What are the signs and symptoms of Lung Cancer?
The primary signs and symptoms of non-small cell lung cancer and small cell lung cancer are essentially the same. Early symptoms may include some or all of the following:
- lingering or worsening cough
- coughing up phlegm or blood
- chest pain that worsens when you breathe deeply, laugh, or cough
- shortness of breath
- weakness and fatigue
- loss of appetite and weight loss
You may also experience recurrent respiratory infections such as pneumonia or bronchitis. As the cancer spreads, additional symptoms depend on where new the tumors form. For example, if in the:
- lymph nodes: lumps, particularly in the neck or collarbone
- bones: bone pain, particularly in the back, ribs, or hips
- brain or spine: headache, dizziness, balance issues, or numbness in arms or legs
- liver: yellowing of skin and eyes (jaundice)
Tumors found at the top of the lungs tend to affect the facial nerves, leading to drooping eyelids, small pupils or a lack of perspiration on one side of the face. This frequently observed collection of symptoms is called Horner syndrome. Tumors can also put pressure on the large vein that transports blood between the head, arms, and heart. This can cause symptoms such as swelling of the face, neck, upper chest, and arms. Lung cancer sometimes creates a substance similar to hormones, causing a wide variety of symptoms called paraneoplastic syndrome, which may or may not include the following:
- muscle weakness
- fluid retention
- high blood pressure
- high blood sugar
Lung Cancer and Back Pain
Back pain is fairly common in the general population. It’s possible to have lung cancer and totally unrelated back pain. In fact, most people with back pain do not have lung cancer. Furthermore, not everyone with lung cancer experiences back pain, but a great many do. For some people, back pain is one of the very first symptoms of lung cancer. Back pain can be caused by the pressure of large tumors growing in the lungs. It can also mean that cancer has spread to the spine or ribs. As the cancer progresses, a cancerous tumor can cause compression of the spinal cord, which can lead to neurologic deterioration causing:
- weakness of the arms and legs
- numbness or loss of sensation in the legs and feet
- urinary and bowel incontinence
- interference with the spinal blood supply
Without treatment, back pain caused by cancer will ultimately worsen. Back pain may improve if treatment such as surgery, radiation or chemotherapy can successfully shrink or remove the tumor. In addition, your doctor can recommend corticosteroids or prescribe pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). For more severe pain, opioids such as morphine or oxycodone may be required.
What causes Lung Cancer?
While anyone can acquire lung cancer, the vast majority (90%) of lung cancer cases are the result of smoking cigarettes. From the moment you inhale smoke into your lungs, it starts damaging your lung tissue. The lungs can repair the damage, but continued exposure to smoke makes it increasingly difficult for the lungs to keep up the rate of repair.
Once the lung cells have been damaged, they begin to behave abnormally, increasing the likelihood of developing lung cancer. Small-cell lung cancer is almost always associated with heavy cigarette smoking. However, when people stop smoking, they lower their risk of lung cancer over time.
Exposure to radon, a naturally occurring radioactive gas, is the second leading cause of lung cancer, according to the American Lung Association. Radon enters buildings through small cracks in the foundation. Smokers who are also exposed to radon are at an extremely high risk of lung cancer.
Breathing in other hazardous substances, especially over a long period of time, can also cause lung cancer. A type of lung cancer called mesothelioma is almost exclusively caused by exposure to asbestos. Other substances that have been known to cause lung cancer include:
- some petroleum products
Inherited genetic mutations may make you more likely to develop lung cancer, especially if you smoke or are exposed to other carcinogens. Sometimes, there’s no obvious cause for lung cancer.
Are there different types of Lung Cancer?
The most common type of lung cancer is non-small cell lung cancer (NSCLC). NSCLC comprises over 80% of all identified cases, and 30% of those cases start in the cells that form the lining of the body’s cavities and surfaces. This type of lung cancer forms in the outer part of the lungs (adenocarcinomas). An additional 30% of cases begin in the cells that line the passages of the respiratory tract (squamous cell carcinoma).
