Lung Cancer FAQs
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In 2016, more than 224,000 people were diagnosed with lung cancer. Whether you’ve been diagnosed or know a friend or family member who has, here’s a guide to the basics of lung cancer.1

What is lung cancer?
Who is at risk for lung cancer?
Do non-smokers get lung cancer?
What are the different types of lung cancer?
What are the common symptoms?
How is lung cancer diagnosed?
Who should be screened for lung cancer?
What does lung cancer treatment involve?
What are some common side effects of treatment?
What is the prognosis for someone with lung cancer?

What is lung cancer?

Cancer is a disease that begins at the cellular level. The cells are the building blocks of all the tissue in the body, and in their healthy state, they grow and divide as the body needs them to maintain the current structure. As cells get old or become damaged, they die, and new cells replace them. Cancer develops when the cells become abnormal, reproduce at high rates, and create tumors. Cancerous tumors can also invade surrounding tissues and may spread to other areas of the body.2

Cancer types are named for the organ in which they originate. Lung cancer is a cancer that begins in the lungs, the main organs of the respiratory system. The respiratory system brings oxygen from the air into the body and removes carbon dioxide from the blood.3

Who is at risk for lung cancer?

While researchers have identified several risk factors for developing lung cancer, it is important to remember that anyone can get lung cancer! Some factors that increase a person’s risk for lung cancer include:

  • Smoking
  • Secondhand smoke exposure
  • Older age
  • Exposure to radon
  • Exposure to asbestos or other workplace carcinogens
  • Family history of lung cancer
  • Exposure to radiation, particularly radiation therapy to the breast of chest
  • Air pollution

Do non-smokers get lung cancer?

While most cases of lung cancer are linked to smoking tobacco, as many as 20% of deaths caused by lung cancer occur in people who do not smoke or use any other form of tobacco (approximately 16,000 to 24,000 Americans every year). Although anti-smoking campaigns implemented in the 1980’s have led to a decrease in smoking-related lung cancers, rates of lung cancer incidence are up among non-smokers. In addition, the lung tumors in non-smokers are often different at a molecular level (specific mutations or changes in the cancer cells) and respond differently to targeted therapy than lung cancers in smokers.4-7

What are the different types of lung cancer?

Any cancer that has its origins in the lungs or any of its structures, like the bronchi (air tubes) or alveoli (air sacs), is named lung cancer. There are several different types of lung cancer, notable for their clinical and biologic differences. Different types of lung cancer also have variations in their growth pattern, propensity to spread or metastasize to other parts of the body, prognoses (or projected outcomes), and require different treatment.8,9 Different types of lung cancer include:

What are the common symptoms?

Lung cancer is usually diagnosed in later stages of the disease, and an estimated 90% of patients with lung cancer are symptomatic at presentation (when they go to the doctor for diagnosis).10Symptoms of lung cancer generally increase in severity as the disease spreads, or metastasizes. Some people experience symptoms even with early stage disease. The most common symptoms of lung cancer include:

How is lung cancer diagnosed?

Getting a diagnosis of lung cancer often includes several steps and tests, and there is no single approach that is best for all people. To confirm lung cancer, a sample of tissue or fluid must be removed from the body and sent to a laboratory for examination. This process is called biopsy. In some cases, a diagnosis of lung cancer is made through surgery. During surgery, doctors can remove any tissue that is suspected of and looks like cancer, and that tissue will be sent to the laboratory for further testing.12 Some of the techniques and procedures used during a diagnosis of lung cancer include:

  • Laboratory tests, including a complete blood count, blood chemistry tests, and the tests completed on a biopsy sample
  • Imaging tests, including chest x-ray, CT (computed tomography) scans, PET (positron emission tomography) scans
  • Sputum cytology, in which a sample of mucus coughed up from the lungs is examined under the microscope
  • Thoracentesis, a procedure in which a needle or small tube is used to remove excess fluid in the pleural space, the space between the lungs and the chest wall
  • Needle biopsy, a procedure in which a sample of tissue is removed from the lungs to examine it for cancerous (malignant) cells
  • Bronchoscopy, a procedure in which a doctor views the airways (bronchi) with the use of a thin, lighted tube containing a camera and may take a tissue sample
  • Thoracoscopy, a minimally invasive surgical procedure in which a thin, lighted scope with a video camera is inserted into the chest through a small incision, allowing the surgeon to visually inspect and potentially to remove tissue samples for biopsy

Who should be screened for lung cancer?

Screening is testing done before any symptoms are noticeable. The purpose of screening is to catch cancer in its earliest, and most treatable, stages. There are multiple national organizations that have very similar, but sometimes slightly varying screening recommendations. Screening recommendations are based on groups of people who fit certain criteria. Risk groups are broken into different categories. Screening recommendations can be found here.

What does lung cancer treatment involve?

