Lung Cancer: Prevention, Diagnosis and Treatment Options

Article written by Dr. Hari Nair, medical oncologist at Bronson Oncology and Hematology Specialists.

Lung cancer is one of the most common cancer diagnoses globally and is the leading cause of cancer-related deaths in the United States. Early detection is key to treating lung cancer, as treatment is often more successful when caught in an early stage.

What is Lung Cancer?

Lung cancer appears when lung cells grow non-stop and form a tumor that affects normal lung function. These cancerous cells can also spread to lymph nodes and other organs of the body by a process known as metastasis. This is why early detection is so important. Once lung cancer – or any form of cancer for that matter – metastasizes, it will cause additional health issues and make treatment more difficult.

There are two types of lung cancer based on what the cancer cells look like under the microscope and their characteristics:

• Non-Small Cell Lung Cancer (NSCLC): This is the most common form of lung cancer. It accounts for around 85% of lung cancers. There are three types of non-small cell lung cancer: squamous cell carcinoma, large cell carcinoma and adenocarcinoma.
• Small Cell Lung Cancer (SCLC): This is a fast-growing cancer. When diagnosed, it is common that small cell lung cancer has already spread to other organs.

Causes of Lung Cancer

Smoking is the greatest risk factor for all forms of lung cancer – especially non-small cell lung cancer. Other lifestyle factors can increase the likelihood of developing lung cancer, including:

• Being exposed to secondhand smoke
• Living where there is air pollution
• Having a family history of lung cancer
• Being infected with the human immunodeficiency virus (HIV)
• Being exposed to radiation (including radiation therapy to the breast or chest, imaging tests such as CT scans and radon in the home or workplace)
• Being exposed to asbestos, arsenic, chromium, beryllium, nickel, soot or tar in the workplace

As with most types of cancer, the chance of developing lung cancer increases as you get older.

Common Symptoms

The most common signs of lung cancer include shortness of breath and a cough that doesn’t go away. Additional symptoms include:

• Ongoing chest discomfort or pain
• Wheezing
• Hoarseness
• Trouble swallowing
• Blood in mucus coughed up from the lungs
• Feeling very tired
• Swelling in the face and/or veins in the neck
• Loss of appetite
• Weight loss for no known reason

If you show signs of lung cancer, talk to your primary care provider. They can discuss your symptoms and refer you to a specialist for further evaluation if needed.

Screening and Prevention

Prevention is the best way to combat lung cancer. Avoiding smoke inhalation or quitting smoking is the most effective prevention measure. Other tactics include:

• Testing your home for radon.
• Avoiding exposure to cancer-causing substances like asbestos and industrial chemicals.
• Maintaining a healthy lifestyle, including regular exercise and a balanced diet rich in fruits and vegetables.

Early detection is crucial to improve survival rates for lung cancer. Screening with low dose computed tomography (LDCT) can reduce lung cancer deaths by detecting the disease at an earlier and more treatable stage. The U.S. Preventive Services Task Force (USPSTF) recommends an annual LDCT screening for:

• People over age 50 who are current or former heavy smokers.
• People who have a smoking history of ‘20 pack years’ or longer: What is a pack year? Multiply the number of packs smoked per day by the number of years you have smoked. For example, one pack a day for 20 years, 2 packs a day for 10 years, or a half pack a day for 40 years.
• People who once smoked heavily, but no longer smoke.

Testing

When lung cancer is suspected, there are a variety of procedures available to test your lungs. The results of these tests can help a doctor determine the prognosis and guide treatment. These tests may include:

• Imaging: Chest X-rays are often the first step in detecting lung problems. If a suspicious area is found, a CT scan is done to provide more detailed information. A PET scan may be used to determine if and where the cancer has spread.
• Biopsy: A sample of abnormal tissue is removed and examined to determine if you have lung cancer.
• Mutation (molecular) Testing: For patients with confirmed lung cancer, testing the tumor for genetic mutations helps determine whether targeted therapy is appropriate.

Treatment Options

Treatment depends on several factors, including the type of lung cancer, its stage and your overall health. Some treatments include:

• Surgery: Surgery is most effective for early-stage NSCLC, where the tumor is confined to one area. Depending on the size and location of the tumor, the surgeon may remove part of the lung or, in some cases, the entire lung.
• Radiation Therapy: Radiation therapy uses high-energy rays to kill or shrink tumor cells. It is used in localized lung cancer in combination with chemotherapy, where the tumors are too large for surgery or if it has spread to the lymph nodes.
• Chemotherapy: Chemotherapy uses medicines to destroy cancer cells throughout the body. Most medications are given as an infusion into the blood. It is used for both NSCLC and SCLC, often completed after surgery and/or radiation therapy.
• Immunotherapy: Immunotherapy works by boosting the body’s own immune system’s ability to find and kill tumor cells. Immunotherapy has transformed the treatment of lung cancer and is often better tolerated than chemotherapy.
• Targeted Therapy: Targeted drugs can attack specific genetic mutations that drive cancer cells to grow. Such therapies are more effective for patients with certain tumor genetic mutations.
• Palliative Care: Palliative care focuses on managing symptoms and improving quality of life. It is a vital component of cancer therapy. It helps with pain control, nausea, vomiting and breathing difficulty, as well as psychological support while going through cancer and its treatment.

Clinical trials are also very common for lung cancer treatment. The Bronson Cancer Center is a member of the Cancer Research Consortium of West Michigan. This means patients treated at Bronson have access to cutting edge research and treatment options that are not yet widely available.

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.