Frequently Asked Questions About Lung Cancer

If you are concerned about lung cancer, have been diagnosed with cancer, or are caring for someone with cancer, you will have questions. Here are some basics to start.

Can lung cancer be prevented?

The best way to avoid getting lung cancer is to quit smoking or don’t start. Avoiding secondhand smoke and being aware of possible exposure to cancer-causing chemicals is also important. Having your home tested for radon and treated, if needed, may also lower your risk for lung cancer. In some cases, people who get lung cancer have no known risk factors. Unfortunately, there is no known way to prevent all cases of lung cancer.

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Can lung cancer be detected early?

Some medical groups recommend that people at high risk — heavy smokers, for example — ask for a CT scan to look for lung cancer. Take this quiz to see if you are a good candidate.

Some lung cancers are found early during tests for other medical problems. But symptoms of lung cancer often don't appear until the disease is advanced. Only about 16 percent of lung cancer cases are found during the early stages, before the cancer has spread. Promptly addressing symptoms, leading to early diagnosis and treatment, can cure some patients. For others, prompt attention to symptoms can help them live longer and have better control of their symptoms.

What are the lungs and what do they do?

Your lungs are part of your respiratory system, which is how you breathe. Your lungs are spongy, cone-shaped organs. The right lung, which is slightly bigger, has three lobes or sections. The left lung has two lobes. Lungs take in oxygen when you breathe in and expel carbon dioxide when you breathe out.

Does smoking cause lung cancer?

Smoking causes about 80 percent of lung cancer deaths in women and 90 percent in men. Harmful substances called carcinogens in tobacco harm cells in the lungs. After a while, these cells may turn into cancer. The longer a person smokes, and the more a person smokes, the higher the risk for lung cancer.

Do nonsmokers get lung cancer?

Nonsmokers have a 20 to 30 percent greater chance of developing lung cancer if they are exposed to secondhand smoke at home or at work. Breathing other people’s smoke kills more than 7,000 Americans every year. Exposure to radon, asbestos, air pollution, other chemicals in the workplace, and a family history of lung cancer, are also risk factors.

Is smoking marijuana harmful to the lungs?

Marijuana contains more carcinogenic chemicals when smoked than cigarette smoke. Because of how it is typically smoked (deeper inhale, held for longer), marijuana smoking leads to four times the amount of tar deposits compared to cigarette smoking. That said, while a few small, uncontrolled studies have suggested that heavy, regular marijuana smoking could increase risk for respiratory cancers, larger quality studies have not found any increased risk of lung cancer.

What are the most common symptoms of lung cancer?

A cough that doesn't go away and gets worse over time is one of the most common symptoms of lung cancer. Other symptoms include:

• Constant chest pain
• Coughing up blood
• Shortness of breath, wheezing, or hoarseness
• Having pneumonia or bronchitis more than usual
• Swelling of the neck and face
• Loss of appetite or weight

Other, less serious problems may cause these symptoms. If you have them, you should see a doctor.

Are lung tumors ever benign?

Benign lung tumors are rare. They are often treated in the same way as cancerous tumors because it may be hard to tell them apart before surgery.

Can the damage from smoking be undone?

Eventually your body cleans your lungs after you stop smoking, but some damage may be permanent. The longer you smoke, the longer it will take for your lungs to recover. But they do begin to return to their natural pink state shortly after you stop smoking. The damage to your heart also gets better over time. Generally, 15 years after you quit, your risk of dying from lung cancer is about half of what it would have been if you had continued smoking.

Are there different types of lung cancer?

There are two main types of lung cancer: non-small cell lung cancer and small cell lung cancer.

Non-small cell lung cancer is the most common lung cancer. It usually grows and spreads more slowly than small cell lung cancer. Non-small cell lung cancer has three types.

Small cell lung cancer is rarer than non-small cell lung cancer, and it grows and spreads faster. Doctors usually don't find this kind of cancer until it has already spread to other body parts. Small cell lung cancer may also be called oat cell carcinoma or small cell undifferentiated carcinoma.

What are the three types of non-small cell lung cancer?

• Adenocarcinoma is the most common kind of lung cancer. It is more likely than other types to occur in women and in people who don't smoke. A lot of people with adenocarcinoma don't have symptoms right away, but this type tends to grow more slowly than the other types, so it may still be found before it has spread.
• Squamous cell carcinoma occurs in men more often than women. This kind of cancer tends to grow in the main airways and may cause symptoms earlier than other types of lung cancer. It is usually found in smokers.
• Large-cell carcinoma is less common. This type tends to be faster growing and is more likely to spread to distant parts of the body.

