Frequently Asked Questions About Lung Cancer

Q: Can lung cancer be prevented?

A: The best way to avoid getting lung cancer is to quit smoking or never to start. Avoiding second-hand smoke and being aware of possible exposure to cancer-causing chemicals is also important. In some cases, people who get lung cancer have no known risk factors. Unfortunately, there is no known way to prevent all cases of lung cancer.

Q: Can lung cancer be detected early?

A: Yes. Many early lung cancers are found as a result of tests that are done for other medical problems. But symptoms of lung cancer often do not appear until the disease is advanced. Only about 15% of lung cancer cases are found in the early stages or before the cancer has spread. Prompt attention to symptoms, leading to early diagnosis and treatment, can result in a cure for some patients. For others, prompt attention to symptoms can help people live longer and have better control of their symptoms.

Q: What are the lungs and what do they do?

A: The lungs are part of the respiratory system, which is how we breathe. The lungs are spongy, cone shaped organs. The right lung, which is slightly bigger, has three lobes or sections. The left lung has two lobes. The lungs take in oxygen when we breathe in and expel carbon dioxide when we breathe out.

Q: What causes lung cancer?

A: The American Cancer Sociaty estimates that smoking causes 87 percent of lung cancers. Harmful substances called carcinogens in tobacco harm cells in the lungs. After a while, these cells may turn into cancer. The longer a person smokes, and the more a person smokes, the higher the risk of lung cancer.

Q: Do non-smokers get lung cancer?

A: Yes, non-smokers get lung cancer. There are factors other than smoking that increase a person’s risk of getting lung cancer. Breathing in other people’s smoke, exposure to pollution, and history of lung disease are also risk factors for lung cancer.

Q: Is smoking marijuana harmful to the lungs?

A: Yes. Marijuana contains more tar than tobacco; is inhaled deeply and held in the lungs longer; is smoked to the end where the tar content is highest; and contains cancer-causing substances. However, since studies are difficult to do in marijuana smokers and since many of them also smoke regular cigarettes, it is hard to prove a definitive link to lung cancer.

Q: What are the most common symptoms of lung cancer?

A: A cough that doesn't go away and gets worse over time is the most common symptom of lung cancer. Other symptoms include constant chest pain, coughing up blood, shortness of breath, wheezing, or hoarseness, having pneumonia or bronchitis more than usual, swelling of the neck and face, and loss of appetite or weight. These symptoms may be caused by other, less serious problems. If you have them, you should see a doctor.

Q: Are lung tumors ever benign?

A: Yes, but benign lung tumors are rare. When they occur, they are treated in the same way as cancerous tumors because it may be hard to tell them apart before surgery.

Q: Can the damage from smoking be undone?

A: Eventually, the body is able to clean the lungs after a person stops smoking. Doctors say it can take many years for a smoker’s lungs to return to normal after they quit smoking. The longer the person smoked, the longer it will take for their lungs to get healthy. But, the lungs do begin to return to their natural pink shortly after smoking is stopped. The damage to the heart also gets better over time. Generally, ten years after a person stops smoking, the risk is 1/3 lower than if the person had continued smoking.

Q: Are there different types of lung cancer?

A: There are two main types of lung cancer, non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer is the most common lung cancer. It usually grows and spreads more slowly than small cell lung cancer. People who get non-small cell lung cancer are usually smokers, or people who spend time with smokers. There are three different types of non-small cell lung cancer. Small cell lung cancer is more rare than non-small cell lung cancer and it grows and spreads more quickly. Doctors usually don’t find this kind of cancer until it has already spread to other body parts. Small cell lung cancer may also be called oat cell carcinoma or small cell undifferentiated carcinoma.

Q: What are the three types of non-small cell lung cancer?

• Adenocarcinoma is the most common kind of lung cancer. It usually happens more to women and to people who smoke. A lot of people with adenocarcinoma do not have symptoms, so it is difficult for doctors to find it early.

• Squamous cell carcinoma occurs in men more than women. This kind of cancer grows more slowly than the others and is the easiest for doctors to find.

