Lung Cancer

Lung cancer starts in the cells of your lungs.

Your lungs are like two soft, sponge-like organs in your chest. They're responsible for taking in oxygen and releasing carbon dioxide as you breathe. Lung cancer is a type of cancer that begins when cells in the lungs grow out of control. This uncontrolled growth can form a tumor.

Sadly, lung cancer is the most common cause of cancer deaths globally. Many people die from it every year.

Smoking is a major risk factor for lung cancer. The more you smoke, and the longer you smoke, the higher your risk becomes. Even if you've smoked for a long time, quitting smoking greatly reduces your risk of getting lung cancer. It's never too late to quit. Importantly, lung cancer can also develop in people who have never smoked. Other factors, like exposure to certain substances at work or in the environment, can increase the risk as well.

Lung cancer often doesn't show any noticeable symptoms in its early stages. Problems usually appear only when the cancer has progressed. When lung cancer is present, you might notice some changes in your body, including:

Symptoms related to the lungs themselves:

• A new cough that won't go away: This is a key sign and often the first symptom people notice. If you've developed a cough that persists for more than a few weeks, it's important to see a doctor.
• Chest pain: Pain in your chest, especially if it's new or unusual, could be a sign of something wrong.
• Coughing up blood (even a small amount): If you cough up any blood, no matter how little, it's a serious sign that needs immediate medical attention.
• Hoarseness: A change in your voice, such as a persistent hoarseness, might be a symptom.
• Shortness of breath: Difficulty breathing or feeling winded more easily than usual could be a sign of lung problems.
• Wheezing: A whistling sound when you breathe might indicate a blockage in your airways.

Symptoms that might mean the cancer has spread to other parts of your body:

• Bone pain: Pain in your bones, particularly if it's new, could be a sign of cancer spreading.
• Headache: A persistent or unusual headache could be a symptom of cancer, but this is less common.
• Unexplained weight loss: Losing weight without trying can be a sign of various health problems, including cancer.
• Loss of appetite: A decreased desire to eat could be linked to a range of health conditions, including cancer.
• Swelling in your face or neck: Swelling in these areas could be a sign of issues related to the lymph nodes or other systems.

Important: If you have any of these symptoms, or any other symptoms that concern you, schedule an appointment with your doctor or other healthcare professional right away. It's crucial to get checked out.

If you smoke and want to quit: Don't hesitate to see your doctor. They can help you develop a plan to quit. Strategies might include counseling, medication, and nicotine replacement therapy. Quitting smoking is a significant step toward improving your overall health.

If you're experiencing any health concerns, schedule a visit with your doctor or other medical provider.

If you smoke and want to quit but haven't been successful, make an appointment. Your doctor can help you develop a plan to quit. This might involve talking with a counselor, using medications, or nicotine replacement therapies.

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Lung cancer develops when the DNA inside lung cells changes. DNA is like a set of instructions for the cell, telling it how to grow, multiply, and when to die. In healthy cells, these instructions are followed precisely. But in lung cancer, the DNA instructions become faulty. These faulty instructions tell the cells to grow and divide much faster than normal, and they don't die when they're supposed to. This uncontrolled growth leads to a buildup of extra cells.

These extra cells can clump together, forming a mass called a tumor. This tumor can grow and push into surrounding healthy tissue, damaging it. Cancer cells can also break off and travel to other parts of the body, a process called metastasis.

Smoking is a major cause of lung cancer. It's a risk factor for both smokers and people exposed to secondhand smoke. However, some people get lung cancer without ever smoking or being exposed to smoke. In these cases, the exact cause is often unknown.

Researchers think smoking damages the cells lining the lungs by exposing them to harmful substances called carcinogens. These carcinogens are found in cigarette smoke. When you inhale smoke, these carcinogens cause changes in your lung tissue almost immediately. While your body might initially repair some of this damage, repeated exposure causes more and more damage over time. This damage can eventually lead to changes in the cells, and these changes can develop into cancer.

