Lung cancer (patient information)

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Overview
Lung cancer is a common cancer in the world. It is a leading cause of cancer death in men and women in the United States. Cigarette smoking is the main and most important cause of most lung cancers. Other risk factors include high levels of pollution, radiation and asbestos exposure. According to the pathology, lung cancer can be divided into small cell lung carcinoma and non-small cell lung carcinoma. Usual symptoms include a cough that doesn't go away and gets worse over time, constant chest pain, coughing up blood, shortness of breath, wheezing, or hoarseness, repeated problems with pneumonia or bronchitis, swelling of the neck and face, loss of appetite or weight loss and fatigue. Treatments involve surgery, radiation therapy, chemotherapy, targeted therapies, or a combination. The prognosis varies widely. It mainly depends on the stage of the cancer and whether or not the tumor can be removed by surgery.

What are the symptoms of Lung cancer?
Early lung cancer often does not cause symptoms. But as the cancer grows, common symptoms may include:
 * a cough that gets worse or does not go away
 * breathing trouble, such as shortness of breath
 * constant chest pain
 * coughing up blood
 * a hoarse voice
 * frequent lung infections, such as pneumonia
 * feeling very tired all the time
 * weight loss with no known cause

Most often these symptoms are not due to cancer. Other health problems can cause some of these symptoms. Anyone with such symptoms should see a doctor to be diagnosed and treated as early as possible.

What causes Lung cancer?
Lung cancer is the deadliest type of cancer for both men and women. Each year, more people die of lung cancer than breast, colon, and prostate cancers combined.

Lung cancer is more common in older adults. It is rare in people under age 45.

Cigarette smoking is the leading cause of lung cancer.

The more cigarettes you smoke per day and the earlier you started smoking, the greater your risk of lung cancer. There is no evidence that smoking low-tar cigarettes lowers the risk.

However, lung cancer has occurred in people who have never smoked.

Secondhand smoke (breathing the smoke of others) increases your risk of lung cancer. According to the American Cancer Society, an estimated 3,000 nonsmoking adults will die each year from lung cancer related to breathing secondhand smoke.

The following may also increase one's risk of lung cancer:


 * High levels of air pollution
 * High levels of arsenic in drinking water
 * Radon gas
 * Asbestos
 * Family history of lung cancer
 * Radiation therapy to the lungs
 * Exposure to cancer-causing chemicals such as uranium, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, chloromethyl ethers, gasoline, and diesel exhaust

Who is at highest risk?
Studies have found the following risk factors for lung cancer:


 * Tobacco smoke: Tobacco smoke causes most cases of lung cancer. It's by far the most important risk factor for lung cancer. Harmful substances in smoke damage lung cells. That's why smoking cigarettes, pipes, or cigars can cause lung cancer and why secondhand smoke can cause lung cancer in nonsmokers. The more a person is exposed to smoke, the greater the risk of lung cancer. For more information, see the NCI fact sheets Quitting Smoking and Secondhand Smoke.


 * Radon: Radon is a radioactive gas that you cannot see, smell, or taste. It forms in soil and rocks. People who work in mines may be exposed to radon. In some parts of the country, radon is found in houses. Radon damages lung cells, and people exposed to radon are at increased risk of lung cancer. The risk of lung cancer from radon is even higher for smokers. For more information, see the NCI fact sheet Radon and Cancer.


 * Asbestos and other substances: People who have certain jobs (such as those who work in the construction and chemical industries) have an increased risk of lung cancer. Exposure to asbestos, arsenic, chromium, nickel, soot, tar, and other substances can cause lung cancer. The risk is highest for those with years of exposure. The risk of lung cancer from these substances is even higher for smokers.


 * Air pollution: Air pollution may slightly increase the risk of lung cancer. The risk from air pollution is higher for smokers.


 * Family history of lung cancer: People with a father, mother, brother, or sister who had lung cancer may be at slightly increased risk of the disease, even if they don't smoke.


 * Personal history of lung cancer: People who have had lung cancer are at increased risk of developing a second lung tumor.


 * Age over 65: Most people are older than 65 years when diagnosed with lung cancer.

