Lung cancer is a malignant tumor of the lungs. There are many different types of lung cancer. However, most can be labeled as small cell and non-small cell lung carcinoma. Small cell cancer is a faster growing type of cancer; however, it is more likely respond to chemotherapy. There are several different forms of non-small cell lung cancer. The prognosis for these subtypes is similar. Lung cancer is the leading cause of cancer death in the United States. It causes more death than colon, prostate, and breast cancer combined.
- Smoking is responsible for more than 85% of all lung cancer cases
- Exposure to second-hand smoke
- Asbestos exposure
- Inhalation of other carcinogens
- Radon exposure
There are a number of symptoms associated with lung cancer. Unfortunately once these symptoms become apparent, the disease is already typically fairly advanced. A person at high risk of having lung cancer, such as a heavy smoker may have the disease for some time before obvious symptoms occur. Following are the most common symptoms.
- Coughing up sputum with signs of blood in it,
- Having a consistent cough most of the time
- Having a change in a cough that you have had for a long time
- Shortness of breath
- Loss of appetite
- Losing weight
Recent studies have suggested that a patient at high risk of having lung cancer, such as heavy smokers, should have CT scan performed in order to detect early stage lung cancer that is potentially curable.
Common tests include:
- Chest x-ray is commonly the first diagnostic tool utilized when any symptoms of lung cancer are present but lacks sensitivity.
- CT scan if an abnormal finding is discovered on a chest x-ray. This test is highly sensitive.
- Positron emission tomography (PET) scan may be utilized If an abnormality is confirmed on the CT scan
- Biopsy may or may not be obtained in order to determine if the x-ray abnormality is a malignancy.
When cancer is localized to the lung, surgery offers the best chance for cure. The most common surgical procedure performed for lung cancer is called a lobectomy. This surgery is traditionally performed through an incision on the side of the chest which allows exposure of the lung as the ribs are spread. The purpose of the surgery is to remove the tumor and the section of the lung in which the tumor is located. Additional lymph nodes will be removed from inside the chest during the lobectomy in order to determine whether or not disease spread has occurred.
Certain patients with lung cancer may be candidates for a less invasive surgical approach called video-assisted thoracoscopic surgery or VATS. With the assistance of a video scope, the surgeon removes the section of the lung where the tumor is located through a smaller incision. VATS surgery has been found to provide patients with much less pain, fewer complications and faster recovery. The surgery is entirely performed using a 5mm camera inserted through a “port” between the ribs viewed on a screen. A metal rib spreader is not used and muscles are not cut providing significantly less chest wall trauma associated with the disadvantages of open surgery.
In certain instances, when the lymph nodes within the center of the chest, or the mediastinum, are found to be enlarged on preoperative work-up, a lung cancer patient may undergo a surgery called a mediastinoscopy prior to his or her lobectomy. This involves passing a scope alongside the trachea or breathing tube through an incision at the base of the neck in order to sample lymph nodes within the chest. The results of the pathology of these lymph nodes will then determine the next appropriate step in the patient’s care.
1. Can lung cancer be detected early?
Presently there is not a proven screening test to detect early lung cancer. However, studies are being done to determine whether or not CT scanning plays a role in screening patients at increased risk of developing lung cancer.
2. Can non-smokers get lung cancer?
Yes, although smoking is hte biggest cause of lung cancer, non-smokers can get lung cancer.