Lung Cancer: 10 Things to Know

Lung cancer is the third most common cancer in men and women. Because it can be difficult to detect in the early stages, lung cancer is the leading cause of cancer-related deaths—more than colon, breast and prostate cancers combined. But not all lung cancers have the same prognosis. It’s important to know your type of lung cancer because it affects your treatment options and your outlook. Here are some key factors to know about lung cancer.

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  1. There are two main types of lung cancer.

  Non-small cell lung cancer accounts for about 85% of lung cancers. This type of lung cancer tends to grow slowly and spread slowly. There are three subtypes of non-small cell lung cancer: adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. Small cell lung cancer makes up most of the remaining lung cancer cases, and tends to grow quickly and spread quickly. The most common subtype of small cell lung cancer is oat cell. The other subtypes are intermediate cell type and combined small cell carcinoma.
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  2. There are often no symptoms in the early stages.

  Tumors can grow in the lungs without causing pain or discomfort. As a result, lung cancer typically doesn’t cause symptoms in the early stages. By the time most people notice symptoms, lung cancer usually has become advanced and spread to other parts of the body. When symptoms develop, they may include hoarseness, shortness of breath, and chest pain that worsens with deep breathing, coughing, or laughing. A cough is also common—a new cough that doesn’t go away or worsens over time, or changes in a chronic cough. The cough may produce blood or bloody or rust-colored mucus.
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  3. Smoking is the main risk factor.

  Anyone can get lung cancer, but smoking puts you at the greatest risk. Smoking—including cigarettes, cigars and pipes—causes 90% of lung cancer cases. Your risk goes up the longer you smoke and the more cigarettes per day you smoke. The good news is quitting decreases your risk, regardless of your age. Other risk factors include family history of lung cancer and exposure to secondhand smoke, radon, asbestos, and other hazardous materials and chemicals.
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  4. Taking lung cell samples is required for a proper diagnosis.

  If you have symptoms of lung cancer, your doctor will likely run some tests, including a chest X-ray, CT scan, or MRI. However, the only way to know for sure if it is cancer is to examine cells under a microscope. Your doctor may obtain cells through a sample of mucus you cough up, called a sputum sample. Or you may need a procedure: either thoracentesis to remove a sample of fluid from around your lungs or a biopsy, where doctors use a needle to take a tissue sample from your lungs.
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  5. A complete diagnosis is necessary to stage lung cancer.

  After diagnosing lung cancer, your doctor may order additional tests and procedures to determine the extent of cancer. This may include internal ultrasound, where a thin tube is placed in your windpipe or esophagus to produce images of the surrounding tissue. Exploratory surgery may be necessary for a complete diagnosis. All of this information helps your doctor determine the cancer stage and plan the most effective treatment.
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  6. Lung cancer stages guide treatment decisions.

  Tumor staging directs the treatment plan. There are six stages for non-small cell lung cancer: occult or hidden, 0, I, II, III and IV. Lower stage lung cancers usually have a better outlook and later stages indicate more severe disease. The stage of your cancer depends on the size of the tumor, how deeply it has grown into the lung, and whether it has spread to your lymph nodes or other organs. Doctors classify small cell lung cancer as limited or extensive. Once your doctor knows the stage, you and your doctor can develop a treatment plan that is right for you.
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  7. Surgery is a primary treatment for most early stage non-small cell lung cancers.

  Surgery removes the cancer and some healthy lung tissue around it. This may involve taking out a wedge, lobe or section of a lung, and in some cases an entire lung. Surgery is a common treatment for most early stage non-small cell lung cancers that have not spread beyond the lung, and offers the highest likelihood of successful outcomes for these cancers. Surgery is rarely an option for small cell lung cancer because this type usually affects both lungs. Doctors may recommend certain lung surgeries to treat symptoms in advanced cases of either type of lung cancer.
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  8. Chemotherapy is the main treatment for all stages of small cell lung cancer.

  Chemotherapy—or chemo—uses potent medicines to treat cancer. Chemotherapy is usually a systemic treatment, meaning it goes throughout the body to kill cancer cells or stop them from growing. It is the main treatment for all stages of small cell lung cancer. Doctors may also use chemotherapy for late stage non-small cell lung cancer when surgery isn’t possible. Chemotherapy may be appropriate for some early stage non-small cell lung cancers to shrink a tumor before surgery or to kill any cancer cells left after surgery.
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  9. Radiation therapy and targeted therapy may also be useful.

  Doctors often combine radiation therapy with chemotherapy to improve long-term outcomes in lung cancer. Radiation is also an option before or after surgery for non-small cell lung cancer, to kill any remaining cancer cells. In the late stages of either type of lung cancer, radiation can help relieve symptoms. Also, targeted therapies—medicines that target specific markers present only on cancer cells—are a treatment option for select non-small cell lung tumors. Doctors can test tissue from a tumor to see if it has the markers that would make this treatment worthwhile.
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  10. You can take charge of your lung health.

  Sometimes lung cancer strikes people with no known risk factors, and prevention isn’t possible in these cases. It’s also not possible to prevent lung cancer from risk factors you can’t control, such as family history. But most cases of lung cancer are preventable by not smoking or stopping smoking. This is the single most important step you can take to lower your odds of developing lung cancer. If you need help quitting smoking, talk with your doctor about treatment options. Don't let setbacks discourage you and never quit trying to quit.