Lung cancer is a type of cancer that begins in the lungs. Your lungs are two spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale.
Lung cancer is the leading cause of cancer deaths in the United States, among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined.
People who smoke have the greatest risk of lung cancer. The risk of lung cancer increases with the length of time and number of cigarettes you've smoked. If you quit smoking, even after smoking for many years, you can significantly reduce your chances of developing lung cancer.
Lung cancer typically doesn't cause signs and symptoms in its earliest stages. Signs and symptoms of lung cancer typically occur only when the disease is advanced.
Signs and symptoms of lung cancer may include:
When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms that worry you.
If you smoke and have been unable to quit, make an appointment with your doctor. Your doctor can recommend strategies for quitting smoking, such as counseling, medications and nicotine replacement products.
Smoking causes the majority of lung cancers — both in smokers and in people exposed to secondhand smoke. But lung cancer also occurs in people who never smoked and in those who never had prolonged exposure to secondhand smoke. In these cases, there may be no clear cause of lung cancer.
How smoking causes lung cancer
Doctors believe smoking causes lung cancer by damaging the cells that line the lungs. When you inhale cigarette smoke, which is full of cancer-causing substances (carcinogens), changes in the lung tissue begin almost immediately. At first your body may be able to repair this damage. But with each repeated exposure, normal cells that line your lungs are increasingly damaged. Over time, the damage causes cells to act abnormally and eventually cancer may develop.
Types of lung cancer
Doctors divide lung cancer into two major types based on the appearance of lung cancer cells under the microscope. Your doctor makes treatment decisions based on which major type of lung cancer you have. The two general types of lung cancer include:
A number of factors may increase your risk of lung cancer. Some risk factors can be controlled, for instance, by quitting smoking. And other factors can't be controlled, such as your family history. Risk factors for lung cancer include:
Lung cancer can cause complications, such as:
If you have signs and symptoms that worry you, start by seeing your family doctor or a general practitioner. If your doctor suspects you have lung cancer, you'll likely be referred to a specialist. Specialists who treat people with lung cancer can include:
What you can do
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared. To help you get ready, try to:
Questions to ask if you've been diagnosed with lung cancer
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For lung cancer, some basic questions to ask include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that come to mind during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask:
Testing healthy people for lung cancer
Doctors aren't sure whether people with no signs or symptoms of lung cancer should undergo screening for the disease. Some studies show that lung cancer screening may save lives by finding cancer earlier, when it may be treated more successfully. But other studies find that lung cancer screening often reveals more benign conditions that require invasive testing and expose people to unnecessary risks.
Screening for lung cancer is controversial among doctors. Studies are ongoing to determine what types of tests may be helpful and who would benefit from lung cancer screening. In the meantime, talk with your doctor if you're concerned about your risk of lung cancer. Together you can determine strategies to reduce your risk and decide whether screening tests are appropriate for you.
Tests to diagnose lung cancer
If there's reason to think that you may have lung cancer, your doctor can order a number of tests to look for cancerous cells and to rule out other conditions. In order to diagnose lung cancer, your doctor may recommend:
Lung cancer staging
Once your lung cancer has been diagnosed, your doctor will work to determine the extent, or stage, of your cancer. Your cancer's stage helps you and your doctor decide what treatment is most appropriate.
Staging tests may include imaging procedures that allow your doctor to look for evidence that cancer has spread beyond your lungs. These tests include CT scans, magnetic resonance imaging (MRI), positron emission tomography (PET) and bone scans. Not every test is appropriate for every person, so talk with your doctor about which procedures are right for you.
Stages of lung cancer
Small cell lung cancer is sometimes described as being limited or extensive. Limited indicates cancer is limited to one lung. Extensive indicates cancer has spread beyond the one lung.
You and your doctor choose a cancer treatment plan based on a number of factors, such as your overall health, the type and stage of your cancer, and your preferences. Options typically include one or more treatments, including surgery, chemotherapy, radiation therapy or targeted drug therapy.
