Cancer is named for – and treatment is based on – the site of the original tumor. Therefore, lung cancer starts in the cells that make up the lungs.
When lung cancer spreads, or metastasizes, it will be treated as metastatic lung cancer. Similarly, when cancer originates in another part of the body and spreads to the lungs, it is not considered lung cancer.
Lung cancer kills more Americans than colon, breast and prostate cancers combined.
Smoking is the biggest risk for getting lung cancer.
Other risk factors include exposure to secondhand smoke, radon, asbestos, arsenic, coal products, air pollution, radiation therapy and family history.
Types of Lung Cancer
There are two main types of lung cancer.
Non-small Cell Lung Cancer
About 85% to 90% of lung cancers are non-small cell.
There are three types, grouped by the type of cell in which they started and by how the cells appear through a microscope: adenocarcinoma, squamous cell carcinoma and large cell carcinoma.
Small Cell Lung Cancer
Also called oat cell cancer, because the cells are shaped like oats when viewed under a microscope.
It accounts for about 10% to 15% of lung cancers. It grows and spreads more quickly than non-small cell lung cancer.
Signs and Symptoms
Symptoms of lung cancer often are not evident until the disease has begun to spread. Common symptoms include:
- Persistent or worsening cough
- Chest pain
- Shortness of breath
- Loss of appetite
- Unexpected weight loss
- Repeated bouts with pneumonia or bronchitis
When it spreads, lung cancer usually goes first to the lymph nodes in the center of your chest or lower neck.
In later stages, it might spread to the liver, brain, bones or other parts of your body. As the cancer spreads, additional symptoms may surface, such as:
- Bone pain
- Belly or back pain
- Yellowing of skin and eyes (jaundice)
- Headache, seizure or confusion
- Enlarged lymph nodes in the neck
- Problems talking
Testing and Diagnosis
Early detection can make cancer easier to treat. High-risk individuals – generally smokers and non-smokers age 50 and over – should talk to their provider and consider low-dose CT screening, even if they exhibit no symptoms.
A biopsy is needed to confirm a cancer diagnosis.
Subsequent tests will help determine what stage the cancer is in by how far it has spread. At that point, you will work with your OSF HealthCare team to determine a treatment plan.
Screening for lung cancer aims to find the disease at an earlier stage, when treatment is more effective.
Low-Dose CT Screening
The test used for this purpose is low-dose computed tomography (also known as low-dose CT or LDCT).
The American Cancer Society and American Thoracic Society recommend high-risk individuals be screened for early detection of lung cancer.
Smokers and former smokers between the ages of 50 and 80 generally are considered high risk. If you are in this group, don’t wait until you experience symptoms of lung cancer.
See your OSF HealthCare pulmonology provider to determine whether you are a candidate for lung cancer screening.
For most people, however, testing begins when your provider thinks you could have lung cancer.
You will be asked for your personal and family health history and possible risk factors to which you’ve been exposed. You will be given a physical exam and other tests, which might include:
- Sputum cytology test
- Chest X-ray
- CT scan
If those tests indicate possible cancer, a biopsy will be performed to confirm the presence and type of lung cancer.
There are different ways a lung biopsy might be done, including:
- Needle biopsy
- Bronchial or transbronchial biopsy
- Endobronchial ultrasound (EBUS)
If the biopsy confirms lung cancer, your providers likely will order more tests. The test results will help determine if the cancer has spread beyond the lungs and what treatment options are best for you.
Your providers will determine the stage of your cancer.
Stage is based on the size of the tumor, the extent to which the cancer has grown into the lymph nodes and whether it has spread to other parts of the body.
Cancer stages are assigned using a 0-4 numbering system, with a higher number indicating more advanced cancer.
But small cell lung cancer often is defined by just two stages: limited and extensive.
Being told you have lung cancer can be scary. It’s easy to feel overwhelmed with uncertainty.
Our team will work with you to answer your questions, determine the course of treatment best suited to you and support you throughout your survivorship journey.
Many health care professionals will be part of your team. These could include:
- Medical oncologist
- Radiation oncologist
- Thoracic surgeon
- OSF Cancer Support Services
Treatment options vary according to the individual and their specific type and stage of lung cancer.
Talk with Your Doctor
The first thing you should do is ask questions about your treatment options.
Ask about possible side effects. Ask about the possibility of clinical trials. Ask for a second opinion. Ask until you are out of questions.
Once you have satisfactory answers, think about your preferences and what side effects you can and can’t handle.
Discuss your concerns with your provider and decide your treatment.