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Lung Cancer Treatment

Lung cancer is the leading cause of cancer deaths in the United States, taking an average of 382 lives per day¹.

The disease is known as a “silent killer” because it often goes undetected in its early stages. Patients may not notice warning signs like chest pain or chronic fatigue until it metastasizes. At that point, the disease is more challenging to treat.

Below, we discuss the signs and causes of lung cancer. We also offer insight into available treatment options, including radiation therapy.

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What is Lung Cancer

Lung cancer is a type of cancer that originates in the lungs. Most lung cancers start in the cells lining the bronchi, air passageways that lead from the windpipe to the lungs. Cancer can also begin in the bronchioles, which are tiny air tubes, or the alveoli, which is where the lungs and blood exchange oxygen.

Like other cancers, lung cancer happens when cells with damaged DNA grow and multiply. A cell’s DNA can be damaged by environmental factors like ultraviolet rays from the sun or chemicals in tobacco. These genetic abnormalities can be inherited as well.

Fortunately, our body typically detects and destroys damaged cells before they divide. But with age, the immune system becomes less adept at distinguishing between normal and abnormal cells.

But what makes a cancer cell abnormal? Chiefly, cancer cells ignore signals to stop dividing and die (a process called apoptosis). Instead, they grow uncontrollably and hide from the immune system, tricking immune cells into protecting malignant tumors. Cancer cells can even tell blood vessels to feed nutrients and oxygen to cancerous growth. When cancer cells invade other parts of the body, this is called metastatic cancer.

Lung Cancer Symptoms

In the early stages of lung cancer, most patients experience no symptoms.

However, as the disease progresses and spreads throughout the lungs or to other body tissues, you may begin to notice sudden changes in your health.

Typical symptoms of lung cancer include:

  • A cough that gets worse or won’t go away
  • Rust-colored phlegm
  • Chest pain
  • Recurring respiratory infections (e.g. bronchitis, pneumonia)
  • Shortness of breath
  • Wheezing
  • Hoarseness
  • Feeling tired all the time (fatigue)
  • Unexplained weight loss
  • Swelling of the face, neck, arms, legs, or feet (edema)

When To See a Doctor

If you notice any of the above symptoms, schedule an appointment with your general practitioner.

Your general practitioner can determine if the medical issues you are experiencing are a sign of lung cancer or if they are related to a non-cancerous condition. From there, he or she can refer you to an oncologist for further testing.

Types of Lung Cancer

An analysis of the cancer cells collected during a biopsy will reveal what type of lung cancer you have.

There are two general types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).

Non-Small Cell Lung Cancer

NSCLC is the most common form of lung cancer, accounting for about 80 to 85% of all cases⁵. Relative to SCLC, this type of lung cancer is less responsive to treatment.

NSCLC Subtypes

  • Adenocarcinoma – a subtype that starts in the lung cells that secrete mucus
  • Squamous Cell Carcinoma – a less common subtype that tends to stay in the lungs
  • Large Cell (Undifferentiated) Carcinoma – a fast-growing cancer that is difficult to treat

Small Cell Lung Cancer

SCLC is the least common form of lung cancer, accounting for just 10 to 15% of all cases5.

Unfortunately, this can spread very quickly. About 70% of patients with SCLC have metastatic cancer by the time they are diagnosed⁵.

Almost all cases of SCLC are caused by smoking or exposure to secondhand smoke. Individuals who have been exposed to radon, asbestos, and certain workplace chemicals are also at risk.

SCLC Subtypes

  • Small Cell Carcinoma – a highly malignant form of SCLC that typically starts in the bronchi
  • Combined Small Cell Carcinoma – a rare subtype that is less responsive to chemotherapy

Lung Cancer Causes and Risk Factors

Cigarette smoking is the leading cause of lung cancer. According to the CDC, 80 to 90% of lung cancer deaths in the U.S. are linked to smoking².

But even non-smokers can develop lung cancer. Though the exact cause may be unknown in these cases, there are certain risk factors strongly linked to the disease.