A rare subset of adenocarcinoma begins in the tiny air sacs in the lungs (alveoli). It’s called adenocarcinoma in situ (AIS). This type of lung cancer isn’t very aggressive and may not invade surrounding tissue or require immediate treatment. Faster-growing types of NSCLC include large-cell carcinoma and large-cell neuroendocrine tumors.
Small-cell lung cancer (SCLC) represents 15-20% of lung cancers. SCLC grows and spreads faster than NSCLC. This also makes it more likely to respond to chemotherapy. However, it’s also less likely to be cured with treatment. In some cases, lung cancer tumors contain both NSCLC and SCLC cells.
Mesothelioma is another form of lung cancer, and it’s almost always associated with asbestos exposure. Carcinoid tumors start in hormone producing (neuroendocrine) cells. Tumors in the lungs can grow quite large before people begin to notice symptoms. Early symptoms can mimic a cold or other common respiratory ailments, so many people don’t seek out medical advice straight away. Ironically, that’s one of the reasons lung cancer is often overlooked and undiagnosed in the early stages.
Risk factors for Lung Cancer
The greatest single risk factor for developing lung cancer is smoking. That includes cigarettes, cigars and pipes. Tobacco products contain thousands of toxic substances. According to the Centers for Disease Control and Prevention (CDC), cigarette smokers are 15-30 times more likely to develop lung cancer than nonsmokers. The longer an individual smokes, the greater the chance of developing lung cancer. Quitting smoking (or never starting) can lower that risk.
Breathing second hand smoke is also a major risk factor. Every year in the United States, over 7,000 people who’ve never smoked die from lung cancer caused by second hand smoke.
Exposure to radon, a naturally occurring gas, increases your risk of lung cancer considerably. Radon rises up from the ground, entering buildings through small cracks in the foundation. It’s the single greatest cause of lung cancer in non-smokers. However, a simple home test can determine if the level of radon in your home is hazardous or not. Your risk of developing lung cancer is also higher if you’ve been exposed to toxic substances such as asbestos or diesel exhaust in the workplace.
Other risk factors include:
- family history of lung cancer
- personal history of lung cancer, especially if you’re a smoker
- previous radiation therapy to the chest
Lung Cancer and Smoking
Not all smokers develop lung cancer, and not everyone who has lung cancer is a smoker. But there’s no question that smoking is the single biggest risk factor, causing 9 out of 10 lung cancer diagnosis. In addition to cigarettes, cigar and pipe smoking are also linked to lung cancer. The more you smoke and the longer you smoke, the greater your chance of developing lung cancer.
You don’t have to be a smoker to be affected. Breathing in other people’s smoke increases the risk of lung cancer. According to the Centers for Disease Control and Prevention, second hand smoke is responsible for over 7,000 lung cancer deaths each year in the United States.
Tobacco products contain thousands of chemicals, and at least 70 of them are known to cause cancer. When you inhale tobacco smoke, this mixture of chemicals is delivered directly to your lungs, where it immediately starts causing damage. The lungs can usually repair damage in the beginning, but the continued effect on lung tissue becomes harder to manage. That’s when damaged cells can mutate and grow out of control, thus causing cancer.
The chemicals you inhale also enter your bloodstream and are carried throughout your body, increasing the risk of other forms of cancer. Former smokers are still at risk of developing lung cancer, but quitting can lower that risk considerably. Within 10 years of quitting, the risk of dying from lung cancer drops by half.
Diagnosing Lung Cancer
After a physical exam, your doctor will tell you how to prepare for specific tests, such as:
- Imaging tests: An abnormal mass can be seen on X-ray, MRI, CT, and PET scans. These scans produce more detail and find smaller lesions.
- Sputum cytology: If you produce phlegm when you cough, microscopic examination can determine if cancer cells are present.
- A biopsy can determine if tumor cells are cancerous. A tissue sample can be obtained by the following means:
- Bronchoscopy: While under sedation, a lighted tube is passed down your throat and into your lungs, allowing closer examination.
- Mediastinoscopy: The doctor makes an incision at the base of the neck. A lighted instrument is inserted and surgical tools are used to take samples from lymph nodes. It’s usually performed in a hospital under general anesthesia.
- Needle: Using imaging tests as a guide, a needle is inserted through the chest wall and into the suspicious lung tissue. Needle biopsy can also be used to test lymph nodes.
