Lung Cancer: Prognosis, Treatment, Signs of Carcinoma
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The deadliest type of cancer for both men and women, lung cancer kills nearly 60 percent of those diagnosed within a year. And while smoking is its top cause, lung cancer sometimes strikes those who have never touched a cigarette. [Article continues below]
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Claiming about 157,000 lives annually – more than breast, prostate, ovarian, colon and lymph cancers combined – lung cancer can also result from exposure to secondhand smoke or radon, family history, or even excessive alcohol use, according to the Mayo Clinic.
Types
Depending on how cells appear when examined under a microscope, lung cancer is divided into two main categories:
- Small cell, which comprises about 20 percent of all cases and occurs almost exclusively in smokers; and
- Non-small cell, a variety that encompasses several similar sub-types: adenocarcinoma, squamous cell carcinoma and large cell carcinoma.
Cases that include both main types are called mixed small cell/large cell lung cancer, according to the National Institutes of Health (NIH).
Additionally, a highly lethal form of cancer called mesothelioma most often arises in the tissue surrounding the lungs. Mesothelioma primarily afflicts those who have been exposed to asbestos, a mineral used in insulation, brakes, flooring and many other goods, according to the Mayo Clinic.
Symptoms & Signs
Early lung cancer is usually symptomless, one of the reasons it often progresses to an incurable stage before being detected. Lung cancer symptoms also resemble those of many other conditions, making it hard to discern the cause. According to the Cleveland Clinic, these symptoms include:
- Persistent, prolonged cough
- Coughing up blood
- Wheezing and shortness of breath
- Chest pain
- Appetite loss
- Hoarseness
- Unexplainable weight loss
- Fatigue or weakness
- Difficulty swallowing
Diagnosis & Tests
Using a stethoscope, doctors sometimes can hear fluid around the lungs, which may suggest lung cancer. But definitively diagnosing it usually involves a combination of several tests, according to the American Cancer Society. These include:
- Imaging tests such x-rays, positron emission tomography (PET) scans, CT scans or MRI scans of the chest.
- Sputum test, which examines coughing-induced phlegm for abnormal cells.
- Biopsy, which examines cells from one or more procedures that retrieve a tissue sample.
- Bronchoscopy: The bronchi, or tubes leading into the lungs, can be viewed through an instrument called a bronchoscope, allowing doctors to see abnormal areas, according to the Cleveland Clinic. Suspicious cells can be taken for biopsy.
- Mediastinoscopy: A lighted tube is inserted above the breast bone through a small incision to see the center of the chest cavity.
If lung cancer is confirmed, doctors will determine whether the malignancy has spread beyond the lungs by using imaging scans of the entire body. Common sites for lung cancer metastases are the liver, bones and brain, according to the Mayo Clinic.
Treatments & Medications
How lung cancer is treated depends primarily on the type and size of cells present and whether they have spread. Often, combinations of therapies are used. Common treatment options include:
- Surgery: If cancer is confined to the lung, surgery may offer a cure. It is typically performed on less advanced cases, either removing a small section of the lung, one of the lobes, or the entire lung. Lymph nodes from around the site will also be removed to determine if the disease has spread.
- Chemotherapy: A systemic approach, chemotherapy is often used in more advanced cases and uses toxic drugs to kill cancer cells in many parts of the body. These drugs, which may come in either injection or pill form, include cisplatin (also known by the brand name Platinol) and paclitaxel (Taxol).
- Radiation: This form of therapy uses intense beams of energy to kill cancer cells. It can target lung cancer externally or be placed internally near tumors via needles, catheter tubes or seeds.
- Targeted drug therapy: One of the newest cancer treatments, this therapy uses certain drugs that target specific anomalies in lung cancer cells, according to the Mayo Clinic. Medications used include bevacizumab (also known as the brand name Avastin), which stops tumors from creating a new blood supply; and erlotinib (Tarceva), which blocks chemicals telling cancer cells to multiply.
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