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What is lung cancer?

Lung cancer starts when abnormal cells grow rapidly in the lining of the tubes, branches or air sacs that make up your lungs. It’s a very common type of cancer. However, it has been declining in recent years. This decline is partly due to fewer people smoking and a broader disease awareness. If you have a history of smoking and meet other criteria, you may qualify for routine lung cancer screening, which catches early signs of lung cancer when it’s most treatable.

There are two main types of lung cancer—non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). While both types of lung cancer start in the lining of the lungs, NSCLC is more common and usually grows slower than SCLC.

Symptoms of lung cancer

Lung cancer causes a range of symptoms similar to other respiratory conditions. In the early stages, you may have no lung cancer symptoms, and the condition is only detected through an imaging test or routine lung cancer screening.

In the beginning stages of lung cancer, respiratory symptoms are more common. As lung cancer spreads, you may have symptoms that affect other places in your body.

Lung cancer symptoms include:

  • A lingering cough
  • Changes in breathing, like wheezing or shortness of breath
  • Changes in your voice, such as hoarseness
  • Coughing up blood or blood in saliva
  • Body pain or chest pain
  • Loss of appetite and weight loss
  • Swelling in the face or neck
  • Fatigue
  • Recurring respiratory infections

Learn more about lung cancer symptoms

When to see a doctor

It’s important to stay in tune with your body and know when to get checked for lung cancer symptoms. Although you can have respiratory symptoms with various conditions, it is crucial to consult a doctor when experiencing lung cancer symptoms, especially if you have been exposed to cigarette smoke, or have a smoking history.

Your doctor is your best resource to understand your symptoms and guide your path to treatment.

Causes of lung cancer

Smoking is the leading cause of lung cancer. Exposure to other harmful substances or chemicals could also lead to lung cancer. However, a small number of people develop lung cancer without any risk factors or prior history of cigarette smoking.

How does smoking cause lung cancer

Tobacco smoke is known to contain several substances that are considered cancer-causing, called carcinogens. Exposure to these chemicals over time leads to more and more damage in your lung tissue, which causes abnormal changes to lung cells, which then multiply over time.

Lung cancer risk factors

While smoking is the most well-known risk factor for lung cancer, other factors increase your risk, too. You can take steps to detect lung cancer early—which often gives you more treatment options.

Risk factors you can change

Certain risk factors for lung cancer are controllable, so you have the power to make changes that could reduce your risk of lung cancer.

Some substances linked to lung cancer that you can avoid include:

  • Tobacco smoke: Being a current or former smoker is the leading risk factor for lung cancer.
  • Secondhand smoke: Even if you don’t smoke, breathing in the smoke from others using cigarettes or cigars also increases your risk of lung cancer.
  • Exposure to radon: Radon is an odorless gas that occurs naturally in the environment. However, exposure to a buildup of this gas in an indoor space, such as your home, increases your risk of lung cancer.
  • Exposure to asbestos and other carcinogens: Exposure to several different substances and chemicals, including asbestos, radioactive materials or diesel exhaust, puts you at risk for lung cancer.
  • Air pollution: Exposure to air pollution can increase your risk for lung cancer.

Risk factors you cannot change

Several risk factors for lung cancer are beyond your control. However, it’s still important to know the risk factors you cannot change and talk with your doctor about other steps to be proactive in caring for your health:

  • Age: In general, your risk of lung cancer increases with age. Very few people who develop lung cancer are under 45. The average age of a lung cancer diagnosis is around 70.
  • Previous radiation therapy: If you’ve had radiation therapy in the chest area for another type of cancer, including breast cancer or lymphoma, you have a higher risk of lung cancer.
  • Air pollution: Exposure to air pollution, especially if you spend much time outdoors in a highly polluted area, can increase your risk.
  • Personal or family history of lung cancer: If you have previously had lung cancer, you have a higher risk of developing a new lung cancer. People with a family history may also have an increased risk. Studies are ongoing to understand how specific genes are related to lung cancer.

