HIPAA Alert: Potential Data Breach Learn More
Lung cancer is the leading cause of cancer deaths in the United States. Because of the threat lung cancer poses, it is important for patients to receive care from highly experienced specialists who make use of cutting-edge diagnostics and therapies. The expert oncologists of Regional Cancer Care Associates (RCCA) treat thousands of lung cancer patients each year. RCCA, which is one of the nation’s largest networks of oncology specialists, has more than 20 locations near you throughout New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area. Here, we discuss what patients should know about lung cancer, its signs, and treatment options.
Lung cancer is cancer that starts in the lungs. The lungs are a pair of organs that facilitate gas transfer to keep the body oxygenated and to discard carbon dioxide. Each lung is divided into lobes. The lobes are full of small sacs, called alveoli, where gas exchange takes place. The alveoli are reached by narrow tubes called bronchioles, which feed into the bronchi, then the windpipe.
Most lung cancers start in the cells lining the alveoli, bronchioles, and bronchi. Lung cancer develops when a few of these cells develop a mutation that spurs out-of-control growth. The mutated cells divide rapidly, creating a constantly growing mass of tissue called a tumor.
Lung cancer is the second most common cancer type in the United States. It is also the most fatal. About 229,410 new cases of lung cancer are diagnosed annually, and about 124,990 deaths are recorded each year. While advances in medicine are leading to fewer new cases and better survival rates, it is still important for people to educate themselves about risk factors for lung cancer. With the right information, individuals are empowered to make good decisions about cancer prevention and care.
Not all lung cancers display symptoms at first. Very early stages are often asymptomatic, with warning signs emerging only when the tumor grows large enough to interfere with lung function. When symptoms finally develop, they may seem trivial or, conversely, they may be severe. New breathing problems are always concerning, so patients should speak with a physician if they notice something wrong.
The earliest signs of lung cancer are usually problems with breathing. As the tumor becomes larger, it presses against nearby lung structures and irritates the lining. Patients experience symptoms such as:
Fatigue, weight loss, and loss of appetite are also common complaints. Cancer requires enormous amounts of energy to fuel its rapid cell growth. It obtains this energy by hijacking the metabolism, stealing calories that would be used to feed the whole body. As a result, the patient experiences a sudden drop in energy levels and may unintentionally lose weight.
As lung cancer progresses, some of cancerous cells may break off the tumor and enter the blood stream or lymphatic system. These cells are transported until they attach to tissue in other parts of the body. The transported cells continue to multiply rapidly, creating new tumors and new symptoms. The most common sites of lung cancer metastasis (spread) are the bones, brain, and liver. Patients may experience:
Late-stage lung cancer symptoms can be managed with advanced treatments and palliative care, helping patients maintain a higher quality of life while living with metastatic lung cancer.
All lung cancers start in a similar way, but they are not all identical. Different types of lung cancer have different characteristics depending on the type of cell in which they originate. There are three distinct categories of lung cancer, each with several subtypes:
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. It accounts for 80% to 85% of all lung cancer cases in the United States. Subtypes include:
Adenocarcinoma of the lung starts in the epithelial cells. The epithelial cells are glandular cell that produce mucus, a sticky fluid that coats the inside of the lungs. Lung adenocarcinomas are the most common type of NSCLC, accounting for 45% of all lung cancer cases.
Squamous cell carcinoma starts in squamous cells, the flat, thin cells that line the inside of the airways in the lung. This type of lung cancer is strongly associated with a history of smoking and is also fairly common. About 21% of all lung cancers are squamous cell carcinoma.
Large cell carcinoma starts in the cells that line the outside of the lung. It produces abnormally large cells that grow and spread very quickly. Although large cell carcinoma is aggressive, it is also uncommon. Only about 10% to 15% of lung cancer cases are large cell carcinoma.
There are other subtypes of NSCLC, including adenosquamous carcinoma, sarcomatoid carcinoma, and more. These are much less common, representing a small percentage of all lung cancer types.
Small cell lung cancer (SCLC) is the second most common type of lung cancer, accounting for about 10% to 15% of all cases. It tends to grow quickly, meaning it has often spread beyond the lungs by the time it is diagnosed. It responds well to chemotherapy and radiation therapy but has a high chance of recurring or coming back after treatment.
Lung carcinoid tumors are a rare type of lung cancer that account for less than 5% of all cases. They form in neuroendocrine cells, which produce hormones that manage airflow, blood flow, and cell growth in the lungs. Most lung carcinoid tumors grow slowly. A small percentage of lung carcinoid tumors, called atypical carcinoid tumors, grow quickly and are more likely to spread.
