Lung cancer is the leading cause of cancer deaths in the United States. Lung cancer is a cancer that starts in the lungs, and can spread to other areas of the body.
Early symptoms of lung cancer can be subtle, but the sooner you are diagnosed, the better your treatment options and possible outcomes.
Lung cancer is primarily treated with surgery, chemotherapy, and radiation. Newer treatments include immunotherapy and targeted therapy.
Read on to learn more about lung cancer, and the current and evolving treatment options.
Early symptoms of lung cancer
Back pain can occur when tumors cause pressure in your lungs or when they spread to your spinal cord and ribs.
Other early signs of lung cancer may include:
- a lingering or worsening cough
- coughing up phlegm or blood
- chest pain that worsens when you breathe deeply, laugh, or cough
- weakness and fatigue
- loss of appetite and weight loss
- recurrent respiratory infections such as pneumonia or bronchitis
Late symptoms of lung cancer
Additional symptoms of lung cancer depend on where new tumors form. Not everyone with late-stage lung cancer will experience every symptom.
Late-stage symptoms might include:
- lumps in the neck or collarbone
- bone pain especially in the back, ribs, or hips
- balance issues
- numbness in arms or legs
- yellowing of skin and eyes (jaundice)
- drooping of one eyelid and shrunken pupils
- lack of perspiration on one side of the face
- shoulder pain
- swelling of the face and upper body
Additionally, lung cancer tumors can sometimes release a substance similar to hormones, leading to a wide variety of symptoms known as paraneoplastic syndrome. Symptoms include: :
Anyone can get lung cancer, but 90 percent of lung cancer cases are the result of smoking.
Smoke damages your lung tissue from the first second you inhale it. Once lung cells are damaged, they begin to behave abnormally. This increases your risk for lung cancer.
Small-cell lung cancer is almost always associated with heavy smoking. When you stop smoking, your lungs may be able to heal, reducing your risk of lung cancer.
You can also increase your risk of lung cancer by breathing in hazardous substances such as:
Research shows that inherited genetic mutations may make you more likely to develop lung cancer, especially if you smoke or are exposed to other carcinogens. Sometimes, there’s no obvious cause for lung cancer.
There are several different types of lung cancer. Most types of lung cancer are either non-small cell lung cancer (NSCLC) or small-cell lung cancer (SCLC). However, some people have tumors that contain both kinds of cells.
- Non-small cell lung cancer (NSCLC): NSCLC makes up about 80 to 85 percent of all cases. There are several types of NSCLC. Most types of NSCL respond well to treatment if caught in the early stages.
- Squamous cell lung carcinoma: About 30 percent of all cases of NSCLC begin in cells that line the passages of the respiratory tract. This is called squamous cell carcinoma.
- Adenocarcinomas: This type usually forms in the outer part of the lungs.
- Adenocarcinoma in situ (AIS): This rare subset of adenocarcinoma begins in the tiny air sacs in the lungs. It’s not aggressive and may not need immediate treatment.
- Adenosquamous carcinoma: This cancer develops in a mixture of squamous cells and mucus-producing cells.
- Large cell carcinoma: Large cell carcinoma is a fast-growing group of NSCLCs that can’t be classified under other cancer types.
- Small-cell lung cancer (SCLC): About 15 to 20 percent of lung cancers are SCLC. This type of lung cancer is more aggressive than NSCLC. Although SCLC often initially responds better to chemotherapy, it is less likely to be cured than NSCLC.
- Mesothelioma: This type of lung cancer is associated with asbestos exposure. It occurs when carcinoid tumors start in hormone-producing (neuroendocrine) cells. Mesothelioma is aggressive and fast-growing. It does not respond well to treatment.
There are multiple known risk factors for lung cancer. These include:
- Smoking: Smoking is the single biggest risk factor for lung cancer. This includes cigarettes, cigars, and pipes. Tobacco products contain thousands of toxic substances. According to the
Centers for Disease Control and Prevention (CDC), cigarette smokers are 15 to 30 times more likely to get lung cancer than nonsmokers.
- Secondhand smoke: Every year in the United States, about
7,300 peoplewho’ve never smoked die from lung cancer caused by secondhand smoke.
- Exposure to radon: Breathing in radon is the leading cause of lung cancer in nonsmokers. It’s a good idea to test your home for levels of radon to reduce your risk.
- Exposure to asbestos, diesel exhaust, and other toxic substances: Breathing in toxic substances can increase your risk, especially if you’re subject to repeat exposure.
- A family history of lung cancer: Having family members with lung cancer increases your risk of lung cancer.
- A personal history of lung cancer: You’re more likely to get lung cancer if you’ve had lung cancer in the past, especially if you’re a smoker.
- Previous radiation therapy to the chest: Radiation therapy can increase your risk of lung cancer.