Doctors classify lung cancer into two main types based on how the cancer cells look under a microscope. The type of lung cancer a person has helps guide their treatment plan.

The two main types are:

• Small cell lung cancer: This type of lung cancer is most often seen in people who have smoked heavily for a long time. It's less common than the other main type.
• Non-small cell lung cancer: This is a group of several different types of lung cancers. These include squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Each of these subtypes has slightly different characteristics and responses to treatment.

Many things can raise your chances of getting lung cancer. Some of these things you can change, like quitting smoking. Others, like your family history, you can't.

Here are some things that can increase your lung cancer risk:

Smoking: The more cigarettes you smoke each day, and the longer you've smoked, the higher your risk. Quitting smoking, no matter when you do it, can greatly reduce your chances of getting lung cancer. Think of it like this: every cigarette you avoid is a step towards a healthier future.

Secondhand Smoke: Even if you don't smoke yourself, breathing in smoke from other people's cigarettes (called secondhand smoke) increases your risk. This is because the smoke contains harmful chemicals that can damage your lungs.

Radiation Therapy: If you've had radiation treatments to your chest for another type of cancer, you might be at higher risk for lung cancer. This is because the radiation can damage your lung tissue over time.

Radon: Radon is a naturally occurring radioactive gas found in the soil and rock. It can seep into buildings, including homes, and build up to unsafe levels. Breathing in high levels of radon can increase your risk of lung cancer. This is important because radon is often undetectable without testing.

Workplace Exposure: If your job exposes you to cancer-causing substances (called carcinogens), your lung cancer risk goes up. Examples include asbestos, arsenic, chromium, and nickel. If you smoke, this risk is even greater. It's vital to be aware of potential workplace hazards and take necessary safety precautions.

Family History: Having a parent, sibling, or child with lung cancer can make you more likely to develop the disease yourself. This may be because of shared genetic factors or environmental exposures.

Understanding these risk factors can help you make informed choices about your health and take steps to lower your risk of lung cancer.

Lung cancer can lead to a number of problems.

One complication is difficulty breathing. If lung cancer grows and blocks the airways, it can make it hard to breathe deeply. Cancer can also cause fluid to build up around the lungs and heart. This fluid prevents the lungs from fully expanding when you inhale, making breathing even more challenging.

Another problem is bleeding in the airways. This can cause coughing up blood, sometimes in large amounts. Fortunately, there are treatments available to manage this bleeding.

As lung cancer progresses and spreads throughout the body, it can cause pain. This is because the cancer might grow into the lining of the lung or spread to other parts of the body, like the bones. If you experience pain, be sure to tell your doctor. There are many treatments available to help control the pain.

Lung cancer can also cause fluid to build up in the space around the lungs, called pleural effusion. This fluid buildup is in the area between the lung and the chest wall. Pleural effusion can worsen breathing problems, making it hard to take a full breath. Treatments are available to remove the fluid and reduce the risk of it coming back.

Lung cancer often spreads to other parts of the body, such as the brain and bones. When cancer spreads, it can cause a range of symptoms depending on where it spreads. These symptoms might include pain, nausea, headaches, or other problems. Once lung cancer has spread beyond the lungs, it's usually not curable. However, treatments can help manage symptoms and improve quality of life, allowing people to live longer.

Lung cancer prevention isn't guaranteed, but you can lower your chances by making some lifestyle changes.

Quit Smoking (and Encourage Others to Quit): Stopping smoking is one of the most important things you can do. Even if you've smoked for a long time, quitting reduces your risk of lung cancer. Talk to your doctor or a healthcare professional about quitting methods. They can help you find options like nicotine patches, gum, medication, or support groups. If you live or work with smokers, encourage them to quit. At the very least, ask them to smoke outside. Also, avoid places where smoking is common, such as bars, and look for smoke-free alternatives.

Protect Yourself from Workplace Hazards: If your job exposes you to harmful chemicals, follow your employer's safety guidelines carefully. This might include wearing protective gear like masks. Talk to your doctor about additional ways to shield yourself from these workplace carcinogens (cancer-causing substances). Smoking greatly increases the risk of lung damage if you're exposed to these workplace toxins.

