All About Lung Cancer
Article written by McKenna Blyly, PA-C, at Bronson Oncology and Hematology Specialists.
What is Lung Cancer?
Lung cancer starts when defective cells within the lungs replicate uncontrollably and grow into masses, called tumors. Eventually, these tumors will affect lung function and spread elsewhere in the body. It is the third most common cancer in the United States with over 200,000 new cases diagnosed each year. The lifetime risk of getting lung cancer is about 1 in 17 for men and 1 in 16 for women, and this number can be higher or lower based on one’s smoking history. Lung cancer is the leading cause of cancer deaths worldwide.
Are There Different Types of Lung Cancer?
Yes. Lung cancer is often divided into two main types: non-small cell lung cancer and small cell lung cancer.
- Non-small cell lung cancer (NSCLC) accounts for over 80% of lung cancer diagnoses. The most common subtypes include adenocarcinoma and squamous cell carcinoma. These cancers differ in which types of lung cells they originate from. They are grouped together because they have similar treatments and outcomes.
- Adenocarcinoma begins in the epithelial cells of the lungs. It is the most common type of lung cancer overall, the most common type among non-smokers and the most common type among younger people.
- Squamous cell carcinoma begins in the squamous cells of the lungs. It is more commonly found in the central part of the lungs and is associated with smoking.
- Small cell lung cancer (SCLC) accounts for up to 15% of lung cancer diagnoses. It grows quickly and often has already spread beyond the lungs when discovered. It is initially quite responsive to chemotherapy and radiation therapy but is more likely to come back after treatment.
Other cancers can occur in the lungs, but are not referred to or treated as lung cancer. Examples include lymphomas (cancer of the lymph nodes) and sarcomas (cancer of bones or soft tissue). Cancers from other organs can spread, also known as metastasize, to the lungs. In that case, it is still referred to and treated as the original cancer. For example, “breast cancer metastatic to the lungs” or “colon cancer metastatic to the lungs.” Likewise, lung cancer can spread to other organs, i.e. “lung cancer metastatic to the brain.”
What Increases Your Risk?
- Smoking cigarettes, cigars and pipes
- Secondhand smoke exposure
- Exposure to carcinogens, or cancer-causing substances, like air pollution, diesel exhaust, radon gas, coal products, asbestos, arsenic, uranium, chromium, silica, nickel and others
- Previous radiation therapy to the chest
- Family history of lung cancer
Smoking tobacco products of any kind is the biggest risk factor for developing lung cancer. It is estimated that 80% of lung cancer deaths are related to smoking. E-cigarettes, vaping and smoking marijuana are also considered to be dangerous, however, there is not enough data to determine the long-term health effects yet, and research is ongoing. It is also possible to develop lung cancer without a history of smoking. In fact, 1 in 5 people with lung cancer have never smoked, so it’s important to talk to your healthcare provider if you have any concerns.
What Are the Symptoms of Lung Cancer?
It’s important to note that the symptoms of lung cancer can mimic many minor illnesses. Many people do not experience any symptoms until the cancer has spread to other parts of the body. Symptoms may include:
- New, persistent or worsening cough
- Coughing up blood (hemoptysis)
- Shortness of breath
- Wheezing
- Hoarseness
- Chest pain or discomfort
- Loss of appetite or unexplained weight loss
- Tiredness or fatigue
- Shoulder pain
- Swelling in the face, neck, arms or chest (superior vena cava syndrome)
- A combination of facial symptoms on only one side of the face: constantly constricted pupil, droopy upper eyelid and decreased sweating (Horner’s syndrome)
How is Lung Cancer Diagnosed?
Medical history, physical exams and blood tests are not specific to lung cancer but may prompt your doctor to order imaging scans. Common scans of the lungs include x-ray, CT and PET scans. A biopsy is ultimately required to diagnose lung cancer. The type of biopsy depends on the location of the finding. If the biopsy confirms lung cancer, the sample is often then sent for further molecular or genomic testing to better classify the cancer and guide potential treatments.
Are There Screenings for Lung Cancer?
Yes! The American Cancer Society recommends yearly lung cancer screening with a low-dose CT (LDCT) scan for people who are 50-80 years old and have at least a 20-pack-year smoking history.
- A pack year is equal to smoking one pack a day for one year. For example, smoking one pack a year for 10 years is equal to a 10 pack-years, and smoking ½ pack a year for 20 years is also equal to 10 pack-years.
Read this article to learn more about LDCT scans.
What is Staging All About?
Lung cancer develops in stages. The stages range from 1 to 4, with the higher the number, the more advanced the disease. Lung cancer staging is based on the size of the tumor and the spread to nearby organs and lymph nodes. Staging can be “clinical” based on imaging and biopsy, or “pathologic” if surgery is needed. When referring to small cell lung cancer, doctors categorize the disease as limited stage or extensive stage, based on whether the cancer could be treated within a single radiation field. Staging guides treatment decisions and estimates prognosis and treatment outcomes.
How is Lung Cancer Treated?
Treating lung cancer is a complex decision made between a patient and their doctor. It depends on many factors including cancer subtype, stage, the patient’s medical history and their personal preference. It may include surgery, radiofrequency ablation, radiation therapy, chemotherapy, immunotherapy and targeted drug therapy.
- Surgery is usually done if the tumor can be completely removed and if the person is otherwise healthy enough for the procedure. People with underlying lung diseases, like COPD or emphysema, might not tolerate lung surgery.
- Radiofrequency ablation can be used for NSCLC if the tumor is near the outer edges of the lungs.
- Radiation therapy can be used by itself, with surgery or with chemotherapy. It can also be used to relieve discomfort from painful tumors.
- Chemotherapy is a medication that stops cancer cells from growing. It is typically given through IV infusion. It can be used in all stages and types of cancer.
- Immunotherapy is another group of medications that is usually given in an IV and allows the body to recognize and fight the cancer itself.
- Targeted drug therapy targets specific mutations in the tumor that help the cancer grow. Immunotherapy and targeted drug therapy are rapidly growing areas of cancer research.
Lung cancer is a serious disease that requires careful medical treatment. You can reduce your risk of lung cancer by avoiding smoking and making healthy lifestyle choices. If you smoke or have smoked in the past, talk to your doctor about yearly low-dose lung CT scans!
Exceptional Cancer Care
If you receive a cancer diagnosis, trust southwest Michigan’s most preferred healthcare system. With locations in Battle Creek and Kalamazoo, Bronson Cancer Center offers a comprehensive approach to care that surrounds patients with the expertise, technology, resources and positivity needed at every stage of the cancer journey. Learn more about Bronson's regional cancer program.
Sources:
McKenna Blyly is a physician assistant at Bronson Oncology and Hematology Specialists in Kalamazoo. She provides care for patients with several forms of cancer, but has a special interest in providing care for hematology conditions.
“My goal is to provide compassionate, high-quality care," she explains. "I believe in the strength of partnerships that encourage trust, informed decision making and overall wellness for each individual going through their cancer journey.”
McKenna became a physician assistant because she loves biology, reading and education. She finds joy in coming to work each day when she sees patients who she's developed trusting relationships with over time. She feels honored to walk alongside patients while they make informed medical decisions.
