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Lung Cancer


Disease: Lung Cancer Lung Cancer
Category: Respiratory diseases
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Disease Definition:

The type of cancer that begins in the lungs is called lung cancer. Located in the chest, the lungs are two spongy organs that take in oxygen when a person inhales and releases carbon dioxide when he/she exhales.

People who are at greatest risk of lung cancer are smokers. Depending on the length of time and number of cigarettes smoked, the risk of lung cancer will increase. Someone could significantly reduce their chances of developing lung cancer if they quit smoking, even if they’ve smoked for many years.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


In its early stages, lung cancer doesn't cause any signs or symptoms. Signs and symptoms of lung cancer typically occur only when the disease is advanced. They may include:


  • Chest pain
  • A new cough that doesn't go away
  • Bone pain
  • Headache
  • Coughing up blood, even a small amount
  • Unintentional loss of weight
  • Wheezing
  • Changes in a chronic cough or "smoker's cough"
  • Hoarseness
  • Shortness of breath

In case someone experiences any worrisome signs or symptoms, they should make an appointment to see a doctor.

A person could also see a doctor if they smoke and want to stop in order to reduce their risk of lung cancer. They may be recommended nicotine replacement products, counseling and medications among other strategies for quitting.


The majority of lung cancer is caused by smoking. This could occur both in smokers as well as people who are exposed to secondhand smoke. However, people who've never smoked and people who've never had prolonged exposure to secondhand smoke could also develop lung cancer. In these cases, the exact cause of lung cancer cannot be found. However, some factors have been found that increase the risk.

By damaging the cells that line the lungs, doctors believe that smoking causes lung cancer. The cigarette smoke is full of cancer-causing substances. So when it is inhaled, almost immediately changes start occurring in the lung tissue. The body could be able to repair this damage at first; however, normal cells that line the lungs will be increasingly damaged with each repeated exposure. As time passes, the damage will cause cells to act abnormally, eventually causing the development of cancer.

Depending on the appearance of lung cancer cells under the microscope, it has been divided into two major types. The treatment will be determined based on which type of lung cancer someone has. Those two types of lung cancer are:

Non-small cell lung cancer:
Several types of lung cancers that behave in a similar way are grouped together in this umbrella term. Large cell cancinoma, squamous cell carcinoma and adenocarcinoma are some of the non-small cell lung cancers.

Small cell lung cancer:
This type is less common than non-small cell lung cancer, and it almost always develops in heavy smokers.

Someone’s risk of lung cancer could be increased by a number of factors, some of which could be controlled, such as smoking, but others can't be controlled, such as sex. Some of the risk factors for lung cancer could be:

The greatest risk factor of lung cancer is smoking. With the number of cigarettes someone smokes each day and the number of years they have smoked, the risk of lung cancer increases. However, this risk could be lowered by quitting at any age.

Exposure to secondhand smoke:
In case someone is exposed to secondhand smoke, their risk of lung cancer will increase even if they don't smoke.

Exposure to asbestos and other chemicals:
Particularly if someone’s a smoker, their risk of developing lung cancer could increase if they’ve been exposed to asbestos in their workplace or other substances that are known to cause cancer such as tar, chromium, nickel and arsenic.

Exposure to radon gas:
The natural breakdown of uranium in water, soil and rock produces radon, which ultimately becomes part of the air that people breathe. In any building, including homes, there could be an accumulation of unsafe levels of radon. To determine whether levels are safe, radon testing could be done.

Certain lung diseases:
The risk of lung cancer could be increased if someone has certain lung diseases, such as chronic obstructive pulmonary disease.

Family history of lung cancer:
People could have an increased risk of lung cancer in case they have a parent, sibling or other first-degree relative with lung cancer.

Excessive alcohol use:
The risk of lung cancer could also be increased if someone drinks more than a moderate amount of alcohol, which is one drink a day for women and two drinks a day for men.



Some of the complications that could be caused by lung cancer include:

Coughing up blood:
A person may cough up blood (hemoptysis) in case lung cancer has caused bleeding in the airway. Treatments could control this bleeding, which could become severe.

Shortness of breath:
In case the cancer grows to block the major airways, people with lung cancer may experience shortness of breath. In case lung cancer has caused fluid to accumulate around the lungs, It could also be more difficult for the lungs to expand fully when the person inhales.

Fluid in the chest:
Fluid could accumulate in the space that surrounds the lungs in the chest cavity (pleural space) due to lung cancer. This condition, which is called pleural effusion, could result either from cancer spreading outside the lungs, or as a reaction to lung cancer inside the lungs. Shortness of breath could be caused by fluid accumulating in the chest. To drain this fluid from the chest and reduce the risk of its recurrence, a person could undergo treatment.