Lung cancer risk factors include:

  • Radon exposure
  • Occupational exposure
  • Personal or family history
  • Previous radiation therapy
  • Secondhand smoke exposure
  • Vaping and marijuana
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Radon Exposure

Radon is the second leading cause of lung cancer in the United States.

This naturally-occurring gas forms in rocks, soil, and water. It can leak into homes and buildings through cracks in foundations. As the gas decays, it emits tiny radioactive particles. When inhaled, these particles damage the cells lining the lungs.

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Vaping and Marijuana

The long-term effects of vaping, or using e-cigarettes, and smoking marijuana are still being researched.

However, experts agree that the toxic chemicals in vape products can cause lung damage.

Experts also agree that marijuana smoke contains many of the harmful substances found in cigarette smoke.

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Secondhand Smoke Exposure

Secondhand smoke is tobacco smoke emitted by another person’s cigarette, pipe, or cigar. Prolonged exposure to secondhand smoke at work or home can increase your chances of developing lung cancer by 20 to 30%³.

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Previous Radiation Therapy

Cancer survivors who had radiation therapy to the chest have a higher risk of developing lung cancer. 

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Personal or Family History

If you are a lung cancer survivor, you are at an increased risk of developing second cancer. You are also at an increased risk of developing lung cancer if your parents, siblings, or children have had lung cancer.

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Occupational Exposure

Some workplace environments like mills, mines, textile plants, and shipyards expose workers to carcinogenic substances on a daily basis. These substances include asbestos, arsenic, diesel exhaust, and some forms of silica and chromium.

Lung Cancer Prevention

There is no sure way to prevent lung cancer.

However, you can reduce your risk of developing lung cancer by:

  • Not smoking/quitting smoking
  • Avoiding secondhand smoke
  • Testing your home for radon
  • Avoiding carcinogenic chemicals at work
  • Eating a balanced diet
  • Limiting stress
  • Exercising regularly

Lung Cancer Screening

If you are a current smoker or have smoked in the past, you may consider scheduling yearly lung cancer screenings.

During this preventative procedure, a special X-ray machine scans your lungs. These detailed images help medical professionals catch lung cancer before symptoms ever appear.

Since early detection can decrease lung cancer mortality by 20%, annual lung cancer screenings are key for high-risk patients⁴.

You are considered high-risk if you:

  • Have at least 20 pack-year smoking history, and
  • Smoke now or have quit within the past 15 years, and
  • Are between 50 and 80 years old

What Is a Pack-Year?

A pack-year is used to measure the amount a person has smoked over time. This is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years someone has smoked.

Lung Cancer Diagnosis

Some cases of lung cancer are detected during annual screenings.

However, lung cancer is more commonly found after the onset of symptoms like chest pain and fatigue.

If you have recently experienced a sudden decline in your health, schedule an appointment with your general practitioner.

If cancer is suspected, he or she will likely refer you to an oncologist. From there, the oncologist will pursue various avenues for diagnosis.

Diagnostic Tools

Common diagnostic imaging tests include:

  • Chest X-ray
  • CT scan
  • MRI scan
  • PET scan
  • Bone scan
  • Blood samples

Diagnosis of lung cancer is typically confirmed with a lung biopsy. During a biopsy, a small tissue sample is collected for lab testing.

Stages of Lung Cancer

Lung cancer staging involves evaluating the size of the tumor in the lung and whether the cancer has been spread to lymph nodes or elsewhere in the body.

Staging is an important aspect of lung cancer treatment and prognosis. Exactly how your lung cancer is staged depends on your cancer type.

Non-Small Cell Lung Cancer Staging

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Stage Grouping

Doctors may also use the stage grouping method to describe NSCLC. There are five general stages of NSCLC:

  • Stage 0 indicates precancerous cells that have not spread into the deeper lung tissue.
  • Stage I lung cancer is limited to the lungs and has not spread to the lymph nodes.
  • Stage II lung cancer may have spread to the nearby lymph nodes.
  • Stage III lung cancer has spread to the lymph nodes and other nearby tissues.
  • Stage IV lung cancer has spread from the lungs to other parts of the body.

