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Understanding Lung Cancer
Lung Cancer by Laurie LaRusso, MS, ELS Definition Lung cancer is a disease in which cancer cells grow in the lungs. Cancer occurs when cells in the body (in this case lung cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissues and can spread to other parts of the body. A benign tumor does not invade or spread. Lung cancers are divided into two types: Non-Small Cell Lung Cancer – generally grows and spreads more slowly (This is the more common type of lung cancer.) Small Cell Lung Cancer – generally grows more quickly and is more likely to spread to other parts of the body Causes The following can cause damage to the cells in the lungs that can lead to lung cancer: Asbestos (a group of minerals that occur naturally as fibers and are used in certain industries) First- or second-hand cigarette, cigar, or pipe smoke. Radon (an invisible, odorless, and tasteless radioactive gas in soil and rocks) Risk Factors A risk factor is something that increases your chance of getting a disease or condition. Cigar and pipe smoking Cigarette smoking Coal dust Exposure to asbestos Exposure to certain air pollutants, such as by-products of the combustion of diesel and other fossil fuels are linked to lung cancer, although the relationship is not yet clear. Exposure to radon Exposure to secondhand smoke, also called environmental tobacco smoke (the smoke in the air when someone else smokes) Lung diseases, such as tuberculosis (TB) Personal history of lung cancer Symptoms Symptoms include: A cough that doesn't go away and gets worse over time Constant chest pain Coughing up blood Fatigue Loss of appetite or weight loss Repeated problems with pneumonia or bronchitis Shortness of breath, wheezing, or hoarseness Swelling of the neck and face Note: These symptoms may also be caused by other, less serious health conditions. Anyone experiencing these symptoms should see a doctor. Diagnosis The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor will also ask about the following: Exposure to environmental and occupational substances Family history of cancer Smoking history Tests may include: Biopsy – removal of a sample of lung tissue to be tested for cancer cells. Methods of lung biopsy include: Bronchoscopy – a thin, lighted tube inserted into the mouth or nose and through the windpipe to look into the breathing passages. Through this tube, the doctor can collect cells or small samples of tissue. Needle Aspiration – a needle inserted through the chest into the tumor to remove a sample of tissue Thoracentesis - use of a needle to remove a sample of the fluid around the lungs to check for cancer cells Thoracotomy - surgery to open the chest and examine lung tissue Chest x-ray Spiral CT – a special type of XRay of the lungs Sputum cytology – examination of a sample of mucus from the lungs Treatment Once lung cancer is found, staging tests are performed to find out if the cancer has spread and, if so, to what extent. Surgery – surgical removal of the cancerous tumor and nearby tissues, and possibly nearby lymph nodes. The type of surgery depends on the location of the tumor in the lung. Surgeries include: Segmental or Wedge Resection – removal of only a small part of the lung Lobectomy – removal of an entire lobe of the lung Pneumonectomy – removal of an entire lung Radiation Therapy or Radiotherapy – the use of radiation to kill cancer cells and shrink tumors. Radiation therapy may also be used to relieve symptoms such as shortness of breath. Radiation may be: External Radiation Therapy - directed at the tumor from a source outside the body (more common for treating lung cancer) Internal Radiation Therapy - radioactive materials placed into the body in or near the cancer cells Chemotherapy – the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. Chemotherapy is often used to kill lung cancer cells that have spread to other parts of the body. Promising New Treatments– The use of photodynamic therapy (PDT) and cryosurgery is not widespread or well established. The National Cancer Institute considers both treatments potential therapies. Photodynamic Therapy (PDT) – a type of laser therapy where a chemical is injected into the bloodstream and absorbed by the cells of body. The chemical rapidly leaves normal cells but remains in cancer cells for a longer time. A laser aimed at the cancer activates the chemical, which then kills the cancer cells that have absorbed it. This treatment may also be used to reduce symptoms of lung cancer when the cancer cannot be removed through surgery. Cryosurgery – a treatment that freezes and destroys cancer tissue Prevention To reduce your risk of getting lung cancer: Avoid places where people are smoking. Do not work or live in a place with asbestos. Don't start smoking. If you smoke, quit. Test your home for radon gases and asbestos. Have these substances removed if they are in the home. Last reviewed: April 2004 by Judy Logan, MD, MS.