In some cases you may choose not to undergo treatment. For instance, you may feel that the side effects of treatment will outweigh the potential benefits. When that's the case, your doctor may suggest comfort care to treat only the symptoms the cancer is causing, such as pain or shortness of breath.
|Treatment options for non-small cell lung cancers|
|I||Surgery, sometimes chemotherapy|
|II||Surgery, chemotherapy, radiation|
|III||Combined chemotherapy and radiation, chemotherapy alone, sometimes surgery based on results of other treatments|
Chemotherapy, targeted drug therapy, clinical trials, supportive care
|Treatment options for small cell lung cancers|
|I||Surgery when possible, but usually combined chemotherapy and radiation|
|II||Combined chemotherapy and radiation|
|III||Combined chemotherapy and radiation, clinical trials, supportive care|
|IV||Chemotherapy, clinical trials, supportive care|
During surgery your surgeon works to remove the lung cancer and a margin of healthy tissue. Procedures to remove lung cancer include:
If you undergo surgery, your surgeon may also remove lymph nodes from your chest in order to check them for signs of cancer.
Lung cancer surgery carries risks, including bleeding and infection. Expect to feel short of breath after lung surgery. If a portion of your lung is removed, your remaining lung tissue will expand over time and make it easier to breathe. Your doctor may recommend a respiratory therapist who can guide you through breathing exercises to aid in your recovery.
Chemotherapy uses drugs to kill cancer cells. One or more chemotherapy drugs may be given through a vein in your arm (intravenously) or taken orally. A combination of drugs usually is given in a series of treatments over a period of weeks or months, with breaks in between so that you can recover.
Chemotherapy can be used as a first line treatment for lung cancer or as additional treatment after surgery. In some cases, chemotherapy can be used to lessen side effects of your cancer.
Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation therapy can be directed at your lung cancer from outside your body (external beam radiation) or it can be put inside needles, seeds or catheters and placed inside your body near the cancer (brachytherapy).
Radiation therapy can be used alone or with other lung cancer treatments. Sometimes it's administered at the same time as chemotherapy.
For people with lung cancers that are very small, one option may be stereotactic body radiotherapy. This form of radiation aims many beams of radiation from different angles at the lung cancer. Stereotactic body radiotherapy treatment is typically completed in one or a few treatments. In certain cases, it may be used in place of surgery for small tumors.
Targeted drug therapy
Targeted therapies are newer cancer treatments that work by targeting specific abnormalities in cancer cells. Targeted therapy options for treating lung cancer include:
Clinical trials are studies of experimental lung cancer treatments. You may be interested in enrolling in a clinical trial if lung cancer treatments aren't working or if your treatment options are limited. The treatments studied in a clinical trial may be the latest innovations, but they don't guarantee a cure. Carefully weigh your treatment options with your doctor. Your participation in a clinical trial may help doctors better understand how to treat lung cancer in the future.
When treatments offer little chance for a cure, your doctor may recommend you avoid harsh treatments and opt for supportive care instead. If you're receiving supportive care, your doctor may treat signs and symptoms to make you feel more comfortable, but you won't receive treatment aimed at stopping your cancer. Supportive care, which is also called palliative care, allows you to make the most of your life without enduring treatment side effects that can negatively affect your quality of life.
In one study, people with advanced non-small cell lung cancer who began receiving supportive care soon after their diagnosis lived longer than those who continued with treatments, such as chemotherapy and radiation. Those receiving supportive care reported improved mood and quality of life. They survived, on average, almost three months longer than did those receiving standard care.
Coping with shortness of breath
Many people with lung cancer experience shortness of breath at some point in the course of the disease. Treatments, such as supplemental oxygen, and medications are available to help you feel more comfortable, but they aren't always enough. To cope with shortness of breath, it may help to:
Tell your doctor if you experience shortness of breath or if your symptoms worsen.
If your doctor has told you that your lung cancer can't be cured, you may be tempted to turn to complementary and alternative medicine for answers. Complementary and alternative lung cancer treatments can't cure your cancer. But complementary and alternative treatments can often be combined with your doctor's care to help relieve signs and symptoms. Your doctor can help you weigh the benefits and risks of complementary and alternative treatments.
The American College of Chest Physicians reviewed available complementary and alternative treatments and found that some therapies may help people with lung cancer, including:
A diagnosis of lung cancer is devastating. It may take some time to come to terms with your feelings. When you're ready, you can take steps to take control of your situation. Taking an active role in your health care may make you feel more empowered in coping with lung cancer. Try to:
There's no sure way to prevent lung cancer, but you can reduce your risk if you:
Want to know more about this article or other health related issues? Ask your question and we'll post some each week for CNN.com reader to discuss or for our experts to weight in.
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