Eat a Healthy Diet: Focus on a balanced diet with plenty of fruits and vegetables. Getting your vitamins and nutrients from whole foods is the best way. Avoid taking large doses of vitamins in pill form, as they can sometimes be harmful. For example, research has shown that beta-carotene supplements actually increased lung cancer risk in heavy smokers.

Stay Active: If you're not already active, start slowly and gradually increase your exercise. Aim to work out most days of the week. Even moderate exercise can make a difference in your overall health and help lower your risk of various health problems.

Diagnosing and Treating Lung Cancer

Lung cancer is a serious disease, but early detection and treatment can significantly improve outcomes. Understanding the process is key.

How Lung Cancer is Diagnosed

Doctors often start by looking for signs on imaging tests, like X-rays. If you have symptoms or a high risk, you might get a low-dose CT scan. This is a special type of X-ray that gives a more detailed look at your lungs. People who smoke or have a history of smoking and are 50 or older are often screened for lung cancer, as are those who quit within the last 15 years. It's crucial to discuss your personal risk factors with your doctor to determine if lung cancer screening is right for you.

If your doctor suspects lung cancer, several tests might be needed to confirm the diagnosis and assess the extent of the disease.

Tests for Lung Cancer

• Imaging Tests: These tests create pictures of your body. They help show where the cancer is located, its size, and if it has spread. Common imaging tests include X-rays, CT scans (computerized tomography), MRIs (magnetic resonance imaging), and PET scans (positron emission tomography).

• Sputum Cytology: Sputum is the mucus you cough up. If you're coughing up mucus, a sample can be examined under a microscope to see if it contains cancer cells.

• Biopsy: This is a procedure to remove a small tissue sample for laboratory analysis. There are several ways to perform a lung biopsy:

  • Bronchoscopy: A thin, flexible tube with a camera and light is inserted through your mouth or nose into your lungs to visualize the airways and collect tissue samples.
  • Mediastinoscopy: A small incision is made at the base of your neck, and tools are used to collect tissue samples from lymph nodes behind your breastbone.
  • Needle Biopsy: A needle, guided by X-rays or CT scans, is inserted into the lung tissue to collect cells. This can also be done to sample lymph nodes or other areas where cancer might have spread.

Analyzing the Results

The lab carefully examines the tissue sample to determine the type of lung cancer. This helps doctors predict how the cancer will behave (prognosis) and develop a treatment plan.

Staging Lung Cancer

Once diagnosed, additional tests may be needed to see if the cancer has spread (staging). These tests often involve imaging, like CT scans, MRIs, or bone scans, and may examine lymph nodes and other parts of the body. Staging helps doctors determine the extent of the cancer.

Lung cancer is often categorized into stages 1 through 4. Stage 1 indicates the cancer is small and confined to the lungs, while stage 4 means the cancer has spread to other parts of the body. In small cell lung cancer, stages are described as limited or extensive, depending on whether the cancer is confined to one lung and surrounding areas or has spread to other parts of the body.

Important Note: Your doctor will discuss the best tests and procedures for your specific situation. Not all tests are necessary for everyone.

Lung Cancer Treatment Options

Lung cancer treatment often starts with surgery to remove the tumor. If the cancer is large or has spread to other parts of the body, surgery might not be possible. In these cases, treatment might begin with medicine (chemotherapy) and/or radiation therapy instead.

Your healthcare team will create a treatment plan based on several factors:

• Your overall health: Your doctor will consider your general health condition when deciding on the best approach.
• The type and stage of the cancer: Different types of lung cancer require different treatments. The stage refers to how far the cancer has spread.
• Your preferences: You have a say in the treatment plan. For example, you might decide that the potential side effects of treatment outweigh the benefits.

Some people with lung cancer choose not to have any treatment, focusing instead on comfort care. Comfort care aims to manage pain and other symptoms caused by the cancer.

