Lung Cancer

Since early lung cancers usually do not exhibit symptoms, by the time symptoms occur, the cancer has often spread (metastasized). The treatment success for metastatic lung cancer can be limited. However, patients with stage 1 lung cancers, or early small lung cancers, detected before spreading, have much better survival rates.

A chest X-ray is an X-ray picture taken of the chest, one image from the back and one from the side. The X-rays form an image of the chest including the lungs, but other structures like the heart and spine, may obscure parts of the lungs where a cancer might be. Chest X-rays have not been shown to be useful for the early detection of lung cancer.

CT imaging utilizes a doughnut-shaped camera (scanner). The CT scanner takes several cross sectional images of the chest. CT imaging results in a more complete picture, it’s as if your body is loaf of bread, and we’re taking one slice of bread at a time and looking at the face of it, and then we continue looking at the face of each slice through the whole loaf.

When screening healthy smokers or former smokers for lung cancer, only the lungs need to be viewed. As a result, the radiation administered during the scan can be lowered to about one-sixth of what is given during a conventional CT scan.

No. The best way to prevent lung cancer is to not smoke, and if you are currently smoking, the best thing to do is quit.

A smoker who stops smoking will significantly reduce his/her risk of lung cancer. However, the risk of cancer will not decrease to the low risk of someone who has never smoked.

First, a physician referral is required. During the imaging test, you will need to lie down on the CT table and hold your breath for about 10 – 15 seconds, while the images are taken. Your results will be provided to your referring physician, who will review them with you during a follow-up consultation.

Many individuals will have a nodule from an old infection, or a scar, which can be difficult to distinguish from a very early cancer. In these cases, the patient will be referred to a pulmonologist for consultation and will need to come back for a follow-up scan in 6 -12 months (based on physician recommendation) to make sure the nodule isn’t growing.

Lung cancer is cancer that begins in the lungs, the main respiratory organs of the body. It can sometimes spread to other organs and lymph nodes. Today, lung cancer is the third most common cancer in the United States, according to the CDC.

The are two main types of lung cancer:

• Small cell lung cancer (SCLC), includes two types that include many different types of cells. This type accounts for 15 percent of lung cancer cases. The cancer cells of each type grow and spread in different ways. The types of small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look when viewed under a microscope:

  • Small Cell carcinoma (oat cell cancer)

  • Combined small cell carcinoma

• Non-small cell lung cancer (NSCLC), which is the most common type of lung cancer, accounting for about 85 percent of lung cancer cases. Subtypes of NSCLC include adenocarcinoma, squamous cell carcinoma and large cell carcinoma

Several common cancers that begin elsewhere in the body can spread (or metastasize) to the lungs, including skin, breast, kidney and pancreas cancers.

The symptoms of lung cancer can be different for every patient, and vary based on how advanced the cancer is. Common symptoms can include:

• Recurring bronchitis, pneumonia and other respiratory infections

• Swollen lymph nodes in the chest

• Chest pain

• A constant or recurring cough

• A raspy or hoarse speaking voice

• Wheezing

• Unexplained shortness of breath

In more advanced lung cancer cases, symptoms may include:

• Unexplained fatigue, loss of appetite and weight loss

• Coughing up blood, or mucus that’s reddish brown

• Recurring headaches that can be severe

• Moderate to severe aches in the bones and chest

• Pleural effusion, a condition in which fluid accumulates in the chest cavity around the cancerous lung

There are several risk factors that are believed to increase your risk of developing lung cancers. These include:

• Smoking and exposure to secondhand smoke, with most cases of lung cancer being due to tobacco use.

• Exposure to radon, a colorless, odorless, naturally-occurring radioactive gas that can seep into and accumulate in homes and workplaces over time

• Exposure to asbestos, a naturally occurring mineral that was once used extensively in residential and commercial insulation and is still found in many older buildings.

• Previously having lung cancer

• A family history of lung cancer

• Previous radiation therapy to the chest

Ways to reduce your risk of developing lung cancer include:

• Quit smoking and encourage smokers you might live with to not expose you and others to secondhand smoke. Hoag offers a smoking cessation class to support your efforts to quit smoking.

• Avoiding radon, including having your home professionally checked. Almost every state in the U.S. has some level of radon. The top ten states with highest average radon concentrations are Alaska, South Dakota, Pennsylvania, Ohio, Washington, Kentucky, Montana, Idaho, Colorado and Iowa.

• Avoiding asbestos, including wearing proper protective gear when working around known asbestos and having older buildings and homes checked for asbestos prior to beginning any demolition or renovation work.

Yes, early lung cancer screening is available at Hoag.

If you are concerned about lung cancer due to a long history of heavy smoking, Hoag’s Early Lung Cancer Screening Program might be right for you. This groundbreaking program catches lung cancer in high-risk patients earlier through annual, low-dose CT screenings for heavy smokers or former heavy smokers between 50-77 years of age. Some private insurance plans and Medicare pay for this vital preventative screening.