Lung Cancer: Overview

What is lung cancer?

Cancer starts when cells change (mutate) and grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. They can spread to other parts of the body, too. This is called metastasis.

Lung cancer is cancer that starts in the cells that make up the lungs. The lungs are 2sponge-like organs in your chest. Their job is to bring oxygen into the body and get rid of carbon dioxide. When you breathe air in, it goes into your lungs through your windpipe (trachea).

There are 2 main types of lung cancer:

• Non-small cell lung cancer. Most lung cancers are non-small cell. They're named for how cancer cells look under a microscope. There are a few subtypes, such as squamous cell carcinoma, adenocarcinoma, large cell carcinoma, and carcinoid tumors.

• Small cell lung cancer. Small cell lung cancer is less common than non-small cell lung cancer. Small cell cancer is sometimes called oat cell cancer. This is because the cancer cells are shaped like oats when looked at under a microscope. This type of lung cancer tends to grow and spread faster than non-small cell cancer.

Who is at risk for lung cancer?

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors cannot be controlled. But others may be things you can change.

The risk factors for lung cancer include:

• Smoking

• Exposure to secondhand smoke

• Exposure to radon

• Exposure to asbestos and other chemicals, such as arsenic, diesel exhaust, and coal products

• Air pollution

• Radiation therapy to the chest in the past

• Personal history of lung cancer

• Family history of lung cancer

Talk with your healthcare provider about your risk factors for lung cancer and what you can do about them.

Can lung cancer be prevented?

There is no sure way to prevent all lung cancers. But you may be able to help lower your risk for it by:  

• Not smoking or quitting, if you do smoke

• Staying away from other people's smoke

• Having your home tested for radon and limiting exposure

• Limiting your exposure to chemicals that can cause lung cancer, such as diesel exhaust and asbestos

• Eating a healthy diet with lots of fruits and vegetables

Are there screening tests for lung cancer? 

Lung cancer might be found with a screening test. Screening means checking for a health problem before a person has symptoms. It may help find some types of cancer early, when they’re small and often easier to treat.

The screening test used for lung cancer is a low-dose CT scan. If you smoke, or used to smoke, talk with your healthcare provider to decide if screening is right for you.

What are the symptoms of lung cancer?

Lung cancer often does not cause symptoms in its early stages. This is when it’s small and hasn’t spread. In fact, many lung cancers don’t cause symptoms until they've already spread.

When early lung cancer does cause symptoms, they’re often like those you might have if you smoke. For instance, some early symptoms of lung cancer include shortness of breath and coughing.

These are some of the more common symptoms of lung cancer:

• Cough that doesn’t go away or gets worse over time

• Chest pain, which might be worse when coughing or taking a deep breath

• Coughing up blood or rust-colored mucus

• Shortness of breath

• Hoarseness

• Wheezing

• Appetite loss

• Unexpected weight loss

• Feeling tired or weak

• Pneumonia or bronchitis occurring more than usual for you

• Swelling in the face or neck

Many of these may be caused by other health problems. It’s important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

How is lung cancer diagnosed?

Your healthcare provider will ask you about your health history, your symptoms, risk factors, and family history of disease. A physical exam will be done. If your healthcare provider thinks you may have lung cancer, you'll need certain exams and tests to be sure.

A biopsy is the only sure way to know if you have lung cancer. Small pieces of tissue are taken out from the tumor and tested for cancer cells. Tests are also done to find out exactly what kind of lung cancer you have.

Your healthcare provider may do a bronchoscopy. This is when a narrow, tube-like scope is put in through your mouth and advanced into your lung. There's a light and camera on the end of the scope. This allows the provider to look at the inside of your lungs. If changed tissue is seen, a piece of it can be taken out through the scope. A needle biopsy can also be done to get a biopsy tissue sample. To do this, an imaging test is used to guide a needle through the skin on your chest and into the tumor. A syringe is then used to pull out cells. Your results will come back in about 1 week.

After a diagnosis of lung cancer, you’ll need more tests. These help your healthcare providers learn more about your overall health and the cancer. They're used to find out the stage of the cancer. The stage is how much cancer there is and how far it has spread (metastasized) in your body. It's one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what this means for your treatment. Ask your provider to explain the details of your cancer to you in a way you can understand.

How is lung cancer treated?

Your treatment choices depend on the type of lung cancer you have, test results, and the stage of the cancer. The goal of treatment may be to cure you, control the cancer, or help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be. Other things to think about are if the cancer can be removed with surgery and your overall health.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy and immunotherapy are systemic treatments.

You may have just 1 treatment or a combination of treatments. Tests will be done during treatment to see how well it's working.

Lung cancer may be treated with:

• Surgery

• Chemotherapy

• Radiation therapy

• Targeted therapy

• Immunotherapy

• Laser therapy

• Photodynamic therapy (PDT)

• Cryosurgery

• Electrocautery

• Supportive care

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your provider before making a decision.

What are treatment side effects?

Cancer treatment like chemotherapy and radiation can damage normal cells. This can cause side effects like hair loss, mouth sores, and vomiting. Talk with your healthcare provider about side effects linked to your treatment. There are often ways to manage them. There may be things you can do and medicines you can take to help prevent or control many treatment side effects.

Coping with lung cancer

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be tough on the mind and body. Keep talking with your healthcare team about ways to make the process easier. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are some tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group in person or online.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

When should I call my healthcare provider?

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse

• Signs of an infection, such as a fever

• Side effects of treatment that affect your daily function or don’t get better with treatment

Ask your healthcare provider what signs to watch for and when to call. Know how to get help after office hours and on weekends and holidays. 

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.