Medical Diagnosis of Lung Cancer

In 2009 alone, The National Cancer Institute estimates that 219,440 new cases of lung cancer will be diagnosed in the United States, and 159,390 people will die of the disease. Lung cancer is found in the tissues in the lung, most commonly in the cells that line airways. Two main types of lung cancer exist: small cell lung cancer, and non-small cell lung cancer.

Symptoms and Risk Factors

• As with many cancers, in its early stages, lung cancer may not have any symptoms. Eventually, some of the symptoms that might appear include a new or worsening cough, shortness of breath, chest pain and coughing up blood. Weight loss and fatigue can also be present.

  Cigarette smoking is related to nearly 90 percent of lung cancer diagnoses, making it an extremely large risk factor. Exposure to asbestos or radon, a family history of lung cancer, and being over 65 years old are also known risk factors.

Diagnosis

• In order to accurately diagnose lung cancer, the doctor will order many tests. Common tests are chest x-rays, a CT scan of the chest, MRI, PET scan, and a bronchoscopy, which helps the doctor biopsy the lung to examine the tissue. The CT scan of the chest is the most effective noninvasive test when lung cancer is a possible diagnosis. An accurate diagnosis of the type of lung cancer is important, because although the two types share similarities, their treatments are different.

Types

• Small cell lung cancer accounts for approximately 13 percent of lung cancers, and non-small cell lung cancer makes up the rest.

  Small cell lung cancers tend to be more aggressive, and spread quickly. Staging of lung cancer is different for the two types. For small cell lung cancers, physicians describe them in two stages: limited stage, which is when the cancer is on only one lung and tissues that are nearby; and extensive stage, which is when cancer is found outside the lung it originated in, or it has metastasized to other parts of the body.

  Non-small cell lung cancer is a slower growing cancer, and is staged in a similar way to other cancers, in numerous stages. The stage is based on the tumor size, and whether cancer has been found in any lymph nodes or other tissues and organs.

Treatment

• Based on which type of lung cancer is diagnosed, treatment is planned accordingly. For non-small cell lung cancer, the stage of the cancer impacts treatment choices.

  For small cell lung cancer that is in the limited stage, treatment might consist of radiation and chemotherapy, or surgery and chemotherapy. If the cancer is extensive, then chemotherapy tends to be the primary treatment.

  Non-small cell lung cancer is treated with a combination of therapies - surgery, chemotherapy, radiation - it depends on the stage of the cancer. If the cancer is very advanced, targeted therapy may be used. Each person is different, and their cancer is different, so the treatment team forms the best treatment plan for each patient, and the plans may not be similar.

Future Directions

• Like with other cancers, clinical trials are being done to find new treatments for lung cancer, supportive therapies, and prevention and risk-reduction efforts are being researched. The National Cancer Institute is currently sponsoring studies to look at possible benefits of taking the vitamin selenium to prevent new lung tumors. If you wish to join a clinical trial, ask your doctor whether you meet the qualifications to be part of the study.