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On Lung Cancer

What is Lung Cancer?
Lung cancer one of the leading cause of cancer deaths globally. Lung cancer takes more lives than breast, prostate and colon cancers combined, accounting for nearly 30% of all cancer deaths. Only cancers that begin in the lungs are called “lung cancer,” but lung cancer cells can spread through the blood stream, invade nearby lymph nodes and metastasize in the brain, bones, liver and other sites.

Risk Factors
Anyone can get lung cancer, including people who never smoked. Those at highest risk are people who currently or used to smoke, people with a family history of lung cancer at any age and people with a family history of any cancer before age 50. Exposure to radon is the second leading cause of lung cancer, and the leading cause among people who have never smoked. Additional risk factors include chronic obstructive pulmonary disease (COPD), prior infection with tuberculosis and exposure to chemicals such as asbestos, Agent Orange, etc. Genetic disposition may also play a role in lung cancer development.

Lung Cancer Screening
A recent study shows that the use of computed tomography (CT) scans for lung cancer screening can save lives from the disease. The National Lung Screening Trial (NLST) included more than 53,000 men and women ages 55 – 74 who were at very high risk for lung cancer as a result of significant smoking history, equivalent to a pack a day for 30 years, or 2 packs a day for 15 years, etc. There were 20 percent fewer lung cancer deaths among people who got CT scans compared to those who had chest X-rays. Because the data are so new, lung cancer screening guidelines are currently being developed, but these results provide great hope for combating lung cancer.

Symptoms
Because the symptoms in patients who present with lung cancer can be caused by many different conditions, it is important for people to see their doctor if they experience any of the symptoms of lung cancer, which include:
• Blood when you cough or spit
• Recurring respiratory infections
• Enduring cough that is new or different
• Ache or pain in shoulder, back or chest
• Trouble breathing
• Hoarseness or wheezing
• Exhaustion, weakness or loss of appetite
Other symptoms may include swelling in the neck and face, difficulty swallowing or weight loss.

Treatment
The most common treatments for lung cancer are surgery, radiation therapy and chemotherapy. Surgery physically removes the cancer tumor and any lymph nodes that may contain cancerous cells. Radiation therapy (also sometimes referred to as radiotherapy, x-ray therapy or irradiation) usesX-rays to damage cancer cells and stop them from growing or multiplying. Chemotherapy drugs are used to kill cancer cells. Unlike surgery and radiation, which are used to treat local disease, chemotherapy is usually systemic; it goes through the whole body and therefore should affect cancer cells anywhere they may be.

Some patients may be prescribed targeted therapy, which includes drugs that “target” specific changes in cancer cells.In normal cell growth, small chemicals called growth factors are produced by one cell and attach to proteins called receptors on that same or nearby cells – like a baseball fitting into a catcher’s glove. By attaching to these receptors, the growth factors are able to “tell” the cell to multiply. In cancer, there may be too many growth factors present, or the receptor may by mutated so that it “thinks” the growth factor is attached when it really isn’t. Some drugs block these receptors to stop the cancer from growing and/or spreading, thereby “targeting” the cancer.

Source: Charles A. Powell, MD, ATS Section on Thoracic Oncology
Source: National Lung Cancer Partnership (www.nationallungcancerpartnership.org)