Tissue samples are sent to a pathologist for analysis. If the result is positive for cancer, further testing, such as a bone scan, can help determine if cancer has spread and to help with staging. For this test, the patient is injected with a radioactive chemical. Abnormal areas of bone will then be highlighted on the images. MRI, CT, and PET scan are also used for staging.
Stages of Lung Cancer
Cancer stages describe how far the cancer has advanced and spread and may help determine the appropriate treatment. The chance of successful or curative treatment is much higher when lung cancer is diagnosed and treated in the early stages, before it spreads. Unfortunately, as lung cancer doesn’t cause any obvious symptoms in the early stages, diagnosis often comes after it has spread throughout the body.
Non-small cell lung cancer has four main stages:
- Stage 1: Cancer is found in the lung, but it has not spread outside the lung.
- Stage 2: Cancer is found in the lung and nearby lymph nodes.
- Stage 3: Cancer is in the lung and lymph nodes in the middle of the chest.
- Stage 3A: Cancer is found in lymph nodes, but only on the same side of the chest where cancer first started growing.
- Stage 3B: Cancer has spread to lymph nodes on the opposite side of the chest or to lymph nodes above the collarbone.
- Stage 4: Cancer has spread to both lungs, into the area around the lungs, or to distant organs.
Small-cell lung cancer (SCLC) has two main stages. In the limited stage, cancer is found in only one lung or nearby lymph nodes on the same side of the chest.
The extensive stage means cancer has spread:
- throughout one lung
- to the opposite lung
- to lymph nodes on the opposite side
- to fluid around the lung
- to bone marrow
- to distant organs
At the time of diagnosis, 2 out of 3 people with SCLC are already in the extensive stage.
Treatment for Lung Cancer
It’s important to seek a second opinion before beginning any course of treatment. If you’re diagnosed with lung cancer, your care will likely be managed by a team of doctors who may include:
- a surgeon who specializes in the chest and lungs (thoracic surgeon)
- a lung specialist (pulmonologist)
- a medical oncologist
- a radiation oncologist
Discuss all your treatment options with your doctors and loved ones before making a decision. Your medical team will coordinate care and keep each other informed about your progress.
Treatment for non-small cell lung cancer (NSCLC) varies from person to person, much of which depends on specific details of your health.
- Stage 1 NSCLC: Surgery to remove a portion of the lung may be required. Chemotherapy may also be recommended, particularly if you’re at high risk of recurrence.
- Stage 2 NSCLC: You may need surgery to remove part or all of your lung. Chemotherapy is usually recommended.
- Stage 3 NSCLC: You may require a combination of chemotherapy, surgery, and radiation treatment.
- Stage 4 NSCLC is particularly hard to cure. Options include surgery, radiation, chemotherapy, targeted therapy, and immunotherapy.
Options for small cell-lung cancer (NSCLC) also include surgery, chemotherapy, and radiation therapy. In most cases, the cancer will be too advanced for surgery to have a meaningful impact on your health and wellbeing. Clinical trials provide access to promising new treatments. Ask your doctor if you’re eligible to participate in a clinical trial.
Some people with advanced lung cancer choose not to undergo treatment. You may consider various palliative care treatments, which are focused on treating the symptoms of cancer rather than the cancer itself.
Home Remedies for Lung Cancer symptoms
Home remedies and homeopathic remedies certainly won’t cure cancer, but certain home remedies may help relieve some of the symptoms and discomfort associated with lung cancer and the dreadful side effects of treatment. Ask your doctor if you should take dietary supplements and if so, which ones they might recommend. Some herbs, plant extracts and other home remedies can interfere with treatment and endanger your health. Please be sure to discuss all complementary therapies with your doctor to make sure they’re safe for you. Options may include:
- Massage: With a qualified therapist, massage can help relieve pain and anxiety. Some massage therapists are trained to work with people with cancer.
- Acupuncture: When performed by a trained practitioner, acupuncture may help ease pain, nausea, and vomiting. But it’s not safe if you have low blood counts or take blood thinners.
- Meditation: Relaxation and reflection can reduce stress and improve overall quality of life in cancer patients.