Metastatic lung cancer is cancer that started elsewhere in the body, such as the breast, pancreas, kidney, or skin, and has spread to the lung. Although lung metastases create tumors in the lungs, they are not considered lung cancers. This is because the cancer cells still exhibit the characteristics of their original cancer type. Treatment for metastatic cancer is based on where the cancer originated.
Lung Cancer Type: | % of Cases: | Growth Rate: | Treatment Options: | |
NSCLC | Adenocarcinoma | 45% | Slow | Surgery, chemotherapy, immunotherapy, targeted therapy |
Squamous cell carcinoma | 21% | Very aggressive | ||
Large cell carcinoma | 10-15% | Aggressive | ||
Small cell lung cancer (SCLC) | 10-15% | Aggressive | Radiation therapy, chemotherapy, immunotherapy | |
Lung carcinoid tumors | <5% | Very slow | Surgery, chemotherapy | |
Metastatic lung cancer | N/A | Variable depending on origin | Surgery, chemotherapy, immunotherapy, or targeted therapy, depending on origin | |
Deaths from lung cancer are declining, largely due to a decline in smoking, which is the leading cause of the disease. Understanding the risk factors for lung cancer is the best way to prevent it. By learning about lung cancer risk, people empower themselves to make informed decisions about lifestyles and screening.
About 87% of all lung cancer cases are connected to a history of smoking tobacco. A pack-year is a unit of measurement for a person’s lifetime exposure to cigarette smoke. It is calculated by multiplying the number of packs smoked per day by the number of years smoked. For example, smoking 1 pack a day for 20 years and smoking 2 packs a day for 10 years both equal 20 pack-years and confer a similar lung cancer risk.
Quitting smoking is the best way to prevent lung cancer. While it does not undo the damage already caused by smoking, it does stop lung cancer risk from increasing further. The sooner people quit, the more opportunity they have to reduce and control their cancer risk.
Although smoking is the most important risk factor, anybody can develop lung cancer, even people who quit or have never smoked at all. Non-smokers should be aware of the other factors that contribute to lung cancer risk, which include:
People don’t have to smoke cigarettes themselves to experience the negative health consequences of smoking. Secondhand smoke has high concentrations of toxic chemicals that increase cancer risk. If people have prolonged exposure to cigarette smoke, they are at increased risk of lung cancer.
Radon gas exposure is the leading cause of lung cancer in non-smokers. Radon is a naturally occurring, colorless, odorless, and tasteless gas that can seep into homes through cracks in the foundation. People can get do-it-yourself (DIY) kits to test their homes for radon gas.
Certain work-related chemicals also increase cancer risk, especially asbestos. People who work in mines, mills, shipyards, and places where asbestos insulation is used are at increased risk of lung cancer. Other workplace carcinogens include radioactive ores and inhaled chemicals, such as arsenic.
People who live in cities have a slightly higher lung cancer risk due to air pollution. It is estimated that 1% to 2% percent of all deaths from lung cancer in the U.S. are caused by outdoor air pollution, especially from diesel exhaust.
Genetic mutations may increase a person’s risk of lung cancer. Siblings, parents, and children of people who have had lung cancer may have a slightly higher risk of also getting lung cancer, especially if the relative was diagnosed at a young age or was a non-smoker.
If people have had a non-cancerous lung disease, such as chronic obstructive pulmonary disease (COPD) or pulmonary fibrosis, they are at greater risk of developing lung cancer. Prior lung cancer diagnoses also increase the risk of getting the cancer again, even if the treatment was successful.
Most lung cancer is detected when it starts causing problems. Symptoms of lung cancer can be caused by other conditions as well, so a thorough diagnosis is required to determine the cause. Physicians perform several test procedures to rule out possibilities and arrive at a conclusive diagnosis:
Medical imaging tests are non-invasive procedures that create an image of the inside of the body. This image can be used to examine the lungs for suspicious tissue masses or calcifications. Types of imaging tests used for lung cancer include:
The oncologist may also request a bone scan. While bone scans cannot diagnose lung cancer, they help determine whether any cancer that may be present has spread to the bones.
A lung biopsy involves taking a small sample of lung tissue or fluids. The sample is examined under a microscope to look for cancer cells. Lung biopsies are used to diagnose cancer and determine its type. They can also tell oncologists more about the cancer’s unique characteristics, which helps inform a treatment plan. Physicians use one of several methods to acquire biopsy samples:
A bronchoscopy uses a specialized camera and a cutting tool mounted on a long, flexible tube. The camera is guided down the trachea to examine the lung airways for tumors. If a tumor or suspicious growth is found, the cutting tool is used to take a sample for testing.