Not all smokers get lung cancer, and not everyone who has lung cancer is a smoker. But there’s no doubt that smoking is the biggest risk factor. It’s responsible for
In addition to cigarettes, cigar and pipe smoking are also linked to lung cancer. The more you smoke and the longer you smoke, the greater your chance of developing lung cancer.
Former smokers are still at risk of developing lung cancer, but quitting can lower that risk considerably. Within 10 years of quitting smoking, the risk of dying from lung cancer drops by half.
Diagnosing lung cancer starts with a conversation with your doctor and a physical exam. They’ll want to go over your health history and any symptoms you’re having. You’ll also need tests to confirm the diagnosis. These might include:
- Imaging tests: An abnormal mass can be seen on X-ray, MRI, CT, and PET scans. These scans produce more detail and find smaller lesions.
- Sputum cytology: If you produce phlegm when you cough, microscopic examination can determine if cancer cells are present.
- Bronchoscopy: While under sedation, a lighted tube is passed down your throat and into your lungs, allowing closer examination of your lung tissue.
You might also have a biopsy. A biopsy is a procedure that involves obtaining a small sample of lung tissue which is then examined under a microscope. A biopsy can determine if tumor cells are cancerous. A biopsy may be performed using one of the the following methods:
- Mediastinoscopy: In a mediastinoscopy, your doctor makes an incision at the base of the neck. A lighted instrument is inserted and surgical tools are used to take samples from lymph nodes. It’s usually performed in a hospital under general anesthesia.
- Lung needle biopsy: With this procedure, your doctor inserts a needle through the chest wall and into the suspicious lung tissue. A needle biopsy can also be used to test lymph nodes. It’s usually performed in a hospital and you’ll be given a sedative to help you relax.
If the biopsy results are positive for cancer, you might need additional testing, such as a bone scan, to help determine if cancer has spread and to help with staging.
Cancer stages tell how far cancer has spread and help guide treatment.
The chance of successful or curative treatment is much higher when lung cancer is diagnosed and treated early. Because lung cancer may not cause obvious symptoms in the earlier stages, diagnosis often comes after it has spread.
Non-small cell lung cancer (NSCLC) stages:
- Stage 1: Cancer is found in the lung, but it has not spread outside the lung.
- Stage 2: Cancer is found in the lung and nearby lymph nodes.
- Stage 3: Cancer is in the lung and lymph nodes in the middle of the chest.
- Stage 3A: Cancer is found in lymph nodes, but only on the same side of the chest where cancer first started growing.
- Stage 3B: Cancer has spread to lymph nodes on the opposite side of the chest or to lymph nodes above the collarbone.
- Stage 4: Cancer has spread to both lungs, into the area around the lungs, or to distant organs.
Small-cell lung cancer (SCLC) stages:
There are two stages of SCLC, limited and extensive. In the limited stage, cancer is found in only one lung or nearby lymph nodes on the same side of the chest.
The extensive stage means cancer has spread:
- throughout one lung
- to the opposite lung
- to lymph nodes on the opposite side
- to fluid around the lung
- to bone marrow
- to distant organs
The primary treatments for lung cancer include surgery to remove the tumor, and chemotherapy and radiation treatments to kill cancer cells. Sometimes, newer cancer treatments such as targeted therapy and immunotherapy are also used, but usually not until later stages.
As a rule, treatment for non-small cell lung cancer (NSCLC) varies from person to person. Your treatment plan will depend on specific details of your health and on the stage of your cancer when you were diagnosed.
Treatment options for NSCLC by stage typically include:
Stage 1 NSCLC: Surgery to remove a portion of the lung may be all you need. Chemotherapy may also be recommended, especially if you’re at high risk of recurrence. Cancer is most treatable if caught at this stage.
Stage 2 NSCLC: You may need surgery to remove part or all of your lung. Chemotherapy is usually recommended.
Stage 3 NSCLC: You may require a combination of chemotherapy, surgery, and radiation treatment.
Stage 4 NSCLC: Options include surgery, radiation, chemotherapy, targeted therapy, and immunotherapy.
Options for small-cell lung cancer (SCLC) also include surgery, chemotherapy, and radiation therapy. In most cases, the cancer will be too advanced for surgery.
If you’re diagnosed with lung cancer, your care will likely be managed by a team of doctors who may include:
- a surgeon who specializes in the chest and lungs (thoracic surgeon)
- a lung specialist (pulmonologist)
- a medical oncologist
- a radiation oncologist
Discuss all your treatment options before making a decision. Your doctors will coordinate care and keep each other informed. You may also want to discuss clinical trials with your doctor.
Clinical trials can provide access to promising new treatments and can be an option if your treatment plan has stalled.
