What is lung cancer?

Lung cancer occurs when abnormal cells grow out of control in the lung. Lung cancer can start anywhere in the lungs and spread to other parts of the body.

Treatment is based on the type and stage of lung cancer. It is also based on other factors, such as your overall health. Treatment may include surgery, radiation therapy, or chemotherapy. It may also include immunotherapy or targeted therapy.

Being treated for cancer can weaken your body. And you may feel very tired. Home treatment and certain medicines can help you feel better.

The first signs of lung cancer may include a new cough or a cough that doesn't go away, wheezing, or feeling short of breath. Other signs may include chest pain and blood in mucus that is coughed up.

Treatment for lung cancer is based on the type and stage of the cancer and other things, such as your overall health. Surgery, radiation, and chemotherapy are the main treatments for both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Other treatments that may be used for both types include immunotherapy, laser therapy, and endoscopic stent placement. NSCLC may also be treated with thermal ablation, photodynamic therapy, or targeted therapy.

Your doctor may suggest a clinical trial.

Your doctor will talk with you about your options and then make a treatment plan.

Some people use complementary therapies along with medical treatment. Therapies like acupuncture or massage may help you cope with the symptoms and stress of cancer. Talk with your doctor about any of these options you would like to try.

Surgery

Surgery may be an option if your doctor thinks all of the cancer can be removed. Nearby lymph nodes may also be removed to find out if the cancer has spread.

To remove the cancer, the doctor may take out:

• A small wedge of lung (wedge resection) or a larger piece of the lung (segmentectomy).
• The affected lobe of the lung. (This is called a lobectomy.)
• The affected lobe and part of the bronchus. (This is called a sleeve resection.)
• The whole lung. (This is called a pneumonectomy.)

Lung surgery may be done through one cut (incision) in the chest (thoracotomy). Or it may be done through several small cuts, using a tiny camera and special tools. (This is called video-assisted thoracic surgery, or VATS.) Your doctor can help you understand which type of surgery is best for you.

Radiation therapy

This uses high-dose X-rays to destroy cancer cells and shrink tumors. Radiation therapy is often used with surgery or chemotherapy to treat lung cancer. It may be used alone if surgery can't be done.

Radiation therapy may also be used to:

• Keep cancer from spreading to the brain. Radiation to the head is called prophylactic cranial irradiation (PCI).
• Relieve symptoms. It may help ease pain from bone tumors or shrink tumors that make it hard to breathe or swallow.

Radiation therapy for lung cancer is usually given by a machine outside the body (external radiation). In some cases, it's given by placing substances inside the body (internal radiation, or brachytherapy).

Chemotherapy

These medicines kill fast-growing cells, including cancer cells and some normal cells. They may be given before or after surgery to help destroy any remaining cancer cells. Chemotherapy and radiation may be given together. (This is called chemoradiation.)

These medicines are often put into a vein. Sometimes they are taken as a pill. The medicines travel through your body to kill cancer cells both inside and outside the lung area.

Other treatments

Other treatment options for both NSCLC and SCLC include:

Immunotherapy.

This treatment helps your immune system fight cancer. It may be given along with chemotherapy.

Laser therapy.

This uses a highly focused beam of light to destroy cancer cells.

Endoscopic stent placement.

If a tumor blocks your airway, the doctor can insert a small hollow tube (stent) to help you breathe more easily.

Photodynamic therapy (PDT).

A special light activates a medicine to destroy cancer cells. The doctor can use a bronchoscope to treat tumors in the airways.

NSCLC may also be treated with:

Thermal ablation.

This uses extreme cold or heat to destroy cancer cells. Cryotherapy (or cryosurgery) is a type of ablation that uses cold. Radiofrequency ablation uses heat.

Targeted therapy.

These medicines target cancer cells and may cause less harm to normal cells. They help keep cancer from growing or spreading.

Some of these medicines target certain tumor markers in the cancer cells. If the cancer has a tumor marker that can be targeted, you may be given one or more of these medicines.

Most lung cancers are caused by smoking. If you use tobacco, you can help lower your risk for lung cancer by quitting.

You may be able to make other changes in your life that can help lower your risk.

• Avoid working in jobs where you are exposed to asbestos, arsenic, or secondhand smoke.
• Check the radon level in your home. If the level is high, lowering it can reduce your risk.
• Don't have chest X-rays you don't need.

Your symptoms, your medical history, and any history of cancer in your family will help your doctor decide how likely it is that you have lung cancer. You may need tests to be sure. Lung cancer is usually first found on a chest X-ray or a CT scan.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
• Follow your doctor's instructions to relieve pain. Use pain medicine when you first feel pain, before it becomes severe. Taking pain medicines regularly is often the best way to keep pain under control.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss. Drink liquid meal replacements for extra calories and protein. Try to eat your main meal early. Eating smaller portions more often may help as well.
• Get some physical activity every day, but do not get too tired. Keep doing the hobbies you enjoy as your energy allows.
• Do not smoke. Smoking can make your cancer symptoms worse. But not smoking will make your treatment work better and may help you live longer. Continuing to smoke may delay healing after surgery. And treatments like chemotherapy and radiation therapy may not work as well if you continue to smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• If you use oxygen, do not smoke, light a cigarette, or use a flame while your oxygen is on. Smoking while using oxygen can lead to fire and even explosion.
• If you have nausea, try to eat several small meals a day. When you feel better, eat clear soups and mild foods until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• Take steps to control your stress and workload. Learn relaxation techniques.
  • Share your feelings. Stress and tension affect our emotions. By expressing your feelings to others, you may be able to understand and cope with them.
  • Consider joining a support group. Talking about a problem with your spouse, a good friend, or other people with similar problems is a good way to reduce tension and stress.
  • Express yourself with art. Try writing, crafts, dance, or art to relieve stress. Some dance, writing, or art groups may be available just for people who have cancer.
  • Be kind to your body and mind. Getting enough sleep, eating a healthy diet, and taking time to do things you enjoy can contribute to an overall feeling of balance in your life and help reduce stress.
  • Get help if you need it. Discuss your concerns with your doctor or counselor.
• If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.

Most lung cancers are caused by cigarette smoking. Smoking cigars or a pipe also put you at risk.

Your risk of getting lung cancer is higher:

• The longer you smoke.
• The more cigarettes you smoke each day.

Quitting smoking lowers your risk. And your risk keeps going down as long as you don't smoke. Cutting down may help.

If you live with a smoker, you are at more risk than a person who doesn't.

Being exposed to certain chemicals like arsenic or asbestos puts you at risk. Exposure to radiation, radon gas, or air pollution also puts you at risk.

Some gene changes can increase your risk.

Smoking, exposure to cancer-causing substances, and gene changes are risk factors. Having one or more risk factors can make it more likely that you will get lung cancer. But some people who get lung cancer don't have any of these risk factors.

Lung cancer is the out-of-control growth of abnormal cells in the lungs. These cells can invade nearby tissues and form tumors. Lung cancer can start anywhere in the lungs and affect any part of the respiratory system.

The main types of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is the most common type. SCLC usually grows quickly and is more likely to spread than NSCLC.

Lung cancer is often caused by cigarette smoking. Tobacco smoke contains carcinogens. These are substances that cause cancer. They damage lung cells, and over time the damaged cells can turn into lung cancer.

Sometimes lung cancer develops in people who have never smoked. A few people get lung cancer after being exposed to other harmful substances, including asbestos, radioactive dust, radon, or radiation such as X-rays. Cancer also may be caused by gene changes (mutations) that occur as you get older.