During a needle biopsy, physicians use CT scan guidance to insert a specialized needle through the chest and into the suspicious area of the lung. The hollow needle is used to remove a small amount of tissue or fluid from around the suspicious growth.
Video-assisted thoracoscopic surgery (VATS) is a minimally invasive procedure to diagnose and treat lung cancer. The surgeon makes a tiny incision in the chest to access the lungs. Using a specialized camera for guidance, the surgeon then removes the whole tumor and some of the surrounding tissue.
Biopsy samples also are used for molecular and biomarker testing. In a laboratory, physicians use advanced tools to examine the genetic makeup of cancer cells. They look for specific mutations. For example, EGFR, ALK, ROS1, and KRAS mutations indicate that the cancer may be more or less receptive to certain targeted therapies, helping oncologists plan the best treatment.
When diagnosing lung cancer, oncologists also determine its stage. Stages of lung cancer describe how far the cancer has spread through the lungs and the rest of the body, providing vital information to guide treatment. Lung cancer staging depends on what type of cancer the patient has.
NSCLC is staged based on the TNM classification. The T refers to the size and location of the tumor, the N indicates whether cancer has spread to nearby lymph nodes, and the M refers to metastasis, or the cancer’s spread to other organs. NSCLC stages include:
Treatment becomes less effective as the cancer advances. Localized lung cancer is comparatively simple to treat with surgery and pre- or post-surgical modalities. As the tumor spreads, eliminating all cancer cells becomes increasingly difficult. If even a few cells survive treatment, the cancer can come back.
|
NSCLC Stage: |
Description: |
5-year survival rate: |
Treatments: |
|
Occult |
Cancer cells only in fluid |
Between 24% and 60% |
Chemotherapy |
|
0 |
Tiny tumor only in the lung lining |
90% to 95% |
Surgery, followed by chemotherapy |
|
I |
Small tumor localized to the lungs |
Up to 92% |
Surgery, followed by chemotherapy |
|
II |
Larger tumor localized to the lungs |
67% |
Surgery, followed by chemotherapy and/or immunotherapy |
|
III |
Larger tumor, cancer cells found in lymph nodes and nearby organs |
40% |
Surgery, followed by chemotherapy and/or immunotherapy |
|
IV |
Any size tumor, cancer cells found in distant organs |
12% |
Chemotherapy, immunotherapy, and/or targeted therapy |
SCLC is staged differently from other types of cancer. It has only two stages, limited and extensive:
|
SCLC Stage: |
Description: |
5-year survival rate: |
Treatments: |
|
Limited |
Only present in one lung and regional lymph nodes |
34% |
Surgery, followed by chemotherapy and radiation therapy |
|
Extensive |
Present in both lungs and may have spread to other areas of the body |
4% |
Combination of chemotherapy, radiation therapy, and/or immunotherapy |
Lung cancer treatment can differ significantly between patients. Oncologists develop personalized plans based on the type of cancer the individual has, what stage it has progressed to, the person’s overall health, and the patient’s preferences. Patients meet with their care team to discuss every option and design a care plan that is right for them. The options may include:
Surgery is the frontline treatment for lung cancer. The goal of treatment is to remove the whole tumor and some of the surrounding tissue to make sure the cancer does not return. One of three procedures may be used, depending on how far the cancer has spread:
Radiation therapy uses high-energy rays to destroy cancer cells. The rays are directed at the tumor using a sophisticated machine to ensure accuracy, pinpointing the tumor while minimizing damage to neighboring healthy tissue. It is often used as an alternative to surgery, especially for patients who are in poor health and may not tolerate surgery.
Stereotactic radiosurgery is a highly precise form of radiation therapy. Rather than using a single, powerful beam, the machine produces nearly 200 tiny beams that intersect at the tumor location. This delivers a massive dose of radiation directly to the tumor without damaging the surrounding areas.
Chemotherapy uses strong drugs that interfere with cell division. Most lung cancer chemotherapy drugs are platinum-based regimens. The drug binds heavy metals to DNA strands during cell division, bending and breaking the strands. Chemotherapy may be used as an adjuvant treatment to keep the cancer from returning after surgery. It may also be used to control the spread of late-stage lung cancer.
Targeted therapy is a cutting-edge innovation that is transforming outcomes for advanced lung cancer. This personalized medicine approach attacks cancer cells that have specific gene mutations while not harming healthy tissue. A few types of targeted therapy have been approved for use in treating lung cancer, each named after the gene it targets:
Targeted therapy drugs usually work by blocking the proteins that drive cancer’s uncontrolled growth. By blocking the activity of these proteins, the drugs stop advanced lung cancer from spreading further.