Some people with advanced lung cancer choose not to continue treatment. You can still choose palliative care treatments, which are focused on treating the symptoms of cancer rather than the cancer itself.
Home remedies won’t cure cancer. However, some may help relieve symptoms associated with lung cancer or the side effects of treatment.
Options may include:
- Massage: Massage can help relieve pain and anxiety. Some massage therapists are trained to work with people with cancer.
- Acupuncture: When performed by a trained practitioner, acupuncture may help ease pain, nausea, and vomiting. However, it’s not safe if you have low blood counts or take blood thinners.
- Meditation: Relaxation and reflection can reduce stress and improve overall quality of life.
- Yoga: Combining breathing techniques, meditation, and stretching, yoga can help you feel better overall and improve sleep.
- Cannabis oil: Some people claim that cannabis oil use reduces pain, relieves nausea and vomiting, and improves appetite. However, more research is needed into these claims. Additionally, state laws on cannabis vary, so this option isn’t available nationwide.
There’s no diet that can minimize lung cancer. However, it’s important to get all the nutrients your body needs.
Cancer treatments can cause you to lose your appetite. They can also make it hard for your body to absorb vitamins. If you’re deficient in certain nutrients, your doctor can advise you on foods or supplements if needed.
Here are a few dietary tips:
- Eat whenever you have an appetite.
- If you don’t have an appetite, try eating smaller meals throughout the day.
- If you need to gain weight, supplement with low-sugar, high-calorie foods and drinks.
- Use mint and ginger teas to soothe your digestive system.
- If your stomach is easily upset or you have mouth sores, avoid spicy food.
- If constipation is a problem, add more high-fiber foods.
As you progress through treatment, your tolerance to certain foods may change. So can your side effects and nutritional needs. It’s worth discussing nutrition with your doctor. You can also ask for a referral to a nutritionist or dietician.
As a rule, the earlier your cancer is diagnosed, the better it will respond to treatment.
The survival rates for lung cancer depend on the type and stage. Your individual life expectancy is influenced by factors such as your age at diagnosis, overall health, and how well your cancer responds to treatment.
- Localized: 60 percent
- Regional: 33 percent
- Distant: 6 percent
- All SEER stages: 23 percent
Small-cell lung cancer (SCLC) is very aggressive. For limited stage SCLC, the 5-year survival rate is
Long-term disease-free survival of SCLC is rare. Without treatment, median survival from diagnosis of SCLC is only 2 to 4 months.
Depending on how far the cancer has spread, the relative 5-year survival rate for mesothelioma is
Keep in mind that survival rates and other statistics provide a broad picture of what to expect. There are significant individual differences, and your doctor is in the best position to discuss your outlook.
In recent years,
Lung cancer can lead to complications. These include:
- High risk of infection: People with lung cancer are at an increased risk of pneumonia, bronchitis, and other infections.
- Facial swelling: Tumors in your lungs can restrict blood flow to your upper body and result in facial swelling.
- Loss of lung function: Shortness of breath, difficulty breathing, and other symptoms of reduced lung function can occur in lung cancer patients.
- Blood clots: People with lung cancer are at a higher risk of clots, especially in their lower legs.
- Spitting up blood: Irritation in airways or from tumors can result in spitting up blood.
- Increased calcium in blood: Sometimes, lung cancer can result in hypercalcemia, or increased calcium in your blood.
- Spinal compression: Tumors can press on the spine and cause pain, weakness, and trouble walking.
- Heart blockage: Tumors in your lungs can compress heart vessels and lead to multiple serious heart conditions.
- Nerve pain: Tumors can result in nerve pain along with numbness, tingling, and weakness.
- Trouble swallowing: Lung cancer can spread to your esophagus and cause trouble swallowing.
There is no guaranteed way to prevent lung cancer. However, you can reduce your risk if you:
- Quit smoking: Smoking is the number-one risk factor for lung cancer. Eliminating smoking greatly reduces your chance of developing lung cancer.
- Avoid radon: You can have your home tested for radon to help reduce your exposure and lung cancer risk.
- Avoid other cancer-causing chemicals: Limiting your exposure to other cancer-causing chemicals can reduce your risk.
- Eat a healthy diet: There is some
evidenceto suggest that eating a diet high in fruits and vegetables can reduce your risk of lung cancer.
Lung cancer is most treatable when it’s caught early. Unfortunately, the early stages of lung cancer don’t always cause symptoms.
Treatment for lung cancer depends on the type of cancer you have and the stage you’re diagnosed with. Treatment often includes surgery, chemotherapy, and radiation. Newer treatments are helping improve survival odds for lung cancer patients, and participating in a clinical trial could offer promise when other treatments stall.
There is no guaranteed way to prevent lung cancer, but by quitting smoking and avoiding hazardous exposures you can dramatically reduce your risk of developing lung cancer.