Lung cancer

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 23, 2016
StartDiseasesLung cancer

Lung cancer remains the most deadly form of cancer in the United States. It occurs mostly in older people, but survival rates are rather good in people where the cancer is discovered early.

Contents

Definition & Facts

Cancer of the lung occurs primarily in people who are 65 or older, and the most common age for a diagnosis is 70. Only about two percent of people will develop the disease before the age of 45. In 2012, which is the last year statistics are available, there were just under 211,000 people diagnosed with lung cancer, and about three-fourths of that number (157,000) died from it.

More men will typically develop it than women, but it appears that the gap is slowly being closed. The odds of developing lung cancer for a man is about 1 in 13, and for a woman it is about 1 in 16. Lung cancer is often not discovered soon enough to prevent serious problems and death.

Symptoms & Complaints

There are two different kinds of lung cancer: small-cell lung cancers (SCLC) and non-small cell lung cancers (NSCLC). In their early stages, there are rarely any symptoms.

Symptoms begin to be evident when it has spread or begins blocking the breathing passages. Small-cell cancers have a tendency to spread faster than other forms. Symptoms primarily are related to breathing problems which include:

If the cancer has already spread to other parts of the body, other symptoms may include some of the following:

Causes

There is no doubt in the medical establishment that smoking is the primary cause of lung cancer. This has been known since the 1950's. Smoking accounts for about 90 percent of all lung cancer cases and an individual's risk level is raised higher:

  • The more cigarettes they smoked
  • The longer they smoked
  • The age they started smoking

There is also a risk among people who have never smoked. Their risk level is increased by the following factors:

Prolonged exposure to air pollution can lead to lung cancer. This can be very similar to being exposed to second-hand smoke, which results in about 3,000 deaths annually. Being exposed to asbestos has a much higher risk, which is raised to 50 times higher if an individual smokes and is exposed to asbestos.

Other diseases of the lungs can also raise the risk level for cancer such as COPD and tuberculosis. When it comes to the second most common cause of lung cancer, radon leads. It is responsible for about 21,000 deaths a year.

Diagnosis & Tests

When a doctor performs a medical exam, lung cancer might be suspected if some of the following symptoms are noticed:

Other indications include unusually higher levels of certain hormones or minerals, such as calcium. After a patient is suspected to have lung cancer, the first test that will be performed is a chest X-ray. If the patient is also coughing up mucous, a sample will be taken and analyzed. If further diagnosis is needed, a bronchoscope will be inserted into the nose and will be used to get a tissue sample – a biopsy of the affected area.

If cancer cells are found, further testing will be needed to determine the type of cancer, and how far it has spread. To do this, doctors may use scanning equipment including CT scans, MRIs, PET scans, and bone scans. Fluid may also be taken from the lining of the lungs, as well as a video-assisted thoracoscopic surgery (or VATS).

Treatment & Therapy

Once an analysis has been made as to the extent of the cancer, a stage of I to IV will be given. The treatment will depend on the stage reached. In stages II through IV, the lung cancer has gone beyond the lung and has spread to other areas. Treatments will be based on the tissue and organs affected by the cancer.

Surgery on the lung may involve removing a tumor, which may include removing a small section or piece of the lung. A more serious case may require that a lobe of the lung be removed, or even the removal of one whole lung. It is also likely that the doctor may remove some of the lymph nodes in the chest to check them for cancer. When a part of the lung is removed, patients may have some difficulty breathing until the remaining portions expand and readjust.

When the diagnosis is small-cell lung cancer (SCLC), surgery is often not used. The reason for this is because this kind of cancer spreads through the body too rapidly and getting it all is not possible. Chemotherapy and radiation therapy are also likely to be used. Medications or radiation may be used for pain relief.

Prevention & Prophylaxis

The primary way to prevent lung cancer is to either never smoke or to stop immediately. Someone who smokes multiplies their risk of lung cancer by 20-25 times. After quitting, it will take about 15 years to lower your risk level to that of someone who never smoked.

Those who are over 50 and have smoked extensively may want to have their lungs checked annually. This type of testing, called low-dose CT scan screening, can reduce the risk of dying from lung cancer by as much as 15 to 20 percent. Radon detectors placed in the home can help to detect unhealthy levels of that gas.