Immunotherapy is another recent advance in late-stage lung cancer treatment. It works by empowering the patient’s immune system to fight cancer. Lung cancer cells produce certain proteins, such as PD-L1, to disguise themselves as normal cells. Checkpoint inhibitors block these proteins, so immune cells can recognize and attack the cancer. Approved checkpoint inhibitors include:
Immunotherapy drugs are typically used to control late-stage lung cancer. They may be used alone or with chemotherapy to achieve the best results.
Treatment: | Best For: | Method: | Side Effects: |
Surgery | Localized NSCLC | Lobectomy VATS | Pain Fatigue Shortness of breath Coughing |
Radiation therapy | Localized SCLC | Beam | Fatigue Dry cough Shortness of breath Skin irritation Sore throat |
Chemotherapy | Adjuvant treatment with surgery or radiation therapy; controlling metastatic cancer | Oral or infusion therapy | Frequent infections Nausea and vomiting Hair loss Fatigue Peripheral neuropathy |
Targeted therapy | Controlling metastatic cancer | Oral | Diarrhea Fatigue Nausea Skin rashes Mouth sores |
Immunotherapy | Adjuvant treatment with surgery and chemotherapy; controlling metastatic cancer | Oral | Fatigue Skin rashes Diarrhea Flu-like symptoms |
RCCA offers advanced cancer care at more than 20 locations near you across New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area, so patients don’t need to travel far for treatment. Contact RCCA today to learn more about lung cancer treatments or to schedule an appointment.
What are the first symptoms of lung cancer?
Lung cancer does not always cause symptoms at first. When symptoms develop, they may include coughing, chest pain, shortness of breath, coughing up blood, or a hoarse voice.
What does lung cancer feel like?
Lung cancer can feel like a persistent cold, a nagging cough, or unexplained weakness. Spreading tumors may cause chest, shoulder, or back pain.
Can you have lung cancer without ever having smoked?
Yes, you can have lung cancer without smoking. About 10% to 20% of lung cancer cases occur in patients who never smoked.
How is lung cancer diagnosed?
Lung cancer is usually detected when it starts causing symptoms. Physicians locate the tumor using medical imaging, then perform a biopsy to test tumor tissue for cancer cells. Molecular testing identifies gene mutations to guide treatment decisions.
What are the treatment options for Stage IV lung cancer?
The treatment options for Stage IV lung cancer include chemotherapy, targeted therapy, and immunotherapy. Palliative care is also available to help patients manage their symptoms and the side effects of treatment.
What is the survival rate for lung cancer by stage?
Lung cancer survival rates decline as the cancer progresses. For example, localized (Stage I) non-small cell lung cancer has a five-year survival rate of up to 92%, while metastatic (Stage IV) NSCLC has a survival rate of 12%. Note that these estimates are generalized statistics and individual patients may have different prognoses.
What is targeted therapy for lung cancer?
Targeted therapy is a type of personalized therapy that attacks cells with specific characteristics. It can be used to combat cancer without damaging healthy tissue.
Can immunotherapy cure lung cancer?
Immunotherapy cannot cure lung cancer, but it can greatly extend patients’ lifespans while reducing treatment side effects when managing late-stage lung cancer.
How long does lung cancer treatment take?
The length of time expected for lung cancer treatment depends on the cancer’s stage and how effective the treatment is. Some patients finish active treatment within a few months, but others receive care for years.
Get the emotional, mental, physical and financial support you and your family need at Regional Cancer Care Associates. Our patient-centered approach helps our team tend to every patient’s unique needs. The oncology team, nurses and support staff bring decades of experience to help patients fight lung cancer.
Whether your journey is just beginning or you’re ready to explore new options, contact RCCA today. You can reach us at 844-346-7222, or schedule a consultation at the RCCA location nearest your town to get seen as soon as possible.
A lung cancer diagnosis can be life-changing, bringing uncertainty and many questions about available treatments. At Regional Cancer Care Associates (RCCA), we understand the importance
This time the diagnosis was definitive – and devastating. After first being told that she had bronchitis, and then pneumonia, Joanne Teeney had traveled from
What if there was a safe, painless, and quick screening test that could reduce the number of lung cancer deaths by 20%? And what if that test was covered by Medicare, Medicaid, and most commercial insurers?
When standard cancer treatments aren’t providing the results you want, clinical trials may offer hope. Our physicians use clinical trials to study new treatments, helping transform cancer care for the better. You can enroll in a clinical trial to try groundbreaking treatment plans at zero cost to you.
Regional Cancer Care Associates is one of fewer than 200 medical practices in the country selected to participate in the Oncology Care Model (OCM); a recent Medicare initiative aimed at improving care coordination and access to and quality of care for Medicare beneficiaries undergoing chemotherapy treatment.
