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Lung Cancer Guide photo Understanding The Issues

What is Lung Cancer?

Lung cancer is the uncontrolled growth of abnormal cells in the lung. Normal lung tissue is made up of cells that are programmed by nature to create lungs of a certain shape and function. Sometimes the instructions to a cell go haywire and that cell and its offspring reproduce wildly, without regard for the shape and function of a lung. That wild reproduction can form tumors that clog up the lung and make it stop functioning as it should. Because of the large size of the lungs, cancer may grow for many years, undetected, without causing suspicion. In fact, lung cancer can spread outside the lungs without causing any symptoms. Adding to the confusion, the most common symptom of lung cancer, a presistent cough, can often be mistaken for a cold or bronchitis.

How common is lung cancer?

Lung cancer is one of the most common cancers in the United States, accounting for about 15 percent of all cancer cases, or 170,000 new cases each year. At this time, over half of the lung cancer cases in the United States are in men, but the number found in women is increasing and will soon equal that in men. Today more women die of lung cancer than of breast cancer.

The majority of people who get lung cancer have been cigarette smokers, but not all people who smoke get lung cancer. And, some people who have never smoked get lung cancer.

Throughout this section there are questions you may wish to answer for yourself. There is a form you can print out to write down your answers.

Members of my family or others close to me who have the same kind of cancer I have:

That person's experience with lung cancer and how it affected me or how I felt about it:

What are the symptoms of lung cancer?

Lung cancer may cause a number of symptoms. A cough is one of the more common ones and is likely to happen when a tumor grows and blocks an air passage. Another symptom is chest, shoulder, or back pain, which feels like a constant ache that may or may not be related to coughing. Other symptoms may include shortness of breath, fatigue, repeated pneumonia or bronchitis, coughing up blood, hoarseness, or swelling of the neck and face.

There may also be symptoms that do not seem to be at all related to the lungs. These may be caused by the spread of lung cancer to other parts of the body. Depending on which organs are affected, symptoms can include headaches, weakness, pain, bone fractures, bleeding, or blood clots.

The symptoms I have:

What are the different types of lung cancer?

The type of cells found in a tumor determines the kind of cancer. The two main types of lung cancer are small cell and nonsmall cell. The terms small cell and nonsmall cell refer to the type of cell a doctor can see under the microscope, not to the size of the tumor. There are more than a dozen different kinds of lung cancer.

The following types of lung cancer cause about 90% of all lung cancer cases:

  • Small cell carcinoma (also called oat cell carcinoma): usually starts in one of the larger breathing tubes, grows fairly rapidly, and is likely to be large by the time of diagnosis.
  • Nonsmall cell lung cancer (NSCLC): is made up of the following three subtypes:

  • Epidermoid carcinoma (also called squamous cell carcinoma) : usually starts in one of the larger breathing tubes and grows relatively slowly. The size of these tumors can range from very small to quite large.
  • Adenocarcinoma: starts growing near the outside surface of the lung and may vary in both size and growth rate. Some slowly growing adenocarcinomas are call alveolar cell cancer.
  • Large cell caracinoma: starts near the surface of the lung, grows rapidly, and is usually large when diagnosed.

The names of some of the uncommon types of lung cancer are carcinoid, cylindroma, mucoepidermoid, and malignant mesothelioma. Approximately 5% to 10% of lung cancers are of these types.

The type of lung cancer I have:
(If you don't know, ask your doctor or nurse and have them write it down for you.)

How is lung cancer diagnosed?

If lung cancer is suspected or detected, you will have a series of tests designed to confirm the disease (diagnosis) and to determine how widely the cancer has spread (staging).

What are the roles of X-rays, MRIs, and CT scans

If a doctor suspects lung cancer, he or she may order a chest X-ray as a first step in diagnosis. Frequently, a CT (computer assisted tomography) scan or an MRI (magnetic resonance imaging) will also be ordered. CT scans and MRIs are test that use computerized pictures to show the body in great detail. They can show the size, shape, and location of a tumor. These tools are also useful in finding out if the tumor has spread from the lung to other parts of the chest or to other parts of the body.

The following are the tests I have had and the results of those tests:

What is a lung biopsy?

A biopsy is a test in which tissue is removed from the suspected tumor and looked at under a microscope to see if cancer cells are present. This may be done by inserting a needle through the chest wall to take a sample of tissue from a known tumor, or it may involve surgery in which the doctor opens the chest wall to remove a part or all of the tumor. A biopsy is necessary for the doctor to confirm a cancer diagnosis and to identify the specific type of cancer you have.

The results of my biopsy:

What is sputum cytology?

Cells that are coughed up from the lungs or breathing tubes can be examined under a microscope to see if they contain cancer. This procedure is called sputum cytology. In some cases, sputum cytology can reveal lung cancers in patients with normal X-rays or can determine the type of lung cancer. Because it cannot pinpoint the tumor's location, a positive sputum cytology test is usually followed by further tests.

What does "staging" mean?

Staging is a process used by physicians to describe how advanced the cancer is. Staging assists the physician in determining a prognosis (what is likely to happen to the person because of the cancer). Knowing the stage helps the physician in planning treatment and evaluating the results. Different staging systems are used for different types of cancer. The staging system used for nonsmall cell lung cancer is discussed in the next section.

The results of my sputum cytology:

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