Are all lung cancers treated the same?

Treatment depends on the type of lung cancer, how far it has spread, and how the cancer responds to treatment. Surgery, chemotherapy, targeted therapy, and radiation therapy are all used to treat lung cancer.

Surgery occurs when the surgeon believes the entire tumor can be removed. Chemotherapy, targeted therapy, and radiation are used to kill cancer cells and stop them from growing and spreading to other parts of your body.

Any of these therapies may be combined, depending on the stage of your lung cancer and your particular situation. Other treatments, such as photodynamic therapy and radiofrequency ablation, may also be used in certain cases.

Does taking large doses of vitamin E or other vitamins prevent lung cancer?

The data on whether vitamin E can lower your cancer risk is mixed. Some studies suggest it may increase your risk. Overdosing on vitamin E is dangerous.

Some evidence indicates that vitamin D may be helpful for current or former smokers. But it can increase your risk of lung cancer if you take it with other supplements.  

Does a negative chest x-ray definitely mean I don't have lung cancer?

X-rays don't always show lung cancers. Tumors can appear as small shadows behind your ribs and can be hard to find.

Does catching lung cancer early offer a better chance of being cured?

Finding lung cancer in its early stages offers a better chance for a cure. Unfortunately, the symptoms of lung cancer, which include a cough that won't go away, chest pain, and coughing up blood, often don't appear until the cancer has grown or spread.

Lung cancer is one of the hardest cancers to find early on. But newer tests, such as spiral CT scans, may help find more cancers early.

If I have lung cancer, will I die?

Having lung cancer is not necessarily a death sentence. Significant progress has been made in treating lung cancer, including surgery, radiation, chemotherapy, and targeted therapy.

Up to 64 percent of people who receive a diagnosis of localized non-small cell lung cancer will live for five years or longer following diagnosis. If the cancer has spread, that number drops to 37 percent.

For small cell lung cancer, the five-year survival rate is 29 percent if the cancer is caught early. Researchers are always looking for better ways to treat lung cancer. Some people with lung cancer are cured, while others may live significantly longer with lung cancer.

Where does lung cancer start?

Most lung cancers start in the bronchi, which are the larger air tubes in your lungs, or the bronchioles, which are the smaller tubes.

What types of surgery treat lung cancer?

Depending on the extent of your cancer, the surgeon may decide to remove part or all of your lung. Taking out a part of the lobe of a lung is called a segmental or wedge resection. A lobectomy removes an entire lobe of your lung. A pneumonectomy is the removal of an entire lung. A sleeve resection removes only the part of the bronchus with cancer. Your lung is then reattached to the remaining part of the bronchus.

After a lung is removed, what happens to the space that's left in my chest?

Space left after surgery fills up with body fluid and scar tissue. Your other lung usually expands. Until this happens, you may feel an emptiness where you had the operation.

Can I breathe and live normally if I have a lung removed?

You will most likely have a normal life, depending on your lung function before surgery. The removal of one or two lobes may limit hard physical exercise. Otherwise, you should be able to breathe and live normally.

If you have an entire lung removed, you may become short of breath when you exert yourself, but you will breathe normally during rest. Breathing exercises will help you adjust. If you already have a lung disease, such as emphysema or chronic bronchitis, you are more likely to have breathing problems after the surgery.

What are clinical trials?

Clinical trials are studies of new kinds of treatment. Doctors conduct clinical trials to learn about how well new treatments work and what their side effects are. Researchers will then compare a treatment that looks promising with current treatments, to see if it works better or has fewer side effects.

People who participate in these studies may benefit from access to new treatments before the Food and Drug Administration approves them. Participants also help further the understanding of cancer and help future cancer patients.

Should I get a second opinion?

Many people with cancer get a second opinion from another doctor. You may choose to get a second opinion if your cancer is rare, you have several treatment options and are not comfortable with the first proposal, or you want someone who has more expertise with your kind of cancer.

How can I get a second opinion?

You have many options:

• Your primary doctor may recommend a specialist, such as a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or programs.
• The Cancer Information Service (800-4-CANCER) informs callers about treatment facilities, including cancer centers and other programs supported by the National Cancer Institute.
• You can get names of doctors from your local medical society, a nearby hospital, a medical school, or local cancer advocacy groups, as well as from other people who have had your type of cancer.

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