Learn About Your Risk for Lung Cancer

By Rebecca Myers, MSN, RN, NPD-BC for MEHOP

Lung Cancer Facts

  • Expected lung cancer deaths for 2021: more than 131,000 in the United States.
  • People who smoke have the highest risk of developing lung cancer – about 90% of lung cancer cases in the U.S.
  • Lung cancer is the leading cause of cancer deaths worldwide.
  • Early stages of lung cancer are more likely to be curable.
  • Your healthcare provider (HCP) uses a range of tests to diagnose, stage, and treat lung cancer.

Facing a lung cancer diagnosis can be frightening. Understanding what to expect may help to decrease the fear associated with this serious disease.

Signs of Lung Cancer

In the early stages, there are no signs of lung cancer. Most signs develop in the later stages of the disease process. Signs of lung cancer can include these:

  • A new cough that does not go away;
  • Coughing up blood;
  • Shortness of breath;
  • Chest pain;
  • Hoarseness;
  • Feeling tired all the time (fatigue);
  • Trouble swallowing;
  • Unexpected weight loss.

Since these signs can indicate several illnesses, your HCP will also obtain your personal and family history. Make sure to tell your HCP if:

  • You smoke or have stopped smoking in the last 15 years;
  • Someone who lives with you smokes (secondhand smoke exposure);
  • You have had radiation therapy in the past;
  • You are exposed to asbestos or other carcinogens at work;
  • Anyone in your family has ever had lung cancer.

Reduce Your Lung Cancer Risk

  • Don’t smoke – if you do smoke, quit. If you don’t smoke, don’t start.
  • Avoid secondhand smoke exposure. Make your home and car smoke-free.
  • Be careful at work to avoid carcinogens (things that cause cancer).
  • Test your home for radon. Radon is the second leading cause of lung cancer. Click to read: How to test your home for radon.

Secondhand smoke is smoke from other people’s cigarettes, cigars, or pipes.

Radon Facts

Radon is a naturally occurring gas from rocks and dirt that can get trapped in homes or offices. Radon gas is invisible, odorless, and tasteless. Radon is the second leading cause of lung cancer causing about 20,000 cases of lung cancer yearly in the U.S.

Lung Cancer Tests

If lung cancer is suspected, your HCP may order tests. A combination of tests may be required for a diagnosis.

  • Blood tests – to measure certain chemicals in your blood.
  • Chest x-ray – can detect abnormal masses or nodules.
  • CT scan – can detect small lesions that may not show up on regular x-ray.
  • Sputum cytology – if you have a cough and are coughing up sputum, it can be studied under a microscope to detect lung cancer cells.
  • Lung biopsy – a sample of abnormal cells are collected and sent to the lab for microscopic study.
    • There are different ways to obtain a lung biopsy including:
      • Needle biopsy – a small sample of a lung mass is taken through a hollow needle.
      • Bronchoscopy – a lighted tube that is inserted into your lungs through the mouth. A sample of cells is taken during this procedure.

Your HCP will determine if test results indicate a diagnosis of lung cancer. The results will also show the type of lung cancer.

Lung Cancer Screening

Lung cancer screening is done with low-dose computed tomography (LDCT) scans. Lung cancer screening can find disease early before there are symptoms. Early stages of lung cancer are more likely to be curable. There are specific guidelines related to lung cancer screening. Ask your HCP if you are eligible.

Types of Lung Cancer

Lung cancers are grouped into two main types: non-small cell and small cell. The type is determined by how the lung cancer cells appear under a microscope. Non-small cell is the most common (84% of lung cancers).

Lung Cancer Staging

Staging refers to how advanced the lung cancer is. Your HCP may order additional testing to determine the stage.

Stages in non-small cell lung cancer:
  • Occult (hidden) stage – the cancer cannot be seen by imaging (x-ray/CT/MRI) or bronchoscopy. Cells are found in sputum or bronchial washings (sample of cells taken from the area leading to the lungs).
    • Stage 0 – abnormal cells are found in the airway lining.
    • Stage I
  • IA – tumor is 3cm or smaller
  • IB – tumor is larger than 3cm but smaller than 4cm

As the non-small cell lung cancer advances, the staging continues as the cancer advances depending on the size and spread to other areas. These are Stage II, Stage III, and Stage IV.