How is lung cancer diagnosed?

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Lung cancer is usually diagnosed when you have symptoms and undergo testing. However, in people at risk for lung cancer, routine screening with a low-dose CT scan can also catch signs of cancer and lead to a diagnosis sooner.

Your care team has several options for imaging tests and diagnostic procedures that help detect and diagnose lung cancer. These tests will provide information about your specific lung cancer to guide your care after diagnosis.

Medical history and physical exam

If you have symptoms of lung cancer, you should schedule a visit to your doctor. Your healthcare provider will ask about your health and family history and perform an exam. You’ll then work together to plan your next steps, which may include imaging tests.

Imaging

Imaging tests give your care team detailed pictures of your lungs or other areas of your body to look for cancer. Some imaging tests are used to detect lung cancer, while others may look for signs that cancer has spread:

  • Chest X-ray: A chest X-ray is a noninvasive imaging test that creates a picture of the inside of your chest. You may undergo further testing if your doctor sees a chest mass or possible lung tumor.
  • CT scan: A low-dose computed tomography (CT) scan with low radiation is the recommended screening test for lung cancer for eligible patients. The actual scan only takes about five minutes and you can find cancer even before you have symptoms.
  • MRI: An MRI of the lungs uses magnets and radio waves to create detailed images. MRIs are most often used to provide further insights about lung cancer after it has been diagnosed.
  • PET: During a PET scan, a small amount of radioactive material is injected into your blood. This material shows where cancer cells are in the body, which helps diagnose and stage your lung cancer.

Sputum cytology

Lung cancer cells can be found in your sputum, the mucus you cough up from your lungs. With sputum cytology, you’ll take samples of this mucus and then send them to a lab, where they’ll be viewed under a microscope.

Thoracentesis

A thoracentesis provides a fluid sample and can relieve symptoms of fluid buildup. During this procedure, a doctor inserts a needle into the space between your chest wall and lung to retrieve fluid for testing.

Biopsy

A biopsy takes tissue samples for testing if you have a lung nodule on an imaging test or lung cancer that may have spread to other areas. These samples are then sent to the lab and are tested for signs of lung cancer.

  • CT-guided needle biopsy: During this type of biopsy, a needle is guided into the nodule or mass in your lung to take a tissue sample.
  • Bronchoscopy: In a bronchoscopy, a doctor inserts a thin tube down your throat and into your airways to look inside the lungs and take samples. The procedure is used to both diagnose and treat symptoms of lung cancer.
  • Thoracoscopy or video-assisted thoracic surgery (VATS): Thoracoscopy is a surgical procedure that uses a scope and a tiny camera inserted through a small incision to video your lungs. It allows your care team to take tissue samples and drain fluid and can also be used during lung cancer treatment.
  • Endobronchial ultrasound: An endobronchial ultrasound uses ultrasound technology during a bronchoscopy to help your doctor view the inside of your lungs and airways. It’s used to diagnose lung cancer and take samples of nearby lymph nodes.
  • Endoscopic esophageal ultrasound combines an ultrasound with an endoscope (a thin, flexible tube with a camera) to view the upper digestive tract. In lung cancer, it may be used to let your team reach nearby lymph nodes for biopsy.
  • Mediastinoscopy or mediastinotomy: These procedures allow your team to take samples of the lymph nodes in the middle of your chest. Mediastinoscopy uses a small incision and scope to reach the area between your lungs under your breastbone. Mediastinotomy is slightly more invasive and uses an incision between two ribs near your breastbone.
woman sitting indoors learning about the different types of lung cancer

Types of lung cancer

The type of lung cancer you have will guide your treatment plan. Your care team will place your lung cancer in one of two main groups—non-small or small cell lung cancer—depending on the original location of the abnormal cells.

