October 16, 2020
More people die from lung cancer each year than any other cancer in the United States. Lung cancer comprises nearly 25% of all cancer deaths and is the second most common cancer for both men and women. Fortunately, the rate of lung cancer has decreased over the last several decades because fewer people smoke. However, the symptoms of lung cancer can mimic other conditions, so it’s important you talk with your doctor if you experience symptoms. To help, this article will cover ways to reduce your risk, the early signs of lung cancer and expectations.
What is lung cancer?
Lung cancer is the rapid and abnormal growth of cells in the lungs. As the cancer cells continue to increase, they become lung tumors. When cancer spreads outside of the lungs, it is known as metastatic lung cancer.
The primary purpose of the lungs is to oxygenate the body and remove carbon dioxide. The lungs are 2 spongy organs on either side of the trachea, also known as the windpipe. The trachea further divides into 2 bronchi, then smaller tubes called bronchioles. At the end of the bronchioles are small sacs called alveoli that absorb oxygen into the blood from the air you inhale and remove the carbon dioxide when you breathe out. Lung cancer can occur in any of these locations.
What are the main causes of lung cancer?
The primary cause of lung cancer is smoking. In fact, more than 90% of all cases are caused by tobacco use.
There are many other risk factors for lung cancer, including:
- Genetics: Inherited genetic mutations can reduce someone’s ability to repair damaged DNA or eliminate carcinogens leading to lung cancer. Genetic mutations increase the risk of developing lung cancer whether the person is a nonsmoker or smoker.
- Age: Most people diagnosed with lung cancer are age 65 or older and the average age of diagnosis is 70.
- African American men are 15% more likely to develop lung cancer than white men.
- However, African American women are less likely to get lung cancer than white women.
- Overall risk by race:
- White/non-Hispanic (56.1%) and African American (55.5%) people are more likely to get lung cancer than indigenous (39.1%), Asian (33.4%) or Hispanic (27.7%).
- Sex: African American and white women have lower rates of lung cancer than men, but the overall rate has been dropping among men over the last few decades.
What are the most common symptoms of lung cancer?
The most common signs of lung cancer are:
- A chronic cough that does not go away or gets worse
- Coughing up bloody spit or mucus
- Chest pain (or discomfort) that worsens with laughing, deep breaths or coughing
- Hoarse voice
- Loss of appetite
- Unexplained weight loss
- Shortness of breath
- Fatigue or weakness
- Lung infections that don’t go away or keep coming back (i.e., bronchitis or pneumonia)
- Difficulty swallowing
- Swelling in veins of face or neck
When men get lung cancer, they are more likely to get squamous cell lung cancer, the most common type to occur in people who smoke. There are more obvious symptoms with squamous cell cancer so it is often diagnosed early. Early diagnosis greatly improves the likelihood of survival. Thus, lung cancer symptoms in men are typically more obvious than lung cancer symptoms in women.
What can mimic the symptoms of lung cancer?
There are a number of lung conditions that can mimic the signs of lung cancer. They include:
- Infectious diseases like tuberculosis, histoplasmosis or actinomycosis
- Foreign body
- Pulmonary infarction
- Benign tumor
If you experience any of these symptoms, it is crucial to know that it’s not always cancer-related. However, by knowing the symptoms of lung cancer or these conditions, you can see your healthcare provider as soon as possible and get an accurate diagnosis.
Does lung cancer affect men or women more?
Lung cancer incidence is greater in men than women, but the gap is decreasing. The overall likelihood that a man will develop lung cancer over the course of his life is about 1 in 15 (or nearly 63 per 100,000 men), but for a woman, the risk is about 1 in 17 (or nearly 50 per 100,000).
These numbers include both smokers and nonsmokers. For smokers, the risk is even higher. About 116,300 men and 112,520 women will be diagnosed with lung cancer in 2020, while approximately 72,500 men and 63,220 women will die.
Men and women experience aspects of lung cancer differently:
- Women are diagnosed at a younger age than men by 2 years.
- Women are more likely to have distinguishable genetic changes related to their cancer.
- Women typically respond to many chemotherapy medications for lung cancer better than men.
- Women are more likely to survive at all stages of lung cancer.
However, it is crucial to be aware that lung cancer occurs in both men and women.
What are the differences between small cell vs. non-small cell lung cancer?
The types of lung cancer are:
- Small cell lung cancer (SCLC), also known as:
- Small cell carcinoma (oat cell)
- Non-small cell lung cancer (NSCLC), also known as:
- Squamous cell carcinoma
- Large cell carcinoma
The major differences between SCLC and NSCLC are that small cell lung cancer appears small and round under a microscope, while NSCLC is larger. Most lung cancer cases are non-small cell lung cancer, which affects 84% of those with a lung cancer diagnosis. However, 13% are diagnosed with small cell lung cancer, which is more aggressive. With SCLC, the goal is typically to manage the disease, whereas with NSCLC the goal may be to cure it.
African American men are more likely to have lung cancer but are less likely to develop SCLC than white men. Non-smoking women who develop lung cancer are more likely to have adenocarcinoma, while men are more likely to develop squamous cell carcinoma and small cell lung cancer.
How can I reduce my risk of lung cancer?
There’s no sure way to prevent lung cancer, but you can reduce your risk if you:
- Don’t smoke: Don’t smoke and don’t start. Quit smoking and avoid secondhand smoke.
