Lung Cancer

What is Lung Cancer?

Lung cancer happens when abnormal cells grow together and form masses called tumors. Lung cancer typically begins in the bronchi or bronchioles (airways of the lungs) or the alveoli (air sacs). While there are more than 20 forms of lung cancer, non-small cell lung cancer and small cell lung cancer are most common. 

Non-small cell lung cancer makes up about 80 to 85 percent of all cases diagnosed. There are three main types: 

  • Adenocarcinoma: This type of slow-growing lung cancer begins in the cells that line the alveoli and make substances such as mucus. It is more common in women and occurs more often in younger people than other types of lung cancer.
  • Squamous cell carcinoma: This type of lung cancer starts in the flat cells that line the inside of the airways. It is often found in the central part of the lungs and is typically linked to a history of smoking.
  • Large cell carcinoma: This type of lung cancer can affect any part of the lung and tends to grow and spread quickly. 

Small cell lung cancer accounts for 10 to 15 percent of lung cancers diagnosed. It tends to be fast-growing and spreads more quickly than non-small cell lung cancers. There are two types of small cell lung cancer:

  • Small cell carcinoma: This type of lung cancer is also known as oat cell cancer and occurs most often in people who smoke.
  • Combined small cell carcinoma: This type of lung cancer occurs most often in adults over age 65 who smoke. 

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of lung cancer. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health. 

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Lung Cancer

Lung cancer is a major health issue in the United States. This quick lung cancer risk assessment can help you identify your lung cancer risk factors and determine if a lung cancer screening is recommended for you.

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♪ [music]

♪ We are sharing important health news with you. Just like with mammography for breast cancer screening and colonoscopy for colon cancer screening, a new test has been approved that can find and detect lung cancer, which is the leading cause of cancer death worldwide for both men and women. Research shows that screening the right people can save lives. Screening can find lung cancer at a much earlier, treatable, and curable stage.

Lung cancer found in its earliest stage can have up to a 90% chance of cure. Because of your age and smoking history, you are at higher risk of getting lung cancer and qualify for the screening test. The good news is this screening test for lung cancer is quick and painless. It requires no needles or dye.

Typically, your clothing can be left in place and there's no need to limit eating or drinking prior to the test. Lung cancer screening takes about 10 minutes and the actual scan only takes a few seconds. Here's how it works. A machine called a CT scanner takes 3D X-ray pictures of your lungs using a small amount of radiation, also called low-dose CT.

This level of radiation is more than a chest X-ray, but is much lower than other types of CT scans. Currently, this screening test is the only one that can find lung cancer early, which allows for more treatment options to save lives. As with all cancer screening, this test is not perfect. Some cancers may still be missed.

Some scans may show spots in the lung that look suspicious but may not be cancerous. These are called false positives. Similar to moles on the skin, your lungs may have nodules or spots that are watched but are normal or non-cancerous. When needed, your doctor may recommend additional testing to determine if you have cancer.

Lung cancer can be aggressive and advance quickly between stages. This is why it is important to be tested annually until you're out of the recommended age range or for as long as your doctor recommends. Regular screenings will let your doctor see if spots on your lungs are stable or whether any changes over time may be more suspicious for cancer. Screening for lung cancer before symptoms appear is important.

Without it, most people don't see signs of the disease until it has spread to other areas of the body making it harder to treat. If your have other health conditions that increase your risk of lung cancer such as diagnosis of COPD, a family history of lung cancer, or a job exposure to cancer-causing agents like radon and asbestos, tell your doctor and find out if a low-dose CT scan is right for you. Lung cancer screening with a low-dose CT scan is recommended by leading advocacy, government, and medical groups including the GO2 Foundation for Lung Cancer, federal government agencies, the National Comprehensive Cancer Network, and the American Cancer Society.

For individuals who meet the high risk criteria, low-dose CT screening for lung cancer is covered annually by Medicare and most private insurance plans at 100% with no out-of-pocket cost just like mammograms and other screening tests. However, additional testing and follow-up scans between screenings may have a cost such as a co-pay or deductible. Ask your doctor if your insurance covers the test. If you smoke, it's still important to consider quitting.

You might think it doesn't matter, but there are many benefits to quitting. Your health care team can provide resources to help you. Don't be afraid to ask your doctor or call 1-800-QUIT-NOW for support. Don't wait.

Talk to your doctor about low-dose CT lung cancer screening and if it's right for you. It could save your life. ♪ [music]

♪ Made possible by GO2 Foundation for Lung Cancer with support from Hilary Deskins, Michael Gieske, Mary Pasquinelli, and Douglas Wood. ♪ [music]

Lung Cancer Signs and Symptoms

Lung cancer symptoms may include:

  • A new cough that doesn’t go away
  • Bloody phlegm
  • Changes in a chronic cough
  • Chest pain
  • Difficulty swallowing
  • Facial swelling
  • Hoarseness or other voice changes
  • Loss of appetite
  • Shortness of breath
  • Unintentional weight loss
  • Wheezing, high-pitched or abnormal breathing sounds 

Diagnosis

To determine if someone has lung cancer, we ask about medical history and conduct a physical exam. We also use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Biopsy: The physician may remove a sample of abnormal cells during a bronchoscopy, during which a lighted tube is passed down the throat and into the lungs, or by inserting a needle through the chest wall and into the lungs. Or, the physician or surgeon may take a biopsy of nearby lymph nodes by making an incision at the base of the neck.