Treatment for lung cancer is determined by several factors, including the stage of cancer, how much the cancer has spread, the type of lung cancer, and the overall health of the patients and whether they have other health conditions. Treatment options may include:

  • Surgery – removal of the tumor, which may include removing a portion or all of a lung; surgery is generally only recommended in cancers that are stage I, stage II and some stage III
  • Radiation therapy – the use of high-energy rays targeted on the cancer
  • Chemotherapy – the use of drugs to kill cancer cells
  • Targeted therapy – a class of drugs that focuses on specific genetic mutations present in the tumor cells
  • Immunotherapy – a class of drugs that boosts the patient’s immune system to find and destroy cancer cells
  • Radiofrequency ablation – the use of high-energy electrical waves to heat and destroy cancer cells
  • Pulmonary rehabilitation – used to help improve lung functioning in patients with lung cancer and other chronic lung diseases
  • Palliative care – supportive care that does not treat the cancer itself, but aims to improve quality of life and is done concurrently with other treatment
  • Complementary medicine – practices which are used in combination with traditional medicine, such as dietary supplements, massage, acupuncture, and hypnosis 13

What are some common side effects of treatment?

Treatment for lung cancer targets cancer cells, but it can also cause unwanted side effects, creating problems that affect healthy tissues or organs. The side effects from treatment for lung cancer depend on the specific treatment given, and side effects vary from person to person. Not everyone who gets the same treatment has the same reaction. Side effects experienced may also be influenced by the patient’s age, other health conditions, and the combination of treatments received.

Common side effects experienced by patients undergoing treatment for lung cancer include:16

What is the prognosis for someone with lung cancer?

Lung cancer causes the most cancer-related deaths in the United States, however the death rates have been declining over time, falling on average 2.0% each year between 2003 and 2012.12,13 The prognosis, or forecast of the outcome of the disease, is unique to every individual with lung cancer. When looking at statistics, researchers look at large numbers of individuals. These numbers can be distressing, as lung cancer survival rate is lower than other types of cancer. However, the statistics do not necessarily predict what will happen to an individual.17

Survival rates are determined on the previous outcomes of people who survive a specific amount of time after diagnosis. In lung cancer, as in other types of cancer, experts use “five-year survival rate” as a marker for lung cancer prognosis. It is important to remember that many people live beyond this 5-year marker after diagnosis of lung cancer and these statistics are not predictive for any particular individual. In addition, to determine these rates, statisticians look at the past. The statistics do not take into account how treatments are evolving and improving over time. The survival rates also are based on the initial diagnosis and do not apply to lung cancers that recur or spread.17,18

view references
  1. Cancer Facts & Figures 2016. American Cancer Society. Accessed at: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2016.html
  2. National Cancer Institute. Accessed online on 8/1/16 at http://www.cancer.gov/.
  3. NCCN Guidelines for Patients. Non-Small Cell Lung Cancer. Version 1.2015. Accessed April 11, 2016 at http://www.nccn.org/patients/guidelines/nscl/index.html.
  4. American Cancer Society. Accessed online on 8/17/16 at http://www.cancer.org/.
  5. Thun MJ, Hannan LM, Adams-Campbell LL, Boffetta P, Buring JE, Feskanich D, Flanders WD, Jee SH, Katanoda K, Kolonel LN, Lee IM, Marugame T, Palmer JR, Riboli E, Sobue T, Avila-Tang E, Wilkens LR, Samet JM. Lung cancer occurrence in never-smokers: an analysis of 13 cohorts and 22 cancer registry studies. PLoS Med. 2008 Sep 30;5(9):e185.
  6. Gazdar AF, Thun MJ. Lung cancer, smoke exposure, and sex. J Clin Oncol. 2007;25:469–471.
  7. Medscape. Accessed online on 8/18/16 at http://www.medscape.com/viewarticle/713744.
  8. National Cancer Institute. Accessed online on 8/4/16 at http://www.cancer.gov/.
  9. Medscape. Accessed online on 8/4/16 at http://emedicine.medscape.com/.
  10. Beckles MA, Spiro SG, Colice GL, Rudd RM. Initial evaluation of the patient with lung cancer. Chest 2003;123:97S-104S.
  11. American Cancer Society. Accessed online on 8/23/16 at http://www.cancer.org/.
  12. NCCN Guidelines for Patients. Non-Small Cell Lung Cancer. Version 1.2015. Accessed April 11, 2016 at: http://www.nccn.org/patients/guidelines/nscl/index.html
  13. NCCN Guidelines for Patients. Non-Small Cell Lung Cancer. Version 1.2015. Accessed April 11, 2016 at: http://www.nccn.org/patients/guidelines/nscl/index.html
  14. Centers for Disease Control and Prevention. Accessed online on 8/1/16 at http://www.cdc.gov/.
  15. SEER Cancer Statistics Factsheets: Lung and Bronchus Cancer. National Cancer Institute. Bethesda, MD. Accessed online on 8/1/16 at http://seer.cancer.gov/statfacts/html/lungb.html.
  16. National Cancer Institute. Accessed online on 10/30/16 at https://www.cancer.gov/.
  17. Lung Cancer Alliance. Accessed online on 8/1/16 at http://www.lungcanceralliance.org/.
  18. American Cancer Society. Accessed online on 8/1/16 at http://www.cancer.org/.
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