Stages in small cell lung cancer:
  • Limited-stage – the cancer is in the lungs and may have spread to between the lungs and to the lymph nodes above the collar bone.
  • Extensive-stage – the cancer has spread from the limited-stage to other areas of the body.

The treatment plans for either type of lung cancer depends on the particular staging and situation of the patient.

Lung Cancer Treatment

Treatment of lung cancer varies depending on the type of lung cancer, the staging, and patient choices. There are other treatments, besides the ones listed below, that are being developed via ongoing research and clinical trials aimed at diagnosing and treating cancer.

If you have lung cancer, your HCP will spend time with you to review the options available to you. Your HCP will also want to include your family in discussions about treatment options. Cancer treatments come with side effects. Make sure you understand the benefits and potential down-side of each option.

You will be choosing the treatments that best fit your needs. If there is anything you don’t understand, ask to have it explained.

Non-small cell lung cancer treatment

There are 10 standard treatments for non-small cell lung cancer. Many of these treatments are used in combination depending on the specific circumstances.

  • Surgery – there are a few types of surgery to remove the non-small cell lung cancer. The type of surgery will depend on the specifics of your case.
  • Radiation therapy – uses radiation to kill cancer cells or keep them from growing. Radiation therapy can be external or internal.
  • Chemotherapy –uses specific drugs to stop cancer growth by killing the cells to stop them from dividing.
  • Targeted therapy – uses drugs or other substances to identify cancer cells and attack them. This therapy causes less damage to normal cells than chemotherapy and radiation.
  • Immunotherapy – a biologic therapy that uses a patient’s immune system to fight cancer cells.
  • Laser therapy – an intense beam of light (laser beam) used to kill cancer cells.
  • Photodynamic therapy (PDT) – uses drugs and a laser to kill cancer cells. The drug is given through the vein and goes to the cancer cells. The drug is inactive until the laser light activates it to kill the cancer cells.
  • Cryosurgery – uses an instrument to freeze and destroy abnormal cells.
  • Electrocautery – uses a probe or needle heated by an electrical current to kill abnormal cells.
  • Watchful waiting – close monitoring of a patient’s condition without starting treatment.
Small cell lung cancer treatment

There are six standard treatments for small cell lung cancer.

  • Surgery – the type of surgery depends on the specific case.
  • Chemotherapy –uses specific drugs to stop cancer growth by killing the cells to stop them from dividing.
  • Radiation therapy – uses radiation to kill cancer cells or keep them from growing. Radiation therapy can be external or internal.
  • Immunotherapy – a biologic therapy that uses a patient’s immune system to fight cancer cells.
  • Laser therapy – an intense beam of light (laser beam) used to kill cancer cells.
  • Endoscopic stent placement – using an endoscope (a thin, tube-like instrument used to view tissues in the body), a stent can be placed to open an airway blocked by abnormal tissue.

Extra Support

There are support groups and supportive therapy available in addition to medical treatments. This extra support can be helpful in providing coping mechanisms for those who have received a lung cancer diagnosis. Support groups and therapy may improve life quality during and after lung cancer treatment.

2021 Lung Cancer Stats

The American Cancer Society estimates 235,760 new cases of lung cancer (119,100 in men and 116,660 in women)and 131,880 deaths from lung cancer (69,410 in men and 62,470 in women).

The Earlier The Better

Early stages of cancer are more likely to be curable. Make an appointment with your HCP to discuss your risk and options.

Resources:

American Cancer Society. How to Test Your Home for Radon. Published October 21, 2019.

American Cancer Society. Key Lung Cancer Statistics. Retrieved July 24, 2021.

Centers for Disease Control and Prevention (CDC). Lung Cancer. Last reviewed November 9, 2020.

Centers for Disease Control and Prevention (CDC). Who should be screened for lung cancer? Last reviewed March 11, 2021.

Mayo Clinic. Lung Cancer. Updated March 23, 2021.

Medline Plus. Lung Cancer. Updated July 7, 2021.

National Cancer Institute (NIH). Cancer Types – Lung. Retrieved July 12, 2021.

National Cancer Institute (NIH). Adjusting to Cancer. Retrieved July 22, 2021.

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