- Hypnosis: Helps you relax and may help with nausea, pain, and anxiety.
- Yoga: Combining breathing techniques, meditation, and stretching, yoga can help you feel better overall and improve sleep.
- Some people with cancer turn to cannabis oil. It can be infused into cooking oil to squirt in your mouth or mixed with food. Or the vapors can be inhaled. This may relieve nausea and vomiting and improve appetite. Note, the laws for use of cannabis oil vary from state to state.
Dietary Recommendations for people with Lung Cancer
There’s no diet recommended specifically for lung cancer, but it is critically important to ensure that your body gets all of the nutrients it requires. If you’re deficient in certain vitamins or minerals, your doctor can advise you which foods to eat. Otherwise, you’ll need a dietary supplement. Again, don’t take supplements without speaking with your doctor as they might interfere with treatment. Here’s are a few dietary tips to consider:
- Eat whenever you have an appetite.
- If you don’t have a major appetite, try eating smaller meals throughout the day.
- If you need to gain weight, supplement with low sugar, high-calorie foods and drinks.
- Use mint and ginger teas to soothe your digestive system.
- If your stomach is easily upset or you have mouth sores, avoid spices and stick to bland food.
- If constipation is a problem, add more high fiber foods.
As you progress through treatment, your tolerance to certain foods may change, as will your nutritional requirements. It’s worth discussing nutrition with your doctor on a frequent basis throughout your treatment. You can also request a referral to a nutritionist or dietician. There’s no diet known to cure cancer, but a well-balanced diet can help you fight side effects and feel better.
Lung Cancer and Life Expectancy
When cancer enters the lymph nodes and bloodstream, it can spread anywhere in your body. The outlook is much better when treatment begins before cancer has the opportunity to spread beyond the lungs. Other factors include age, overall health, and how well your body responds to treatment. And because early symptoms can be easily overlooked, lung cancer is usually diagnosed in later stages. Survival rates and other statistics provide a broad picture of what to expect. There are significant individual differences, however. In recent years, new treatments have been approved for stage 4 non-small cell lung cancer (NSCLC). Some people are surviving much longer than previously seen with traditional treatments.
The following are the estimated five-year survival rates for NSCLC by SEER stage:
- Localized: 60 percent
- Regional: 33 percent
- Distant: 6 percent
- All SEER stages: 23 percent
Small-cell lung cancer (SCLC) is very aggressive. For limited stage SCLC, the five-year survival rate is 14 percent. Median survival is 16 to 24 months. Median survival for extensive stage SCLC is 6 to 12 months. Long-term disease-free survival is rare. Without treatment, median survival from diagnosis of SCLC is only two to four months. The relative five-year survival rate for mesothelioma, a type of cancer caused by asbestos exposure, is 5 to 10 percent.
Facts and Statistics about Lung Cancer
Lung cancer is the most common form of cancer in the world. According to the American Lung Association, there were 2.1 million cases diagnosed in 2018, and 1.8 million deaths from lung cancer.
The most common type of lung cancer is non-small cell lung cancer (NSCLC), accounting for 80 to 85 percent of all cases, according to the Lung Cancer Alliance.
Small-cell lung cancer (SCLC) represents about 15 to 20 percent of lung cancers. At the time of diagnosis, 2 out of 3 people with SCLC are already in the extensive stage.
Anyone can get lung cancer, but smoking or exposure to secondhand smoke is linked to about 90 percent of lung cancer cases. According to the Centers for Disease Control and Prevention (CDC)Trusted Source, cigarette smokers are 15 to 30 times more likely to get lung cancer than nonsmokers.
In the United States, each year about 7,300 people who never smoked die from lung cancer caused by secondhand smoke.
Former smokers are still at risk of developing lung cancer, but quitting can significantly lower that risk. Within 10 years of quitting, the risk of dying from lung cancer drops by halfTrusted Source.
Tobacco products contain more than 7,000 chemicals. At least 70 are known carcinogens.
According to the US Environmental Protection Agency (EPA), radon is responsible for about 21,000 lung cancer deaths every year in the United States. About 2,900 of these deaths occur among people who have never smoked.