What is Lung Cancer?

Lung cancer is the second most common form of cancer in the United States for both men and women, according to the Centers for Disease Control and Prevention (CDC). It’s also the leading cause of cancer-related death, reports the CDC.


Smoking and inhaling tobacco smoke carcinogens make up around 87 percent of all lung cancer cases. In workers who are exposed to asbestos and who also smoke, the lung cancer risk is higher than each of those risks separately, according to the American Cancer Society. Lung cancer can also form due to damaged cells from second-hand smoke exposure.

Learning about lung cancer can help you to explore treatment option, improve your prognosis, connect with a lung cancer doctor, and get legal and/or financial assistance.


Understanding Lung Cancer

Misdiagnosis IconYour cells are the building blocks of your body that makeup all your organs and tissues. This includes your lungs and cancer begins in your cells. Regular cells in your lungs and other areas of your body grow and separate to form new cells when your body needs them. When these regular cells get damaged or grow old, they die, and this is where your new cells form in their place.

In some cases, however, it doesn’t always work like this. Sometimes new cells will form even when your body doesn’t need them, and the damaged or old cells don’t die. This causes a buildup of additional cells that form a growth or tumor (mass of tissue). Lung tumors can be either not cancerous (benign) or cancerous (malignant).

Three Types of Lung Cancer

There are three primary types of lung cancer. Your doctor will need to determine which type you have in order to provide you with treatment. These types include:

1. Non-Small Cell Lung Cancer. The most prevailing form of lung cancer is non-small cell lung cancer (NSCLC).

NSCLC accounts for 85% of lung cancers and includes the following types:

  • Adenocarcinoma
  • Squamous cell carcinoma
  • Large cell carcinoma
  1. Small Cell Lung Cancer. Also referred to oat cell cancer, small-cell lung cancer (SCLC) comprises around 15 percent of all cancers of the lung. This type of cancer tends to grow more rapidly than NSCLC but is also quick to respond to treatments.

3. Lung Carcinoid Tumor.  Carcinoids contribute around two percent of lung cancers. Each year in the U.S., there are approximately 4,000 new diagnosed lung carcinoid tumor cases. These cancerous tumors are comprised of neuroendocrine cells. Two types of Lung Carcinoid Tumors exist: typical, which are slower; and atypical, which are faster and more likely to spread throughout your other organs.

Symptoms of Lung Cancer

Prognosis IconThe symptoms you experience depend on where your cancer is located, how big it is, and where it has spread. Symptoms of lung cancer can take years before they appear, typically after you reach an advanced stage of the disease.

Often, lung cancer symptoms affect air passages and chest, these include:

  • Intense or persistent coughing
  • Difficulty swallowing or breathing
  • Pain in your back, chest or shoulder from coughing
  • Hoarseness of the voice
  • Changes in mucus color that you cough up from your sputum (lower airways)
  • Blood in the sputum or coughs that contain blood
  • Chronic pneumonia or bronchitis
  • Stridor (harsh sounds while you breathe)

As lung cancer cells begin spreading and using more of your body’s energy, other symptoms might appear that could be associated with other conditions including:

  • Fatigue
  • Fever
  • Swelling of the face or neck
  • Unexplained weight loss
  • General weakness
  • Pain in your bones or joints
  • Memory or brain function problems
  • Blood clots or bleeding

You may experience enlarged or swollen lymph nodes that present themselves early. If your cancer reaches your brain, it could cause seizures, vertigo, or headaches.


Causes of and Risk Factors for Lung Cancer

Causes and Exposures of Lung Cancer

When the gene mutation of a lung cell makes that cell unable to correct damage to the DNA or unable to die, lung cancer occurs. There are multiple reasons why mutations can occur. Some causes of lung cancer include:

  • Carcinogens (tobacco, arsenic, asbestos)
  • Smoking
  • Genes
  • Air pollution
  • Family history

There are certain risk factors to consider as well.

Are You at Risk for Lung Cancer?

