What is Lung Cancer?
The lungs are a pair of elastic sacks situated in either side of the chest. The lungs have a series of branching passages through which air is drawn so that blood can exchange oxygen with carbon dioxide. Lung cancer is uncontrolled growth of abnormal cells that begins in one or both lungs. There are several different types of lung cancer.
This article refers to primary lung cancer, or lung cancer that begins within the lungs. Sometimes cancers can travel (or metastasize) to the lungs from other parts of the body. These cancers are referred to as secondary lung cancers because the cancer starts at an outside (primary) site and metastasizes to the lung.
Lung cancers are grouped into two broad categories; small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). These two groups differ in how they grow, spread and are treated.
Lung Cancer Prevention
Smoking is the number one risk factor contributing to lung cancer and is linked to 80-90% of lung cancer deaths. Smoking can contribute to cancer to nearly any part of your body and also contributes to heart disease, stroke, COPD and many other diseases. Secondhand smoke is also a risk to develop lung cancer and other smoking related diseases.
Radon is a naturally occurring colorless and odorless gas and is the second leading cause of lung cancer according the the American Lung Association (ALA). Radon comes up from the ground and gets trapped in houses and structures. An estimated 1/15 houses in the U.S. has high levels of Radon and testing your home is recommended by the Environmental Protection Agency. There are additional risk factors such as asbestos and family history. Quitting smoking and avoiding environmental exposures such as smoking, Radon and asbestos are ways to decrease risk of developing lung cancer.
Lung Cancer Screening
Yearly lung cancer screening with low-dose CT imaging for those at risk is the most effective cancer screening test. It is recommended that previous smokers and those at risk who qualify should receive annual screenings. However, screening rates remain dismally low.
Read more about the importance of lung cancer screening and help by becoming a community advocate to improve outcomes of this terrible disease.
Lung Cancer Treatment
Treatment for lung cancer will depend on the type (NSCLC vs SCLC) and stage of cancer. Once diagnosed the cancer will be fully staged. Stage I cancers can be treated with either stereotactic body radiation therapy (SBRT) or localized surgery; Both treatments have equal control rates. Late (stage IV) cancers will likely be treated with systemic therapy which includes immunotherapy, targeted therapies and chemotherapy. Radiation can be used for stage IV patients to relieve symptoms and to treat cancer if it moves (metastasizes) to the brain.
Stage II and III cancers will be treated by a combination of radiation, surgery and systemic therapies. Patients with stage II or even stage III may be candidates for surgical resection depending on overall health, type of cancer and location. Surgery is often followed by chemotherapy and possibly radiation. Many stage III cancers are treated by a combination of chemotherapy combined with radiation.
At MUSC Health Florence, lung cancers are discussed at a multidisciplinary tumor conference where all involved physicians (medical and radiation oncologist, pulmonologist, surgeon, radiologist and pathologist) work together. The multidisciplinary team carefully considers each individual case and makes a group decision to maximize each patient outcome.
Lung Cancer Outcomes
There have been many recent, exciting advances in the management of lung cancer. Lung cancer screening has been proven to dramatically improve survival by detecting the cancer at an earlier stage when cure is most likely. Recent advances in surgery and radiation (such as SBRT) are improving outcomes in lung cancer patients. Newer systemic therapies like immunotherapy are improving outcomes with less side effects for locally advanced and stage IV patients.
Although we have made significant advances in the prevention, screening and treatment of lung cancer, much work remains to be done. Get involved in your community and raise awareness about lung cancer screening.
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