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Lung Cancer

About Lung Cancer

Lung cancer is cancer that begins in the lungs, the two organs found in the chest that help you breathe.

The lungs are made up of areas called lobes. The right lung has three lobes; the left lung has two, so there's room for the heart. When you breathe, air goes through your nose, down your windpipe (trachea), and into the lungs where it spreads through tubes called bronchi. Most lung cancer begins in the cells that line these tubes.

There are two main types of lung cancer:

  • Non-small cell lung cancer (NSCLC) is the most common type of lung cancer.
  • Small cell lung cancer makes up about 20% of all lung cancer cases.

If the lung cancer is made up of both types, it is called mixed small cell/large cell cancer.

If the cancer started somewhere else in the body and spread to the lungs, it is called metastatic cancer to the lung.


References

Mason RJ, Murray J, VC Broaddus, Nadel J. Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: WB Saunders; 2005:1311-1409.

Gallus S. Smoking high tar cigarettes increases risk of death from lung cancer, but no differences in risk for smokers of very low, low and medium tar cigarettes. Evidence-based Healthcare. Aug 2004; 8(4); 207.

Sugimura H. Long-term survivorship in lung cancer: a review. Chest. Apr 2006; 129(4): 1088-97.

Review Date: 7/31/2006
Reviewed By: Rita Nanda, M.D., Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Symptoms

Early lung cancer may not cause any symptoms. Many times, lung cancer is found when an x-ray is done for another reason.

Symptoms depend on the specific type of cancer you have, but may include:

  • Cough that doesn't go away
  • Coughing up blood
  • Shortness of breath
  • Wheezing
  • Chest pain
  • Loss of appetite
  • Losing weight without trying
  • Fatigue

Additional symptoms that may also occur with lung cancer:

  • Weakness
  • Swallowing difficulty
  • Nail problems
  • Joint pain
  • Hoarseness or changing voice
  • Swelling of the face
  • Facial paralysis
  • Eyelid drooping
  • Bone pain or tenderness

These symptoms can also be due to other, less serious conditions, so it is important to talk to your health care provider.


References

Mason RJ, Murray J, VC Broaddus, Nadel J. Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: WB Saunders; 2005:1311-1409.

Gallus S. Smoking high tar cigarettes increases risk of death from lung cancer, but no differences in risk for smokers of very low, low and medium tar cigarettes. Evidence-based Healthcare. Aug 2004; 8(4); 207.

Sugimura H. Long-term survivorship in lung cancer: a review. Chest. Apr 2006; 129(4): 1088-97.

Review Date: 7/31/2006
Reviewed By: Rita Nanda, M.D., Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com

Causes

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 non-smoking 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

References

Mason RJ, Murray J, VC Broaddus, Nadel J. Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: WB Saunders; 2005:1311-1409.

Gallus S. Smoking high tar cigarettes increases risk of death from lung cancer, but no differences in risk for smokers of very low, low and medium tar cigarettes. Evidence-based Healthcare. Aug 2004; 8(4); 207

Sugimura H. Long-term survivorship in lung cancer: a review. Chest. Apr 2006; 129(4): 1088-97.

Review Date: 7/31/2006
Reviewed By: Rita Nanda, M.D., Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com

Diagnosis

The health care provider will perform a physical exam and ask questions about your medical history. You will be asked if you smoke, and if so, how long you have smoked.

When listening to the chest with a stethoscope, the health care provider can sometimes hear fluid around the lungs, which could (but doesn't always) suggest cancer.

Tests that may be performed include:

  • Chest x-ray
  • Sputum cytology test
  • Blood work
  • CT scan of the chest
  • MRI of the chest
  • Positron emission tomography (PET) scan

In some cases, the health care provider may need to remove a piece of tissue from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this:

  • Bronchoscopy combined with biopsy
  • Pleural biopsy
  • CT scan directed needle biopsy
  • Mediastinoscopy with biopsy
  • Open lung biopsy

References

Mason RJ, Murray J, VC Broaddus, Nadel J. Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: WB Saunders; 2005:1311-1409.

Gallus S. Smoking high tar cigarettes increases risk of death from lung cancer, but no differences in risk for smokers of very low, low and medium tar cigarettes. Evidence-based Healthcare. Aug 2004; 8(4); 207.