If you’re a survivor of lung cancer, you’re at a higher risk of developing another lung cancer, particularly if you’re a smoker. If your parents or siblings have lung cancer, it puts you at a higher risk of the disease. This could be due to genetics or it could be due to them working or living in the same place where lung cancer-causing substances occur.

Common substances found in some workplaces that put people at risk of lung cancer include:

  • Arsenic
  • Asbestos
  • Some forms of chromium and silica
  • Diesel exhaust

Many of these types of substances can put you at a higher risk of lung cancer than if you were to smoke.

Diagnosing Lung Cancer

Doctors use your symptoms and other procedures to diagnose lung cancer. They often use imaging tools such as:

  • CT scans
  • Chest X-rays
  • MRI Scans
  • Bronchoscopy
  • PET scans

Doctors will also give you a chest exam, physical exam, and an analysis of blood in your sputum. These procedures help the doctors detect and locate where the tumor is and if there are other organs that it affects.

These diagnostic techniques provide the doctor with essential information, but, the only true way of making a lung cancer diagnosis is to extract cancer cells and examine them under a microscope.

Once you receive a diagnosis, an oncologist will figure out what stage you’re at with your cancer and see how far it has spread. The stage you’re at will determine treatment options and prognosis outcome.


Lung Cancer Stages

Lung cancer goes through certain stages. Each type of lung cancer has its own stages.

Non-Small Cell Lung Cancer

Stage I: There’s no tumor in lymph nodes, but the tumor is found in one of your lungs.

Stage II: Cancer has reached your lymph nodes that surround the infected lung.

Stage III: Cancer has now spread to your lymph nodes around your chest wall, diaphragm, and trachea on the infected lung side. This state can be referred to as locally advanced disease and contains two subtypes: IIIa and IIIb

Stage IIIa: Cancer has spread only to the lymph nodes on the same side of the primary tumor.

Stage IIIb:  Cancer has now reached the lymph nodes of your neck, the other side of your chest, above your collarbone, and/or your other lung.

Stage IV:  The most advanced stage of cancer, also called advanced disease. Cancer has spread to other parts of your lungs and throughout the rest of your body.

Small Cell Lung Cancer

This type of lung cancer has two stages:

Limited: During this stage, the tumor is in one of your lungs and in lymph nodes nearby.

Extensive: During this stage, the tumor has reached the other lung and other organs in your body.

The American Joint Commission on Cancer has started to implement a more detailed staging system for Small Cell Lung Cancer similar to that used for NSCLC, but this has yet to be commonly used.

The American Joint Commission on Cancer has started to implement a more detailed staging
system for Small Cell Lung Cancer similar to that used for NSCLC, but this has yet to be
commonly used.

Lung Carcinoid Tumors

The stages of this type of cancer use the TNM staging system through the American Joint Committee on Cancer (AJCC). The TNM system describes three essential pieces of information:

  • T: Tumor size — how large is it? Has the tumor spread and grown into nearby organs or other structures?
  • N: Nodes— has the tumor reached nearby lymph nodes?
  • M: Metastasized – if it’sHas the tumor spread to the distant organs such as the liver, the most common spread site

Doctors will use numbers and letters after the T, N, or M to provide more details. The higher the number, the more advanced the stage of the tumor. Once the individual factors have been determined, a process is known as “stage grouping” will assign the overall stage of the carcinoid tumor.

A clinical stage will be determined based on the following results: biopsies, imaging tests, physical exams, and any other test your doctor ordered. Should you undergo surgery, a further pathologic stage will examine tissues removed during the procedure.

The staging of Lung Carcinoid Tumors is complex and can be difficult to understand. Be sure to ask your doctor to break down the stages in more understandable language so that you are on the same page as they are and fully understand your condition.


Pleural Mesothelioma vs. Lung Cancer

Lung cancer and pleural mesothelioma are two distinct cancers that asbestos exposure causes. They originate in different areas but cause similar symptoms, such as difficulty breathing and chest pain. Although physicians use similar tools as well to diagnose both cancers, their treatment will usually differ.

