Q: Can lung cancer be prevented?
A: The best way to avoid getting lung cancer is to quit smoking or never to 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. 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.
Q: Can lung cancer be detected early?
A: Yes. Some medical groups now recommend that certain people at high risk for the disease, such as people who have smoked heavily, talk with their doctor about getting a spiral CT scan to look for lung cancer. Some lung cancers are found early as a result of tests that are done for other medical problems. But symptoms of lung cancer often don't appear until the disease is advanced. Only about 15% of lung cancer cases are found in the early stages, before the cancer has spread. Prompt attention to 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.
Q: What are the lungs and what do they do?
A: The lungs are part of the respiratory system, which is how we breathe. The lungs are spongy, cone-shaped organs. The right lung, which is slightly bigger, has 3 lobes or sections. The left lung has 2 lobes. The lungs take in oxygen when we breathe in and expel carbon dioxide when we breathe out.
Q: Does smoking cause lung cancer?
A: Yes. The American Cancer Society estimates that smoking causes about 80% of lung cancer deaths. 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.
Q: Do nonsmokers get lung cancer?
A: Yes, nonsmokers can get lung cancer, but the risk is much lower than in smokers. There are factors other than smoking that increase a person's risk of getting lung cancer. Breathing in other people's smoke, exposure to radon, asbestos, air pollution, certain chemicals in the workplace, and a personal or family history of lung cancer are also risk factors for lung cancer.
Q: Is smoking marijuana harmful to the lungs?
A: Yes. Marijuana contains more tar than tobacco; is inhaled deeply and held in the lungs longer; is smoked to the end where the tar content is highest; and contains cancer-causing substances. However, because studies are difficult to do in marijuana smokers and because many of them also smoke regular cigarettes, it's hard to prove a definitive link to lung cancer.
Q: What are the most common symptoms of lung cancer?
A: 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; and loss of appetite or weight. These symptoms may be caused by other, less serious problems. If you have them, you should see a doctor.
Q: Are lung tumors ever benign?
A: Yes, but benign lung tumors are rare. When they occur, they are often treated in the same way as cancerous tumors because it may be hard to tell them apart before surgery.
Q: Can the damage from smoking be undone?
A: Eventually the body is able to clean the lungs after a person stops smoking, but some damage may be permanent. The longer the person smoked, the longer it will take for his or her lungs to get healthy. But, the lungs do begin to return to their natural pink shortly after a person stops smoking. The damage to the heart also gets better over time. Generally, 15 years after a person stops smoking, the risk of dying from lung cancer is about half of what it would have been if the person had continued smoking.
Q: Are there different types of lung cancer?
A: There are 2 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 3 types. Small cell lung cancer is rarer than non-small cell lung cancer, and it grows and spreads more quickly. 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.
Q: 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 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 almost always found in smokers.
- Large-cell carcinoma is a less common kind of lung cancer. This type tends to be faster growing and is more likely to spread to distant parts of the body.
Q: Are all lung cancers treated the same?
A: No. 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 is used when the surgeon believes all of the tumor can be removed. Chemotherapy, targeted therapy, and radiation are used to kill cancer cells and stop them from growing. Any of these therapies may be used together, depending on the stage of the lung cancer and the particular patient's situation. Other treatments, such as photodynamic therapy and radiofrequency ablation, may also be used in certain cases.
Q: Does taking large doses of antioxidants like vitamin E prevent lung cancer?
A: Most research so far has not found that antioxidants lower the risk for lung cancer. In fact, some studies have found that supplements of beta carotene, an antioxidant related to vitamin A, actually increased the risk for lung cancer in smokers. More research in this area is needed.
Q: Does a negative chest X-ray definitely mean I don't have lung cancer?
A: No. X-rays don't always show lung cancers. Tumors can appear as small shadows behind the ribs and can be hard to find.
Q: Does catching lung cancer early offer a better chance of being cured?
A: Yes, 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.
Q: If I have lung cancer, will I die?
A: 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. 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.
Q: Where does lung cancer start?
A: Most lung cancers start in the bronchi, which are the larger air tubes located in the lungs, or the bronchioles, which are the smaller tubes.
Q: What types of surgery are used to treat lung cancer?
A: Depending on the extent of the cancer, the surgeon may decide to remove part or all of the lung. Taking out a part of the lobe of a lung is called a segmental or wedge resection. If a lobectomy is performed, an entire lobe of the lung is removed. A pneumonectomy is the removal of an entire lung. A sleeve resection removes only the part of the bronchus with cancer. The lung is then reattached to the remaining part of the bronchus.
Q: After a lung is removed, what happens to the space that's left in the chest?
A: Space left after surgery becomes filled up with body fluid and scar tissue and the other lung usually expands. Until this happens, there may be a feeling of emptiness on the side of the operation.
Q: Can I breathe and live normally if I have a lung removed?
A: Most likely, depending on your lung function before the surgery. The removal of 1 or 2 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 at rest you will breathe normally. Breathing exercises will help you adjust to this. If you already have a lung disease, such as emphysema or chronic bronchitis, you are more likely to have breathing problems after the surgery.
Q: What are clinical trials?
A: Clinical trials are studies of new kinds of cancer treatments. Doctors conduct clinical trials to learn about how well new treatments work and what their side effects are. If they look promising, they are then compared to what is the current treatment 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 FDA approves them. Participants also help further our understanding of cancer and help future cancer patients.
Q: Should everyone get a second opinion?
A: Many people with cancer get a second opinion from another doctor. There are many reasons to get a second opinion, including not being comfortable with the treatment decision, having a rare type of cancer, having different treatment options, or not being able to see a cancer expert.
Q: How can someone get a second opinion?
A: There are many ways to get a second opinion:
- The person's primary doctor may be able to 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.
- Patients can get names of doctors from their local medical society, a nearby hospital, a medical school, or local cancer advocacy groups, as well as from other people who have had that type of cancer.
March 30, 2020
Foster, Sara, RN, MPH