Lung Cancer Risk Assessment
Lung cancer is cancer that usually starts in the lining of the bronchi (the main airways of the lungs), but can also begin in other areas of the lungs, including the bronchioles, or alveoli. It is the leading cause of cancer death in both men and women. In 2016, about 224,000 new cases of lung cancer are expected, according to the American Cancer Society.
Lung cancers are believed to develop over a period of many years. Nearly all lung cancers are carcinomas, a cancer that begins in the lining or covering tissues of an organ. The tumor cells of each type of lung cancer grow and spread differently, and each type requires different treatment.
A risk factor is anything that increases a person’s chance of getting a disease, such as cancer. Different cancers have different risk factors.
Several risk factors make a person more likely to develop lung cancer:
Smoking is the leading cause of lung cancer, with about 80% of lung cancer deaths thought to be a result of smoking.
Additional risk factors include:
- Secondhand smoke. This refers to breathing in the smoke of others.
- Radon. A radioactive gas that cannot been seen, tasted, or smelled. It is produced by the natural breakdown of uranium. High levels of radon may be found in some homes or other buildings, especially basements.
- Asbestos exposure
- Talc. While no increased risk of lung cancer has been found from the use of cosmetic talcum powder, some studies of talc miners and millers suggest a higher risk of lung cancer and other respiratory diseases from their exposure to industrial-grade talc. Talcum powder is made from talc, a mineral which, in its natural form, may contain asbestos; however, by law, all home-use talcum products (baby, body, and facial powders) have been asbestos-free since 1973.
- Cancer-causing agents in the workplace, including:
- Radioactive ores, such as uranium
- Vinyl chloride
- Nickel chromates
- Coal products
- Mustard gas
- Chloromethyl ethers
- Diesel exhaust
- Personal or family history of lung cancer
- Air pollution. In some cities, air pollution may slightly increase the risk of lung cancer.
Not all lung cancers can be prevented. But there are things you can do that might lower your risk, such as changing the risk factors that you can control.
- Don’t smoke. If you smoke, quit.
- Stay away from second-hand smoke.
- Make your home and community smoke-free.
- Check your home for radon.
- Eat lots of fruits and vegetables and get more exercise.
Lung cancers are generally divided into 2 types:
Non-small cell lung cancer
This type is much more common than small cell lung cancer, accounting for about 85% to 90% of lung cancers. The 3 main kinds of non-small cell lung cancer are named for the type of cells in the tumor:
- Squamous cell carcinoma (also called epidermoid carcinoma). It often begins in the bronchi near the middle of the lungs.
- Adenocarcinoma. This type usually begins along the outer edges of the lungs. It is the most common type of lung cancer in people who have never smoked.
- Large cell carcinomas. These are a group of cancers with large, abnormal-looking cells. These tumors may begin anywhere in the lungs and tend to grow quickly.
Small cell lung cancer
This type is sometimes called oat cell cancer because the cancer cells may look like oats when viewed under a microscope, grows rapidly and quickly spreads to other organs. There are two stages of small cell lung cancer:
- Limited. In this stage, cancer is generally found in only one lung. There may also be cancer in nearby lymph nodes on the same side of the chest.
- Extensive. In this stage, cancer has spread beyond the primary tumor in the lung into other parts of the body.
Your physician will be able to identify which type of lung cancer you have after his assessment and work up. It is important to find out what kind of lung cancer a person has. The different types of carcinomas, involving different regions of the lung, may cause different symptoms and are treated differently.
The following are the most common symptoms for lung cancer. However, each individual may experience symptoms differently. Lung cancer usually does not cause symptoms when it first develops, but symptoms often become present after the tumor begins growing. A cough is the most common symptom of lung cancer.
Other symptoms include:
- Constant chest pain
- Shortness of breath
- Recurring lung infections, such as pneumonia or bronchitis
- Bloody or rust-colored sputum
- A tumor that presses on large blood vessels near the lung can cause swelling of the neck and face
- A tumor that presses on certain nerves near the lung can cause pain and weakness in the shoulder, arm, or hand
- Fever for unknown reason
Like many other cancers, lung cancer can cause:
- Loss of appetite
- Loss of weight
- Pain in other parts of the body not affected by the cancer
- Bone fractures
Other symptoms can be caused by substances made by lung cancer cells, which is referred to as a paraneoplastic syndrome. For example, certain lung cancer cells produce a substance that causes a sharp drop in the level of sodium in the blood, which can cause many symptoms, including confusion and sometimes even coma. None of these symptoms is a sure sign of lung cancer. Only a doctor can tell whether a patient’s symptoms are caused by cancer or by another problem. Consult your doctor for a diagnosis.
Lung cancer treatment depends on the type of cancer (small cell or non-small cell), the size of the tumor, and whether or not it has spread. New, less invasive surgery may help patients recover more quickly with the same results as older, more invasive surgery.
Surgery is the usual treatment for disease in its early stages when it has not spread outside the lungs. Sometimes in the early stages chemotherapy is used in combination with surgery.
New, less invasive surgery may help patients recover more quickly with the same results as older, more invasive surgery.
Radiation and chemotherapy are sometimes used in combination with surgery for later stages of the disease.
Some patients with stage IV lung cancer (disease that has spread to distant organs) may be treated with oral therapies. These are patients with tumors that show certain genetic changes. Patients should have their tumors tested for these genetic changes.