Surgical Options for Lung Cancer

Surgery may be an option if the cancer is confined to the lungs. Surgery may involve removing part of the lung (or even the entire lung) depending on the size and location of the tumor. Several types of lung surgery exist:

• Wedge resection: A small section of the lung containing the cancer and some surrounding healthy tissue is removed.
• Segmental resection: A larger part of the lung is removed, but not a whole lobe.
• Lobectomy: The entire lobe (section) of a lung is removed.
• Pneumonectomy: The entire lung is removed.

During surgery, the surgeon aims to remove the cancer and some healthy tissue around it to ensure all cancerous cells are removed. The surgeon might also remove lymph nodes (glands) in the chest to check them for cancer cells.

Sometimes, chemotherapy or radiation therapy is used before surgery to shrink the tumor, making it easier to remove. These treatments may also be used after surgery to kill any remaining cancer cells or prevent the cancer from returning.

Other Treatments for Lung Cancer

• Radiation Therapy: This treatment uses powerful energy beams (like X-rays or protons) to target and destroy cancer cells. The machine moves around the patient, directing the radiation to specific spots on the body. Radiation therapy can be used before or after surgery for lung cancer that hasn't spread outside the chest. It's often combined with chemotherapy. If surgery isn't possible, radiation and chemotherapy may be the first line of treatment. In cases where the cancer has spread, radiation therapy can help manage symptoms.

• Chemotherapy: This treatment uses strong medicines to kill cancer cells. These medicines are often given through a vein or taken as pills. Chemotherapy is typically given in cycles over weeks or months, with breaks in between to allow the body to recover. Chemotherapy is often used after surgery to kill any remaining cancer cells. It can also be used before surgery to shrink the tumor, or alone to manage symptoms in advanced stages of the disease.

• Stereotactic Body Radiotherapy (SBRT) / Stereotactic Radiosurgery: This is a type of intense radiation therapy that targets the cancer from many angles. It's usually completed in a few treatments and may be suitable for people with small lung cancers who can't have surgery, or for cancers that have spread to other parts of the body.

• Targeted Therapy: These medicines target specific molecules in the cancer cells, causing them to die. Targeted therapies may be used for lung cancers that have spread or recurred after initial treatment. Before using this treatment, your doctor will test your cancer cells to see if these medicines might work.

• Immunotherapy: These medicines help the body's immune system recognize and destroy cancer cells. The immune system fights off infections by attacking harmful cells. Immunotherapy may be used after surgery to kill any remaining cancer cells or to control the cancer if surgery isn't an option.

• Palliative Care: This is specialized care for people with serious illnesses, focusing on managing symptoms and improving quality of life. Palliative care can help with pain, nausea, and other symptoms caused by the cancer, regardless of other treatments being pursued. A team of doctors, nurses, and other healthcare professionals provide this support. You can receive palliative care at the same time as other cancer treatments.

The best treatment plan for lung cancer depends on many factors, and your healthcare team will work with you to determine the most appropriate approach.

Dealing with a lung cancer diagnosis can be tough, and it takes time to figure out what helps. In the meantime, several things can be helpful.

Understanding Your Lung Cancer: Learning about lung cancer is important for making choices about your treatment. Talk to your doctor and healthcare team. Ask about your test results, the different treatment options available, and if you'd like, your outlook (prognosis). The more you know, the more confident you'll feel about making decisions.

Strong Relationships: Maintaining close connections with friends and family is crucial. They can offer practical help, like taking care of chores while you're in the hospital or dealing with errands. Their emotional support is also vital when you're feeling overwhelmed by the diagnosis.

Talking About Your Feelings: It's important to talk about your hopes and fears with someone. This could be a friend, family member, or someone else who can listen. A counselor, medical social worker, clergy member, or a cancer support group can provide valuable support and understanding. Your healthcare team can tell you about support groups in your area.

Reliable Information Sources: For more information about lung cancer, you can also check out the National Cancer Institute and the American Cancer Society. These organizations offer trustworthy resources and information.