- Avoid environmental carcinogens:
- Radon: Test your home for this radioactive, colorless, odorless, tasteless gas that comes up through the ground and accumulates in places with inadequate ventilation like buildings or mines. Long-term exposure to radon, particularly in well-insulated and sealed homes, increases your risk for cancer. One in 15 homes has high levels of radon that is typically concentrated in the basement or first floor.
- Arsenic: This natural element is found in rocks, soil, water and air. You can inhale the arsenic or ingest it. However, exposure to high levels of arsenic increases the risk of lung cancer.
- Asbestos: While no longer used in building materials, asbestos exposure is the primary cause of 4% of cases of lung cancer.
- Eat a diet full of fruits and vegetables.
- Exercise most days of the week for at least 30 minutes at a moderate intensity level.
How can you detect lung cancer early?
Many lung cancers in the early stages do not have noticeable symptoms. Some early signs and symptoms of lung cancer should be reported to your healthcare provider. Early detection may improve your chances to manage or cure your disease. The early signs of lung cancer in a nonsmoker are different from those who smoke. Nonsmokers typically experience nonspecific symptoms such as fatigue or shortness of breath with activity.
The American Cancer Society recommends screening for lung cancer in current or former smokers between the ages of 55-74 with an annual low-dose CT scan. It is vital to discuss this imaging with your healthcare provider and your insurance company to learn about recommendations and costs. The CT scan can detect lung cancer when it is still very small. Discuss screening with your healthcare provider and see if it is appropriate for you.
How is lung cancer diagnosed?
Lung cancer is diagnosed using:
- Imaging tests: X-rays may detect an abnormal nodule or mass while a computed tomography scan can reveal an abnormal lesion.
- Sputum cytology: If you have a cough that produces sputum, it can be examined under a microscope to detect cancerous cells.
- Biopsy: This is a tissue sample of abnormal cells, often taken during a bronchoscopy where your doctor uses a lighted tube to examine your lungs. There is also the mediastinoscopy, which is an incision at the base of the neck where tissue samples are removed from lymph nodes behind the breastbone. Another option is the needle biopsy, performed with imaging to guide the needle through the chest wall and into the lung to collect the tissue sample.
The lab will evaluate the cells to determine the type of lung cancer and the stage of cancer to guide the treatment. Staging is done by CT, MRI, positron emission tomography (PET) or bone scans.
The stages of lung cancer are defined by the classification of malignant tumors (TNM), a global standard to describe the anatomical spread of cancer. The TNM stands for tumor (T), lymph node (N) and metastasis (M) and ranges from 0 (carcinoma in situ (CIS)) to stages I through IV (1 to 4).
The lower the number, the less cancer has spread through the body. Each stage is further broken into letters. While everyone’s journey with this disease differs, similar stages typically have a similar prognosis and treatment options.
How can you treat lung cancer?
The type of treatment for lung cancer depends on the type of cancer. People with NSCLC can be treated with a combination of:
- Surgery: Surgeons remove the cancerous tissue in a minimally invasive procedure.
- Chemotherapy: Systemic medication that destroys cancerous cells by oral medicine or intravenous infusion. It may be used to shrink a tumor or as standalone treatment.
- Radiation therapy: High-dose X-rays that shrink swollen lymph nodes, decrease tumor size and kill cancer cells.
- Brachytherapy: High-dose radiation that spares healthy surrounding tissue.
- Immunotherapy: Harnesses the patient’s immune system to precisely recognize and destroy highly targeted cancer cells without harming healthy tissue and often with fewer side effects.
- Interventional radiology: Diagnostic and therapeutic treatment for lung cancer through:
- Embolization: Cuts off blood supply to a tumor that feeds cancer cells.
- Radiofrequency ablation: A nonsurgical, minimally invasive procedure that uses radiofrequency waves to heat up a small area of nerve tissue to stop it from sending pain signals.
- Chemoembolization: Biodegradable beads with chemotherapy that target the tumor and stop blood flow. The chemo drugs stay out of the bloodstream so they produce fewer side effects.
- Microwave ablation: Microwaves heat and kill tumor cells while being guided by CT or MRI for lung cancer with few cancerous lesions.
- Calypso® 4D localization system™: Continuous tracking of targeted tissue to treat lung cancer precisely during radiation therapy.
- CT-guided biopsy: CT scanning technology combined with imaging to accurately target areas for a tissue sample biopsy.
Can lung cancer be cured?
Yes, lung cancer can be treated and you can survive a lung cancer diagnosis. However, survival rates vary depending on the type and stage of lung cancer at the time of diagnosis. Lung cancer often has a very serious prognosis, but those with earlier diagnoses have increased chances of survival. Even when projecting the future cancer mortality risk within the next decade, lung cancer will remain at the top of the list.
When evaluating those with advanced lung cancer symptoms and signs, the survival rate decreases substantially. The overall likelihood of living 5 years with NSCLC is 24% and drops to 6% with SCLC.
Why choose The University of Kansas Cancer Center for lung cancer diagnosis and treatment?
If you have identified signs and symptoms of lung cancer, you may feel overwhelmed about where to start. Each patient at The University of Kansas Cancer Center works with a multidisciplinary team of cancer specialists, including a disease-specific nurse navigator. The University of Kansas Cancer Center is the only National Cancer Institute-designated cancer center in Kansas and throughout the region.