sputnum (spit or phlegm);
> Shortness of breath;
> Recurring infections such as bronchitis and pneumonia;
> New onset of wheezing.

How is lung cancer diagnosed?
If your doctor suspects lung cancer, your doctor may use one or more diagnostic tests to determine if you have lung cancer. These could include
> Chest x-ray
> CT scan
> Magnetic resonance imaging (MRI)
> Positron emission tomography (PET)
> Bone scans
> Sputum cytology
> Needle biopsy
> Bronchoscopy
> Mediastinoscopy and mediastinotomy
> Thoacentesis and thoracoscopy
> Bone marrow biopsy
> Blood count and blood chemistry

What is staging?
Staging describes the extent of the cancer. It determines if the cancer has spread and if so, what parts of the body are affected. Staging a cancer is important to assist the doctor with determining the appropriate course of treatment and assessing an accurate prognosis.
The most common staging system is the TNM.
> T – size of the tumor
> N – degree to which regional lymph nodes are involved
> M – the absence or presence of distant metasteses
Once the TNM has been determined, then a stage of I, II, III or IV is assigned.
> Stage I – cancers are small and local and usually curable
> Stage II x III – typically these are locally advanced and could involve the lymph nodes
> Stage IV – cancer has metastasized and can be inoperable.

What are treatment options?
The three types of treatment most commonly used to treat lung cancer include chemotherapy, radiation, and surgery. Additionally, targeted therapies are now emerging.

What clinical trials are available?
Clinical trials are studies that seek to find better ways to prevent, screen, diagnose and treat a disease such as cancer. Clinical trials test new approaches to treatment, such as, new drugs, new approaches to surgery or radiation therapy, or a combination of treatments. Learn more about clinical trials.

What questions should I ask my doctor?
It is often helpful to make a list of questions before an appointment. This will help to remember what the doctor says. Patients and care givers can write notes or ask if they may use a tape recorder. Sometimes it is helpful to have a family member or friend at the appointment to take notes, ask questions or just listen. Below are a few suggested questions a patient may ask their doctor.
Will you please write down the type of cancer that I have?
What stage is my cancer and what does that mean?
What are my treatment options?
What treatment do you recommend and why?
What are the risks and benefits of each treatment?
What are possible side effects of treatment?
How will you help manage my side effects?
How will treatment affect my normal activities?
Are there specific things I must do to get ready for treatment?
Are there other things I can be doing to help with my treatment, such as diet and exercise?
What resources can I use to learn more about my cancer and help me deal with it?

Make an appointment

Resources
Alliance for Lung Cancer Advocacy – 1-800-298-2435
American Cancer Society – 1-800-ACS-2345
Cancer news on the net: Lung cancer links
CancerSource.com
Columbia Presbyterian Medical Center/Lung Cancer Screening
Lung cancer information center
Lung cancer online
National Cancer Institute – 1-800-4CANCER
Survivors for Lung Cancer Awareness
The Association of Cancer Online Resources (ACOR)
The Wellness Community
Women Against Lung Cancer (WALC)