Lung Cancer: An Overview

Patient Expert

You or a loved one has just been diagnosed with lung cancer. It’s scary, it’s shocking… and you don’t even know where to begin to understand what’s happened, and what comes next. Start here, with some simple lung cancer FAQS.

Q. Will I survive?

A. This is the first question every person with a cancer diagnosis asks: What are my chances?

Thankfully (or not), there’s no one-size-fits-all answer. Your chance of surviving lung cancer will be based on a number of factors, chiefly what type of lung cancer you have; and how far advanced it is. Up to 50 percent of those diagnosed with early stage lung cancer will survive for at least five years. For those diagnosed at a later stage, after the cancer has spread from the lungs to other parts of the body, the prognosis is more serious.

Q. I thought that cough I had was just a bad cold. What are the usual symptoms of lung cancer?

A. Sometimes a cough is just a cold. But if the cough doesn’t go away; or if you have chronic bronchitis, you could be facing lung cancer.

Other possible symptoms include the following:

  • Hoarseness
  • Weight loss/loss of appetite
  • Chest pain
  • Shortness of breath/wheezing
  • Unusual fatigue

If you have any of these symptoms – and especially if you’re a smoker – it’s wise to see a doctor to find out what’s causing them. Some types of lung cancer have better prognoses when caught early; so don’t hesitate to ask your doctor what s/he thinks.

Q. I’ve been diagnosed with Non-Small Cell Lung Cancer. Are there other types, as well? And how dangerous is this?

A. There are three main types of lung cancer: Non-Small Cell Lung Cancer (NSCLC), Small Cell Lung Cancer (SCLC), and Lung Carcinoid Tumors.

NSCLC is by far the most common type of lung cancer, representing about 85 percent of lung cancer diagnoses. Falling within this type are subtypes squamous cell carcinoma (40 percent of diagnoses); adenocarcinoma (30 percent), and large cell carcinoma (15 percent). Your doctor will tell you exactly what you’ve been diagnosed with, which might be a single type, or a combination of subtypes.

Squamous cell carcinoma is most frequently diagnosed in smokers.

Adenocarcinoma is often diagnosed in former smokers, but is regularly diagnosed in non-smokers, as well; it’s the most common type of lung cancer for women, and younger people.

Of the three, large cell carcinoma tends to be the most aggressive, and adenocarcinoma the least aggressive.

SCLC (a.k.a. “oat cell cancer”) is diagnosed about 10 to 15 percent of the time, making it much less common than NSCLC. Patients with SCLC are nearly always smokers, or former smokers. SCLC is aggressive, and usually spreads quickly; those with an SCLC diagnosis are less likely to survive their cancer than patients with NSCLC.

Lung Carcinoid Tumors represent only about five percent of all lung cancer diagnoses. The most common subtype of this cancer is typical carcinoid tumors, which thankfully are usually slow-growing, and can often be cured by surgery. Patients with this diagnosis have the highest chance of surviving their cancer for at least five years.

Q. What’s the usual treatment for lung cancer?

A. This depends in large part on the type of cancer you have, as well as how far it’s advanced.

The primary treatment for NSCLC is usually surgery. There are different types of surgery, including the following:

  • Thoracotomy, a standard procedure where the surgeon opens the chest to remove the tumor;
  • Radiofrequency ablation (RFA), a less invasive procedure involving “burning” cancer cells to death via electronic current delivered through a probe;
  • VATS (video-assisted thoracoscopic lobectomy), a minimally invasive procedure using tiny cameras and surgical instruments inserted into the chest through small slits.

Follow-up treatment for NSCLC may include radiation and chemotherapy, both designed to wipe out any remaining cancer cells. Targeted therapy and immunotherapy may follow chemotherapy; both drug-based, they seek to destroy cancer cells in different ways than chemotherapy, and are often used if chemotherapy hasn’t proved effective.

The primary treatment for SCLC is usually chemotherapy, often paired with radiation. Patients with an SCLC diagnosis aren’t usually candidates for surgery, as typically their cancer has already spread.

Q. What happens once I finish treatment?

A. You’ll need to continue seeing your oncologist regularly. Typically, you’ll see your doctor every 6 to 12 months for the first two years, and once a year thereafter. Your visit will include CT scans to check your lungs for the presence of any new lesions, which might signal a recurrence.

Q. How will I know if my cancer comes back?

The symptoms of a lung cancer recurrence may include hoarseness and wheezing; and difficulty swallowing. If you experience any of these, contact your doctor right away. In addition, fluid in the lining of the heart or lungs can also signal a recurrence.

In addition, let your doctor know if you’re having headaches, pain on the right side, nausea/vomiting, bone pain, unexplained weight loss, or yellowing of the skin or eyes. Any of these can be a sign the cancer has spread.

Sources

"Lung Cancer." American Cancer Society. Accessed December 17, 2015. http://www.cancer.org/cancer/lungcancer/.

"Lung Cancer Basics" - Lung Cancer Alliance. Accessed December 17, 2015. http://www.lungcanceralliance.org/get-information/the-basics-about-lung-cancer.html.

Breast cancer survivor and award-winning author PJ Hamel, a long-time contributor to the HealthCentral community, counsels women with breast cancer through the volunteer program at her local hospital. She founded and manages a large and active online survivor support network.