  • Non-small cell lung cancer (NSCLC)

    Non-small cell lung cancer is the most common type—making up about 80-85% of cases. This type of lung cancer is typically slow-growing and may not cause symptoms in the early stages. It has subtypes based on the kind of cell where the cancer starts to form. These types have similar treatment options and prognoses.

    • Adenocarcinoma: Adenocarcinoma accounts for most cases of NSCLC, and it starts in the cells in the lung that make mucus. It’s the most common type of lung cancer found in people who don’t smoke.
    • Squamous cell carcinoma: This type of lung cancer starts in the squamous cells that line the inside of the lung’s airways. It is typically found in the central part of the lungs.
    • Large cell carcinoma: Large cell carcinoma, or undifferentiated carcinoma, can appear anywhere within the lung. It is the least common type of NSCLC and generally spreads and grows rapidly.
  • Small cell lung cancer (SCLC)

    Small cell lung cancer is sometimes called oat cell cancer. SCLC is rarer than NSCLC and makes up only about 10-15% of all lung cancer cases. It’s often linked to a history of tobacco use and grows faster than other types of lung cancer.

enlarged view of lung cancer cells under a microscope

Lung cancer stages

Lung cancer staging helps you understand the size and location of your lung cancer and how far it has spread. During staging, you may have imaging tests such as a CT, MRI or PET scan to look for signs of cancer cells in different body areas. The stage of your lung cancer provides essential information to guide your decisions in selecting the treatment plan for your specific condition.

Non-small cell lung cancer is put into one of five stages—from 0 to 4. The higher the number, the more your lung cancer has spread. Stage 0 non-small cell lung cancer is the earliest stage, while stage 4, metastatic lung cancer, is the most advanced.

Small cell lung cancer usually only has two stages. In limited-stage SCLC, lung cancer is still limited to a portion of the chest that can be treated with radiation, whereas extensive-stage SCLC has spread to other areas or distant areas. Most cases of SCLC are found when they’ve reached the extensive stage.

How lung cancer is treated

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Many factors affect the right lung cancer treatment for you. Your care team will work with you to create a plan based on your type and stage of lung cancer and your personal health and goals.

Treatment options are often different for non-small cell and small cell lung cancer. Your team may be able to remove cancer with surgery during earlier stages of the condition, while later-stage treatment focuses on slowing the growth of cancer and managing symptoms.

Surgery

Surgery is often one of the main treatment options in earlier stages of non-small cell lung cancer. It isn’t a standard treatment for small cell lung cancer. The goal is to remove as much of the lung cancer as possible, and often, these procedures are performed using minimally invasive techniques.

  • Segmental or wedge resection: These surgical procedures remove only a segment of a lung lobe or a wedge-shaped area of tissue that contains the lung tumor.
  • Lobectomy: A lobectomy is one of the most common surgical procedures for lung cancer. It removes the entire lobe where the tumor is located.
  • Pneumonectomy: Pneumonectomy is surgery that removes your entire lung on one side. It’s used when the location or spread of the lung cancer doesn’t allow for a lobectomy.
  • Sleeve resection: This surgery removes part of a bronchus, one of the large air passages connecting to your windpipe. The remaining end is then reconnected to the lung.

 

Radiation therapy

The primary type of radiation therapy for lung cancer is external beam radiation. It uses high-energy rays from a machine outside the body to target specific areas of cancer. It’s sometimes used along with surgery or chemotherapy to destroy cancer cells. In people with advanced lung cancer, radiation therapy is a treatment to manage symptoms.

Stereotactic body radiotherapy

Stereotactic body radiotherapy, also known as radiosurgery, uses highly targeted radiation beams from many different angles to destroy areas of cancer. Unlike traditional radiation therapy, you may only need one or two treatments. It’s more common as a treatment for non-small cell lung cancer, where surgery often isn’t an option.

Chemotherapy

There are several different types of chemotherapy used to treat lung cancer. These drugs typically work by stopping fast-dividing cancer cells from multiplying. Chemotherapy may be used before or after surgery, especially for non-small cell lung cancer. In small cell lung cancer, chemotherapy is often the primary treatment.