Once you inhale asbestos, it may become lodged in the lining of your lungs (pleural lining) or lodged in your lung tissue and may cause cancer in both areas. With lung cancer, asbestos becomes lodged in your lung tissue; with pleural mesothelioma, asbestos becomes lodged in your pleural lining.

Some of the major differences between pleural mesothelioma and lung cancer include the following:

  • Pathology: the two cancers develop differently. Lung cancer is within the actual lungs
    and is often comprised of distinct masses with clear borderlines, while mesothelioma
    develops in the pleural lining and is comprised of a network of tumors lacking clear
    boundaries.
  • Causes: mesothelioma is almost always a result of asbestos exposure. These fibers can
    become lodged in the pleural cavity. Lung cancer can be caused by a variety of factors
    including not only asbestos but also smoking, pesticide exposure, pollutants, and radon.
    Surprisingly, smoking has little to no effect on the cause of mesothelioma, though it can
    affect the development of the disease and the patient’s overall health.
  • Diagnosis: the process for diagnosing these diseases can be very similar, including
    radiology and pathology. Tissue biopsies are the main diagnostic difference, as the two
    diseases will present with drastic differences. Lung cancer can also be diagnosed through
    testing an individual’s sputum or phlegm.
  • Treatment: The treatment plans for mesothelioma and lung cancer include similar stages,
    but their success rates will vary. Both diseases will often start by treating with surgery,
    radiation, and/or chemotherapy.

Lung Cancer Treatment Options

There are a number of treatment options to treat lung cancer. These treatments include:

  • Radiation therapy
  • Preventative Radiation Therapy to the Brain
  • Chemotherapy
  • Surgery
  • Targeted therapy (e.g. erlotinib (Tarceva and others), Afatinib (Gilotrif), Gefitinib (Iressa), Bevacizumab (Avastin), Crizotinib (Xalkori), Ceritinib (Zykadia))
  • Immunotherapy

The type of treatment for your cancer case depends on the type of lung cancer you have, its stage, and your current health. At any lung cancer stage, you’ll receive care to help manage your breathing and control your pain. Most treatment plans will be multimodal, which means they will
combine several forms of treatment. This can be any combination of treatment styles as
determined by your oncologist.

Lung Cancer Specialists

If you are experiencing symptoms that you’re concerned with, you can begin with your
own doctor. If they suspect you have lung cancer, they’ll likely refer you to an oncology
specialist. If your doctor suspects that you have pleural mesothelioma, they’ll likely refer you
specifically to a mesothelioma specialist. Specialists treat individuals with various types of
cancer in different ways.

Specialists treat individuals with various types of cancer in different ways.

  • Oncologists: Specializes in diagnosing and treating cancerTreat cancer
  • Pulmonologists: Specializes in diagnosing and treating pulmonary (lung) conditions and diseases, including cancer and mesothelioma.
  • Radiation Oncologists: Specializes in using ionizing radiation to treat cancer with radiation
  • Thoracic Surgeons: Operate on the lungs surgeon who specializes in operating on organs within the chest, including the heart and lungs.
  • Palliative Care Specialists: A team of doctors and nurses specially trained to provide an extra layer of support in treatingTreats the symptoms of cancer and the cancer self-treatment.
  • Pathologists: test and identify tissue, fluid, and blood samples to determine type and staging and cancers in addition to causes and effects of other diseases.

Lung Cancer Prognosis

Your prognosis depends on many factors, including the type of cancer you have and stage, where it’s located, how you respond to treatment, and your general health. Everyone responds differently to treatment, which makes it difficult to know the effectiveness of a given treatment.

Improving Your Lung Cancer Prognosis

Early diagnosis and newer treatments are improving the survival rates of lung cancer patients. After a cancer diagnosis, many things can affect your prognosis. Typically, the earlier it’s diagnosed, the easier the treatment will be and the better your prognosis may be. Your general health and age play a role. Your lifestyle factors in such as if you smoke.

Another important factor is the doctor who is treating you. They obviously need to have experience in treating lung cancer. It also helps to have a strong support system through family and friends.