Imaging tests: Chest X-rays can reveal an abnormal mass. Computerized tomography (CT) scans can reveal small tumors or lesions in the lungs that may not be detected on an X-ray. Learn more about Baptist Health's lung CT screenings.

Sputum cytology: The physician can examine mucus coughed up from the lungs under a microscope to look for cancer cells. 

Causes

Smoking is the leading cause of non-small cell lung cancer, but not all people who develop the disease are smokers. Lung cancers in non-smokers often have certain gene changes different from those in the tumors of smokers. 

Nearly all cases of small cell lung cancer are due to cigarette smoking. It is very rare in people who have never smoked. 

Risk Factors

Risk factors that can contribute to lung cancer include:

Age: Most lung cancers develop in adults over the age of 50.

Asbestos exposure: Some people exposed to asbestos have developed lung cancer.

Exposure to air pollution: Continuous exposure to pollutants can increase the risk of developing cancer.

Exposure to secondhand smoke: If someone smokes in the home, a person has a greater risk of small cell lung cancer.

Genetics: First-degree relatives of people with lung cancer are at a slightly higher risk.

Occupational exposure: People exposed to radon, uranium, diesel exhaust and certain chemicals may be at an increased risk of lung cancer.

Other cancers: Cancers that begin in other parts of the body can spread to the lungs. 

Prevention

While some risk factors cannot be controlled, there are ways you can help prevent lung cancer.

Don’t smoke: Smoking is a known cause of nearly all lung cancers. 

Get screened: Several organizations recommend people with an increased risk of lung cancer consider annual CT scans to look for lung cancer. If you’re 55 or older and smoke or used to smoke, talk to your physician about the benefits and risks of lung cancer screening.

Prognosis

The earlier that lung cancer is diagnosed, the better the outcome. Lung cancer is the leading cause of cancer deaths among men and women in the United States. Prognosis depends on the size and location of the cancer, the type, the presence of symptoms, whether it has spread to other areas of the body and a person’s overall health. 

Treatment and Recovery

Lung cancer treatment depends upon how far the condition has progressed, a person’s overall health and his or her preferences. Treatment methods may include:

Surgery

Surgery is meant to remove all of the lung cancer and a margin of healthy surrounding tissue. If lung cancer is detected at an early stage and has not spread (or has only spread to a couple of adjacent lymph nodes), surgery can be curative.

Chemotherapy

Chemotherapy uses special drugs designed to kill cancer cells. Chemotherapy can be administered as a pill or injected into the bloodstream and may be given before surgery to shrink a tumor, after surgery to kill remaining cancer cells and as a means of reducing symptoms. 

Radiation Therapy

This treatment uses high-energy radiation to kill cancer cells. The radiation may be directed specifically to the lung or administered to various sites throughout the body. Most often, radiation treatments are given five days a week for several weeks. 

Targeted Therapy

Certain drugs can treat lung cancer by taking advantage of specific defects in cancer cells that fuel their growth or by targeting genetic mutations. 

Complications

Lung cancer can recur or spread to other areas of the body, so follow-up care after successful treatment is important. In addition, the cancer itself and some treatments can result in complications. These include: 

  • Airway obstruction
  • Fluid in the chest
  • Heart and circulation problems
  • Hoarseness
  • Pain
  • Swallowing problems
View Hide Transcript
♪ [music] ♪

In the state of Kentucky, we're well known
for several things, but unfortunately,

we're also number one in the U.S.

when it comes to lung cancer, both for the
incidents of people who develop a lung

cancer and also, unfortunately,
how many people die from a lung cancer.

One of the things that we have that's very strong
here at Baptist Health Lexington is our lung cancer

screening program where we try to capture people when
they are over the age of 55 or have actually smoked

more than 10 years in their life, and if we
can use a low-dose screening CT scan once

a year, it's been shown that it'll reduce the incidence
of death from lung cancer by as much as 20%.

The basics of treatment that we use for lung cancer
have really come a long way in the past 5 to 10 years.

The main options of surgery and radiation,
they're still our main options,

but as far as the surgery side goes,
we're now using minimally invasive techniques.

These are shorter surgeries that don't result in
a long hospitalization, and actually, as a whole,

they have much less side effects.

And just as surgery has improved, so has radiation.

Now, we've been known here for
a long time for having our CyberKnife unit.

CyberKnife combines robotics with radiation treatments
and allows us to deliver a very precise and accurate

treatment to these tumors when they're very small and
they actually have a very low risk for side effects.

The ultimate goal that we have when we treat here is to
make sure we take care of the patient as a whole and

have all the treatment modalities available to them so
that they have the best treatment with the least amount

of side effects, and they can live
their best life after we're done.

♪ [music] ♪

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