Targeted drug therapy

Targeted drug therapy targets specific abnormalities (or markers) in cancer cells to stop them from growing. As targeted therapies only work on particular cell changes or mutations, you may undergo biomarker testing to decide if these drugs could work on your cancer.

Immunotherapy

Lung cancer cells may have certain features that prevent your body’s immune system from identifying them as harmful. Immunotherapy utilizes your immune system, helping it recognize and attack cancer cells. This treatment can be used with or without chemotherapy for operable and non-operable lung cancer.

Palliative care

Your care team may recommend supportive palliative care for lung cancer. Palliative care focuses on improving quality of life, managing symptoms and providing additional support services. You may choose to continue other treatment options while receiving palliative care.

How to prevent lung cancer

While not every case of lung cancer is preventable, you can take steps to reduce your risk. Smoking is the most significant risk factor for lung cancer, so quitting tobacco is one of the best choices for your lungs. If you’re ready to quit, talk with your doctor or find free resources at YesQuit.org or SmokeFree.gov.

Screening is another great choice if you have a high risk. While screening may not prevent lung cancer completely, early detection and treatment can stop the cancer from spreading.

Lung cancer screening

The earlier you find lung cancer, the better. A simple yearly imaging test could detect lung cancer before you have symptoms, especially in people with a high risk of lung cancer. Lung cancer screening uses a low-dose CT scan to look for signs of cancer or lung nodules, giving you peace of mind about your lung health.

Ask your doctor about a referral for lung cancer screening if you meet the following guidelines:

  • 50-80 years old
  • Smoking history equal to 20 pack years or more (number of packs per day x number of years smoked = total pack years)
  • Current smoker or stopped smoking in the last 15 years
  • No lung cancer symptoms

Why Baylor Scott & White Health for lung cancer care

Whether you want to learn about lung cancer screening, find your path forward after a diagnosis or get a second opinion for your treatment, our lung cancer care teams across Texas give you many options. We offer advanced diagnostic technology, complex lung cancer procedures like robotic bronchoscopy, and numerous support services to meet your needs.

Our Dallas and Temple hospitals have been nationally ranked by U.S. News & World Report for Pulmonology & Lung Surgery. And with ongoing research and clinical trials, we continue to lead the way in providing even more options for your care.

Lung cancer care near you

You have access to multiple care centers, including centers specializing in lung cancer care. Get started by finding a lung cancer care location near you.

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Frequently asked questions

  • Can lung cancer cause back pain?

    Yes. Sometimes, lung cancer can cause back pain. Inflammation in the chest caused by lung cancer or a tumor that spreads or puts pressure on the spine can lead to back, shoulder or neck pain. This pain may feel sharp or dull.

  • Can lung cancer be seen on an X-ray?

    Yes. Some lung tumors can be seen on a chest X-ray. However, an X-ray can’t diagnose lung cancer because other conditions may appear similar to cancer on an X-ray. If you have an X-ray that shows a lung mass, you’ll have more testing to confirm the cause.

  • Can lung cancer be genetic?

    Genes play a role in some lung cancer cases, but it’s not a common cause. It’s a topic of ongoing research. If you have a strong family history, such as a sibling or parent diagnosed with lung cancer, talk to your doctor about how it affects your risk. 

  • Will lung cancer show up in blood work?

    Lung cancer can’t currently be diagnosed with routine blood work, but multi-cancer early-detection blood tests are now entering the market. However, none are FDA-approved yet and ongoing research will define the ability to detect lung cancer from blood samples.

    If you’ve already been diagnosed, your care team may use tests like a complete blood count to check on your overall health or biomarker testing to look for specific gene mutations or markers related to lung cancer.

  • Where does lung cancer spread?

    Lung cancer can spread to other areas of the chest or any distant area in the body. Some common places where lung cancer spreads include the lymph nodes, bones, liver, brain or adrenal glands.