Lung Cancer Facts

Lung cancer is the uncontrolled growth of abnormal cells that start off in one or both lungs; usually in the cells that line the air passages. The abnormal cells do not develop into healthy lung tissue, they divide rapidly and form tumors. As tumors become larger and more numerous, they undermine the organ’s ability to provide the bloodstream with oxygen. Primary lung cancer originates in the lungs, while secondary lung cancer starts somewhere else in the body, metastasizes, and reaches the lungs. They are considered different types of cancers and are not treated in the same way.

There are two main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC accounts for nearly nine out of every 10 cases and typically grows at a slower rate than SCLC.

• Small cell lung cancer: It’s also known as “oat-cell” cancer because the cells look like oats under the microscope. It often starts in the bronchi, then quickly grows and spreads to other parts of the body, including the lymph nodes. This type of lung cancer represents fewer than 20 percent of lung cancers and is typically caused by tobacco smoking.  

• Non-small cell lung cancer: Non-small cell lung cancer is the most common type of lung cancer. Most often, it develops slowly and causes few or no symptoms until it is far advanced. SCLC tends to be more aggressive and spread more rapidly than NSCLC. Treatment options vary, depending on which type of lung cancer you have.

Lung cancer typically doesn’t cause signs and symptoms in its earliest stages. Signs and symptoms of lung cancer typically occur only when the disease is advanced. Signs and symptoms of lung cancer may include:

• A new cough that doesn’t go away
• Coughing up blood, even a small amount
• Shortness of breath
• Chest pain
• Hoarseness
• Losing weight without trying
• Bone pain
• Headache

People with an increased risk of lung cancer may consider annual lung cancer screening using low-dose CT scans. Lung cancer screening is generally offered to people 55 and older who smoked heavily for many years and are otherwise healthy. Discuss your lung cancer risk with your doctor. Together you can decide whether lung cancer screening is right for you. If there’s reason to think that you may have lung cancer, your doctor can order a number of tests to look for cancerous cells and to rule out other conditions. Tests may include:

• Imaging tests. An X-ray image of your lungs may reveal an abnormal mass or nodule. A CT scan can reveal small lesions in your lungs that might not be detected on an X-ray.

• Sputum cytology. If you have a cough and are producing sputum, looking at the sputum under the microscope can sometimes reveal the presence of lung cancer cells.

• Tissue sample (biopsy). A sample of abnormal cells may be removed in a procedure called a biopsy. Your doctor can perform a biopsy in a number of ways, including bronchoscopy, in which your doctor examines abnormal areas of your lungs using a lighted tube that’s passed down your throat and into your lungs; mediastinoscopy, in which an incision is made at the base of your neck and surgical tools are inserted behind your breastbone to take tissue samples from lymph nodes; and needle biopsy, in which your doctor uses X-ray or CT images to guide a needle through your chest wall and into the lung tissue to collect suspicious cells. A biopsy sample may also be taken from lymph nodes or other areas where cancer has spread, such as your liver.

Careful analysis of your cancer cells in a lab will reveal what type of lung cancer you have. Results of sophisticated testing can tell your doctor the specific characteristics of your cells that can help determine your prognosis and guide your treatment.

Once your lung cancer has been diagnosed, your doctor will work to determine the extent (stage) of your cancer. Your cancer’s stage helps you and your doctor decide what treatment is most appropriate. Staging tests may include imaging procedures that allow your doctor to look for evidence that cancer has spread beyond your lungs. These tests include CT, MRI, positron emission tomography (PET) and bone scans. Not every test is appropriate for every person, so talk with your doctor about which procedures are right for you.

The stages of lung cancer are indicated by Roman numerals that range from 0 to IV, with the lowest stages indicating cancer that is limited to the lung. By stage IV, the cancer is considered advanced and has spread to other areas of the body.

You and your doctor choose a cancer treatment plan based on a number of factors, such as your overall health, the type and stage of your cancer, and your preferences. In some cases, you may choose not to undergo treatment. For instance, you may feel that the side effects of treatment will outweigh the potential benefits. When that’s the case, your doctor may suggest comfort care to treat only the symptoms the cancer is causing, such as pain or shortness of breath.

• Surgery: During surgery your surgeon works to remove the lung cancer and a margin of healthy tissue. Procedures to remove lung cancer include:
  • Wedge resection to remove a small section of lung that contains the tumor along with a margin of healthy tissue
  • Segmental resection to remove a larger portion of lung, but not an entire lobe
  • Lobectomy to remove the entire lobe of one lung
  • Pneumonectomy to remove an entire lung

If you undergo surgery, your surgeon may also remove lymph nodes from your chest in order to check them for signs of cancer. Surgery may be an option if your cancer is confined to the lungs. If you have a larger lung cancer, your doctor may recommend chemotherapy or radiation therapy before surgery in order to shrink the cancer. If there’s a risk that cancer cells were left behind after surgery or that your cancer may recur, your doctor may recommend chemotherapy or radiation therapy after surgery.

Radiosurgery: Stereotactic body radiotherapy, also known as radiosurgery, is an intense radiation treatment that aims many beams of radiation from many angles at the cancer. Stereotactic body radiotherapy treatment is typically completed in one or a few treatments. Radiosurgery may be an option for people with small lung cancers who can’t undergo surgery. It may also be used to treat lung cancer that spreads to other parts of the body, including the brain.

Radiotherapy: This treatment uses high-powered energy from sources such as X-rays and protons to destroy cancer cells and shrink tumors. Doctors carefully direct the energy to the liver, while sparing the surrounding healthy tissue. During external beam radiation therapy treatment, you lie on a table and a machine directs the energy beams at a precise point on your body. A specialized type of radiation therapy, called stereotactic radiosurgery, involves focusing many beams of radiation simultaneously at one point in your body.

Chemotherapy: Chemotherapy uses drugs to kill cancer cells. One or more chemotherapy drugs may be given through a vein in your arm (intravenously) or taken orally. A combination of drugs usually is given in a series of treatments over a period of weeks or months, with breaks in between so that you can recover. Chemotherapy is often used after surgery to kill any cancer cells that may remain. It can be used alone or combined with radiation therapy. Chemotherapy may also be used before surgery to shrink cancers and make them easier to remove. In people with advanced lung cancer, chemotherapy can be used to relieve pain and other symptoms.

Immunotherapy: Immunotherapy uses your immune system to fight cancer. Your body’s disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process.

Palliative Care: Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy. When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer. Palliative care is provided by our skilled team of doctors, nurses and specially trained professionals, aimed at improving the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving. Learn more about San Cristóbal Palliative Care.

San Cristobal Cancer Institute offers a wide array of options to help our patients feel calm and supported during the process of screening, diagnosis and treatment, as well as getting back to life after cancer.  Browse our alternatives for patients – including financial aid for those eligible – in our Patient Resources section.