• Large-cell carcinoma is the least common kind of lung cancer. In this type, many large-cell carcinomas can spread to the stomach, intestines, and liver.

Q: Are all lung cancers treated the same?

A: No. Treatment depends on the type of lung cancer, how far it has spread, and how the cancer responds to treatment. Surgery, chemotherapy, and radiation therapy are all used to treat lung cancer. Surgery is used when the surgeon believes all of the tumor can be removed. Chemotherapy and radiation are used to kill cancer cells and stop them from growing. Any of these 3 therapies may be used together, depending on the stage of the lung cancer and the particular patient's situation.

Q: Does taking large doses of antioxidants (e.g. vitamin E) prevent lung cancer?

A: More research needs to be done before we can say for sure that antioxidants can reduce a person’s risk of lung cancer. Clinical trials are currently underway using antioxidants to try to answer this question.

Q: Does a negative chest x-ray mean I don’t have lung cancer?

A: No. X-rays don’t always show lung cancers. Tumors can appear as small shadows behind the ribs and can be hard to find.

Q: Does catching lung cancer early offer a better chance of being cured?

A: Yes, lung cancer in its early stages offers a better chance for a cure. Unfortunately, the symptoms of lung cancer, which include a cough that won’t go away, chest pain, and coughing up blood, often do not appear until the cancer has grown or spread. Lung cancer is one of the hardest cancers to find early on.

Q: If I have lung cancer, will I die?

A: Having lung cancer is not a death sentence. Significant progress has been made in treating lung cancer, including surgery, radiation, and chemotherapy. Researchers are always looking for better ways to treat lung cancer. Patients continue to live longer with lung cancer.

Q: Where does lung cancer start?

A: Most lung cancers start in the bronchi, which are the larger air tubes located in the lungs, or the bronchioles, which are the smaller tubes.

Q: What types of surgery are used to treat lung cancer?

A: Depending on the extent of the cancer, the surgeon may decide to remove part or all of the lung. Taking out a part of the lung is called a segmental or wedge resection. If a lobectomy is performed, an entire lobe of the lung is removed. A pneumonectomy is the removal of an entire lung.

Q: After a lung is removed, what happens to the space that’s left in the chest?

A: Space left after surgery becomes filled up with body fluid and scar tissue and the other lung usually expands. Until this happens, there may be a feeling of emptiness on the side of the operation.

Q: Can I breathe and live normally if I have a lung removed?

A: Yes. The removal of one or two lobes may limit hard physical exercise. Otherwise you should be able to breathe and live normally. If you have an entire lung removed, you may become short of breath when you exert yourself but at rest you will breathe normally. Breathing exercises will help you adjust to this.

Q: What are clinical trials?

A: Clinical trials are studies of new kinds of cancer treatments. Doctors conduct clinical trials to learn about how well new treatments work and what their side effects are. If they look promising, they are then compared to what is the current treatment to see if it works better or has fewer side effects. People who participate in these studies may benefit from access to new treatments before the Food and Drug Administration (FDA) approves them. Participants also help further our understanding of cancer and help future cancer patients.

Q: Should everyone get a second opinion?

A: Many people with cancer get a second opinion from another doctor. There are many reasons to get a second opinion, including if the person is not comfortable with the treatment decision, if the type of cancer is rare, if there are different ways to treat the cancer, or if the person is not able to see a cancer expert.

Q: How can someone get a second opinion?

A: There are many ways to get a second opinion:

• The person's primary doctor may be able to recommend a specialist such as a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or programs.

• The Cancer Information Service (1-800-4-CANCER) informs callers about treatment facilities, including cancer centers and other programs supported by the National Cancer Institute.

• Patients can get names of doctors from their local medical society, a nearby hospital, a medical school, or local cancer advocacy groups, as well as from other people who have had that type of cancer.

• Consult the Official ABMS Directory of Board Certified Medical Specialists. This reference book lists doctors by state. It gives their specialty, background, and training. It is available at most public libraries. You can also view it online at www.abms.org.