Diagnosis
If you have a symptom that suggests lung cancer, your doctor must find out whether it's from cancer or something else. Your doctor may ask about your personal and family medical history. Your doctor may order blood tests, and you may have one or more of the following tests:


 * Physical exam: Your doctor checks for general signs of health, listens to your breathing, and checks for fluid in the lungs. Your doctor may feel for swollen lymph nodes and a swollen liver.


 * Chest x-ray: X-ray pictures of your chest may show tumors or abnormal fluid.


 * CT scan: Doctors often use CT scans to take pictures of tissue inside the chest. An x-ray machine linked to a computer takes several pictures. For a spiral CT scan, the CT scanner rotates around you as you lie on a table. The table passes through the center of the scanner. The pictures may show a tumor, abnormal fluid, or swollen lymph nodes.

Finding Lung Cancer Cells
The only sure way to know if lung cancer is present is for a pathologist to check samples of cells or tissue. The pathologist studies the sample under a microscope and performs other tests. There are many ways to collect samples.

Your doctor may order one or more of the following tests to collect samples:


 * Sputum cytology: Thick fluid (sputum) is coughed up from the lungs. The lab checks samples of sputum for cancer cells.


 * Thoracentesis: The doctor uses a long needle to remove fluid (pleural fluid) from the chest. The lab checks the fluid for cancer cells.


 * Bronchoscopy: The doctor inserts a thin, lighted tube (a bronchoscope) through the nose or mouth into the lung. This allows an exam of the lungs and the air passages that lead to them. The doctor may take a sample of cells with a needle, brush, or other tool. The doctor also may wash the area with water to collect cells in the water.


 * Fine-needle aspiration: The doctor uses a thin needle to remove tissue or fluid from the lung or lymph node. Sometimes the doctor uses a CT scan or other imaging method to guide the needle to a lung tumor or lymph node.


 * Thoracoscopy: The surgeon makes several small incisions in your chest and back. The surgeon looks at the lungs and nearby tissues with a thin, lighted tube. If an abnormal area is seen, a biopsy to check for cancer cells may be needed.


 * Thoracotomy: The surgeon opens the chest with a long incision. Lymph nodes and other tissue may be removed.


 * Mediastinoscopy: The surgeon makes an incision at the top of the breastbone. A thin, lighted tube is used to see inside the chest. The surgeon may take tissue and lymph node samples.

When to seek urgent medical care?
Anyone with symptoms similar to those listed above should see a doctor to be diagnosed and treated as early as possible.

Treatment options
Patients with lung cancer have many treatment options. The selection depends on the stage of the tumor. The options are surgery, radiation therapy, chemotherapy, targeted therapies, or a combination of these methods. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effect may not be the same for each person, and they may change from one treatment session to the next.


 * Surgery: Surgery is the main treatment for most lung cancer, if the stage of the cancer and the patient's general health are possible. Surgical removal of all the tumor and surroundings is recommended.


 * Radiation therapy: This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation.


 * Chemotherapy: The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.


 * Targeted therapies: These measures use drugs that target tumor blood vessel growth and drugs that target epidermal growth factor receptor (EGFR) to treat lung cancer.

Diseases with similar symptoms

 * Chronic obstructive pulmonary disease
 * Pulmonary tuberculosis
 * Pneumonia
 * Pulmonary abscess

Where to find medical care for Lung cancer?
Directions to Hospitals Treating Lung cancer

What to expect (Outlook/Prognosis)?
The prognosis of pancreatic is poor and it depends on the following:
 * Whether or not the tumor can be removed by surgery.
 * The stage of the cancer: the size of the tumor, whether the cancer has spread outside the pancreas
 * The patient’s general health
 * Whether the cancer has just been diagnosed or has recurred

Prevention
Epidemiology data show the following intervention may help to reduce your risk of lung cancer.
 * Avoiding smoking and breathing in other people's smoke.
 * Reduing or eliminating exposure to radon.
 * Avoiding exposure to known cancer-causing chemicals, in the workplace and elsewhere.
 * Keeping a healthy diet with lots of fruits and vegetables.
 * For current or former smokers, giving them high doses of vitamins or vitamin-like drugs.