Lung Cancer


General information

Lung cancer is still the most common cancer, with over 200,000 new cases in the United States in 2012.  Lung cancer is still the most common cause of cancer deaths in men and woman although rates are declining. 


What are the risks?

Smoking is the major risk factor for lung cancer, increasing the risk over 20 times that of non-smokers. Quitters lower their cancer risks slowly over 15 years but always remain 2 times more likely to develop cancer than non-smokers. Other risks include: secondhand smoke, radon, asbestos, radiation therapy, arsenic, nickel, chromium. Genetic factors and pulmonary fibrosis also increase lung cancer risk.


Are there screening tests

Screening yearly for lung cancer with CT scans is now being recommended for individuals age 55-74 with a 35 pack year smoking history.


What are the symptoms of lung cancer?

Unfortunately, lung cancer is often discovered at a fairly advanced stage. Many of the symptoms including cough, chest pain and shortness of breath are common in all smokers. Hoarseness and hemoptysis (coughing up blood), and unexplained weight loss are worrisome symptoms for lung cancer.


What are the types of lung cancer?

There are four types of lung cancer histologically:  adenocarcinoma, squamous cell carcinoma, large cell carcinoma, and small cell carcinoma.  The type of lung cancer is usually established by a pulmonologist via bronchoscopic biopsy.


How is lung cancer treated?

Once the diagnosis of lung cancer is established, treatment is initiated based on the stage or extent of disease spread.  This is often determined by x-rays and scans ordered by a pulmonologist. Surgery is the standard treatment for stage I and II non-small cell lung cancers.  Generally in these stages the tumor is confined to the lung and adjacent lymph nodes. Small cell lung cancer is usually not treated with surgery. For patients who may be too ill or have limited breathing reserve and are unable to undergo surgery, high dose radiation therapy (often called stereotactic radiation therapy) is often used. Stage III non-small cell lung cancer when mediastinal nodes are involved, often involves the combined efforts of surgery, chemotherapy, and radiation therapy. Stage IV lung cancer, where the tumor has spread outside the lung, is rarely curable and treatments are aimed to palliate symptoms.


Which doctors usually treat lung cancer?

Lung cancer evaluation is usually carried out by a pulmonologist often after a referral for an x-ray abnormality discovered by a family physician. The pulmonologist may consult other physicians including surgeons, radiation oncologists, chemotherapy oncologists based on what treatments are needed for the type and stage of cancer.


Is there hope?

Treatments are always improving, death rates from lung cancer are declining, and the number of smokers in the United States is decreasing.  Trends are showing improved cure rates and survival times but there is still a long way to go.