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TNM System

The most widely used method for staging NSCLC is the TNM classification system. With this system, doctors describe the cancer’s severity using three different categories:

  • T describes the primary tumor.
  • N indicates if the cancer has spread to nearby lymph nodes.
  • M stands for metastasis.

Each letter is then assigned a number, usually 0 to 4, to indicate its severity.

Small Cell Lung Cancer Staging

SCLC is typically categorized as either limited stage or extensive stage.

In limited stage SCLC, the lung cancer is confined to one side of the chest.

In extensive stage SCLC, the cancer has spread widely throughout the lung, to the other lung or chest tissues, or throughout the body.

Lung Cancer Prognosis and Outlook

Lung cancer staging helps your cancer care team develop an appropriate cancer treatment plan. Staging also offers insight into survival rates.

Survival rates indicate the percentage of people with a specific type and stage of cancer who survived for a specific period of time.

Since these percentages are based on samplings of patients, they cannot predict the exact outcome for a single individual. However, they do provide patients with insight into how effective their treatment may be.

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Survival Rates for SCLC

SCLC is aggressive, spreading throughout the body quickly. Because of this, the overall five-year survival rate for both limited and extensive stage SCLC is typically <10%¹⁰.

Survival Rates for NSCLC

The five-year survival rates for patients with NSCLC are:

  • Stage I, 54%
  • Stage II, 35%
  • Stage IIIA, 10 to 15%
  • Stage IIIB, less than 5%
  • Stage IV, less than 2%⁷

Lung Cancer Treatment

Lung cancer treatment depends on the type and stage of the disease, but may include:

  • Surgery
  • Radiation
  • Chemotherapy
  • A combination of these treatments

When the disease is in the early stages and has not spread to the lymph nodes, surgery or focused radiation are the primary treatment options.

However, when the cancer has spread to the lymph nodes or the middle of the chest (mediastinum), treatment typically involves radiation therapy and chemotherapy.

Lung Cancer FAQs

Can lung cancer be cured?

If lung cancer is caught in its early stages, there is a chance of complete remission (the disappearance of all signs of cancer). However, remission becomes less likely the later the cancer is diagnosed.

Does vaping cause lung cancer?

Maybe. Research is currently being conducted to examine the link between vaping, or smoking e-cigarettes, and lung cancer. Though no studies currently verify the link between vaping and cancer, experts agree that the chemicals in vaping products damage the lungs.

What are the signs of lung cancer?

The signs of lung cancer include symptoms like coughing, rust-colored phlegm, chest pain, recurring respiratory infections, shortness of breath, wheezing, hoarseness, fatigue, weight loss, and swelling.

What does lung cancer feel like?

In its early stages, lung cancer is asymptomatic. That means patients may not feel anything at all. However, as the disease progresses, most patients begin to feel tired and unwell.

How do you get lung cancer?

Cigarette smoking is the number one cause of lung cancer. But lung cancer can also be caused by exposure to carcinogenic substances, previous radiation therapy, or genetics.

Sources

Lung cancer key findings. (2021).
https://www.lung.org/research/state-of-lung-cancer/key-findings

What are the risk factors for lung cancer? (2022).
https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm

Health effects of secondhand smoke. (2021).
https://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/health_effects/index.htm

Lung cancer fact sheet.
https://www.lung.org/lung-health-diseases/lung-disease-lookup/lung-cancer/resource-library/lung-cancer-fact-sheet

What is lung cancer? (2019).
https://www.cancer.org/cancer/lung-cancer/about/what-is.html

Lung cancer survival rates. (2022).
https://www.verywellhealth.com/lung-cancer-survival-rates-by-type-and-stage-2249401

Fiver-year survival rates. (2002).
https://training.seer.cancer.gov/lung/intro/survival.html

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