Pain could be caused in case advanced lung cancer spreads to the lining of the lung or to another area of the body. In case someone experiences pain, they should tell their doctor. This pain could become constant, although initially it may be mild and intermittent. To become more comfortable, people could try medications, radiation therapy or other treatments.

Cancer that spreads to other parts of the body (metastasis):
Cancer that spreads could cause headaches, pain, nausea or other signs and symptoms, depending on which organ is affected. Lung cancer usually spreads to other parts of the body, most commonly to the opposite lung, the bones, adrenal glands and brain. Even though in most cases the treatment for metastasis only involves relieving signs and symptoms, treatments in some cases are available for isolated metastasis.

This disease is fatal in most cases, and the survival rates for people with lung cancer are very low. People could discuss their chances of survival with their doctor. People who have the greatest chances for a cure are those diagnosed at the earliest stages.


Based on the patient’s overall health, the type and stage of the cancer and their preferences, treatment regimen will be determined. Targeted drug therapy, chemotherapy, surgery and radiation therapy are some of the treatment options for lung cancer.
However, if someone feels that the side effects of their treatment will outweigh its potential benefits, they may choose not to undergo treatment at all. In this case, to treat only the symptoms that the cancer is causing, such as pain, the patient may be suggested comfort care.

In case someone has stage I of this type of lung cancer, their treatment options could be surgery, and in some cases, chemotherapy.

In case someone has stage II, their options may be surgery in addition to chemotherapy and radiation.
In case someone has stage IIIA, their treatment will be chemotherapy combined with radiation, and sometimes surgery, based on the results of treatment.
If someone has stage IIIB of this type of lung cancer, they will be treated with chemotherapy, and in some cases radiation.
In case someone’s cancer has reached stage IV, they will be treated with chemotherapy, targeted drug therapy, clinical trials, as well as supportive care.

In case someone’s small cell lung cancer is limited, they will be treated with chemotherapy combined with radiation and in some cases, surgery.
However, if the small cell lung cancer is extensive, treatment will include chemotherapy, clinical trials, in addition to supportive care.

During surgery, the lung cancer, in addition to a margin of healthy tissue will be removed. Some of the procedures that are used to remove lung cancer are:

Wedge resection:
This procedure is done to remove a small section of the lung that contains the tumor, in addition to a margin of healthy tissue.

Segmental resection:
In this procedure, a large portion of the lung will be removed, but not an entire lobe.

This procedure is done to remove an entire lob of one lung.

In this procedure, an entire lung is removed.

During surgery, the doctor may also remove lymph nodes from the chest of the patient to check for signs of cancer.
Bleeding and infection are some of the risks of lung cancer surgery. After lung surgery, the patient will also feel short of breath, but over time, it will be easier to breathe because the lung tissue will expand. To aid in the recovery, the patient may be recommended a respiratory therapist who can guide him/her through breathing exercises.

In this method, drugs are used to kill cancer cells. Chemotherapy drugs could either be taken orally or administered through a vein in the arm (intravenously). Usually, a combination of chemotherapy drugs is given over a period of weeks or months in a series of treatments, with breaks in between so that the body will be able to recover.
Chemotherapy could sometimes be used to lessen the side effects of cancer. But usually, chemotherapy is used either as a first line of treatment for lung cancer or as an additional treatment after surgery.

In this method, high-powered energy beams such as X-rays are used to kill cancer cells. Radiation therapy could be put inside needles, seeds or catheters and placed inside the body near the cancer, a method called brachytherapy, or it could be directed at the lung cancer from outside the body, which is a method called external beam radiation.
Radiation therapy could be used alone, or it could be used with other lung cancer treatments, such as chemotherapy.

Targeted therapies are newer cancer treatments that work by targeting specific abnormalities in cancer cells. Some of the methods of targeted drug therapy to treat lung cancer may include:

When blood vessels connect to tumors, they could supply oxygen to the tumor and allow it to grow. Bevacizumab stops a tumor from creating a new blood supply. Bleeding, blood clots and high blood pressure are some of the risks of this treatment. Bevacizumab has been approved for advanced and recurrent non-small cell lung cancer. Usually, bevacizumab is used in combination with chemotherapy.

The chemicals that signal the cancer cells to grow and divide are blocked by erlotinib. A skin rash and diarrhea are some of its side effects. This drug has been approved for people with advanced and recurrent non-small cell lung cancer that haven't benefited from chemotherapy.

When treatments offer little chance for a cure, the doctor may recommend the patient avoid harsh treatments and opt for supportive care instead. When a person is receiving supportive care, even though they won't receive treatment aimed at stopping the cancer, they will receive treatment for their signs and symptoms, which will make them feel more comfortable. Supportive care allows people to make the most of their final weeks or months without enduring treatment side effects that could negatively affect their quality of life.


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