Sugimura H. Long-term survivorship in lung cancer: a review. Chest. Apr 2006; 129(4): 1088-97.

Review Date: 7/31/2006
Reviewed By: Rita Nanda, M.D., Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com

Treatment

Treatment depends on the specific type of lung cancer. Each type is treated differently. Chemotherapy, radiation, and surgery may be needed.

Non-Small Cell Lung Cancer:

There are many different types of treatment for non-small cell lung cancer:

  • Surgery - part or all of the lung is removed
  • Radiation therapy - uses powerful x-rays or other radiation to kill cancer cells
  • Chemotherapy - uses drugs to kill cancer cells and stop new ones from growing
  • Laser therapy - a small beam of light burns and kills cancer cells
  • Photodynamic therapy - uses a light to activate a drug in the body, which kills cancer cells
  • Watchful waiting - in rare cases, the person may only be monitored until symptoms change

Treatment depends upon the stage of the cancer. A combination of treatments may be needed. Research has suggested that chemotherapy or a combination of chemotherapy and radiation therapy prior to surgery might be the best treatment for some patients.

Surgery is the often the first line of treatment for most patients with stage I and II non-small cell lung cancer, and some patients with stage III tumors. Surgery can cure the disease.

Chemotherapy alone is often used when the cancer has spread (stage IV). Chemotherapy has been shown to prolong the life and improve the quality of life in some stage IV patients.

References

Mason RJ, Murray J, VC Broaddus, Nadel J. Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: WB Saunders; 2005:1311-1409.

Gallus S. Smoking high tar cigarettes increases risk of death from lung cancer, but no differences in risk for smokers of very low, low and medium tar cigarettes. Evidence-based Healthcare. Aug 2004; 8(4); 207.

Sugimura H. Long-term survivorship in lung cancer: a review. Chest. Apr 2006; 129(4): 1088-97.

Mehra R, Moore BA, Crothers K, Tetrault J, Fiellin DA. The association between marijuana smoking and lung cancer: a systematic review. Arch Intern Med. 2006 Jul 10;166(13):1359-67.

American Cancer Society. Cancer Facts and Figures 2006. Atlanta, Ga: American Cancer Society; 2006.

U.S. Preventive Services Task Force. Lung cancer screening. Ann Int Med. 2004;140:738-739.

Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG. Clinical Oncology. 3rd ed. Orlando, Fl: Churchill Livingstone; 2004:1690-1701.

American Cancer Society. Cancer Facts and Figures 2006. Atlanta, Ga: American Cancer Society; 2006.

U.S. Preventive Services Task Force. Lung cancer screening. Ann Int Med. 2004;140:738-739.

Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG. Clinical Oncology. 3rd ed. Orlando, Fl: Churchill Livingstone; 2004:1708-1722.

Jackman DM, Johnson BE. Small-cell lung cancer. Lancet. 2005;366:1385-1396.

Review Date: 7/31/2006
Reviewed By: Rita Nanda, M.D., Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com

Metastatic Cancer

Metastatic tumors in the lungs are malignancies (cancers) that developed at other sites and spread via the blood stream to the lungs. Common tumors that metastasize to the lungs include breast cancer, colon cancer, prostate cancer, sarcoma, bladder cancer, neuroblastoma, and Wilm's tumor. However, almost any cancer has the capacity to spread to the lungs.

In most cases, metastatic cancer to the lung is a sign that the cancer has spread into the bloodstream. Usually cancer will be present even in places not seen by CT scans. In these circumstances, removing the visible tumors by surgery is usually not beneficial. Chemotherapy is usually the treatment of choice.

Cure is unlikely in most cases. Patients with testicular cancer or lymphoma, however, have a higher likelihood of long-term survival and cure compared with those with most other cancers.

In some circumstances in which the primary tumor has been removed and cancer has spread to only limited areas of the lung, the lung metastases can be removed surgically with the goal of long-term survival or, occasionally, cure.

Radiation therapy, the placement of stents inside the airways, or laser therapy are sometimes used but are less common than surgery or chemotherapy.

Review Date: 9/11/2006
Reviewed By: Rita Nanda, M.D., Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com

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