 Adenocarcinoma usually
begins along the outer edges of the lungs and
under the lining of the bronchi. It is the
most common type of lung cancer in women and
in people who have never smoked.
Large
cell carcinomas are a group
of cancers with large, abnormal-looking
cells. These tumors usually begin
along the outer edges of the lungs.
- Small cell lung cancer,
sometimes called oat cell cancer because the
cancer cells may look like oats when viewed
under a microscope, grows rapidly and quickly
spreads to other organs.
It is important to find out what kind of lung
cancer a person has. The different types of carcinomas,
involving different regions of the lung, may
cause different symptoms and are treated differently.
What
are the symptoms of lung cancer?
The following are the most common symptoms for
lung cancer. However, each individual may experience
symptoms differently.
Lung cancer usually does not cause symptoms when
it first develops, but they often become present
after the tumor begins growing. A cough is the
most common symptom of lung cancer. Other symptoms
include:
- constant chest pain
- shortness of breath
- wheezing
- recurring lung infections, such as pneumonia
or bronchitis
- bloody or rust colored sputum
- hoarseness
- a tumor that presses on large blood vessels
near the lung can cause swelling of the neck
and face
- a tumor that presses on certain nerves near
the lung causing pain and weakness in the shoulder,
arm, or hand
- fever for an unknown reason
Like all cancers, lung cancer can also
cause:
- fatigue
- loss of appetite
- loss of weight
- headache
- pain in other parts of the body not affected
by the cancer
- bone fractures
Other symptoms can be caused by substances made
by lung cancer cells - referred to as a paraneoplastic
syndrome. Certain lung cancer cells produce a
substance that causes a sharp drop in the level
of sodium in the blood, which can cause many
symptoms, including confusion and sometimes even
coma.
None of these symptoms is a sure sign of lung
cancer. Only a physician can tell whether a patient's
symptoms are caused by cancer or by another problem.
Consult your physician for a diagnosis.
What
are the risk factors for lung cancer?
A risk factor is anything that increases a person's
chance of getting a disease such as cancer. Different
cancers have different risk factors. Several
risk factors make a person more likely to develop
lung cancer:
- Smoking is the leading cause of lung cancer,
with more than 90 percent of lung cancers thought
to be a result of smoking.
Additional risk factors include:
Because marijuana is an illegal substance, it
is not possible to control whether it contains
fungi, pesticides, and other additives.
- recurring inflammation, such as from tuberculosis
and some types of pneumonia
- asbestos exposure (Smoking doubles this
risk.)
- talcum powder
While no increased risk of lung cancer has been
found from the use of cosmetic talcum powder,
some studies of talc miners and millers suggest
a higher risk of lung cancer and other respiratory
diseases from their exposure to industrial grade
talc. Talcum powder is made from talc, a mineral
which, in its natural form, may contain asbestos,
although, by law, all home-use talcum products
(baby, body, and facial powders) have been asbestos-free.
In some cities, air pollution may slightly increase
the risk of lung cancer.
If you are at an increased risk for developing
lung cancer, it is important to discuss with
your doctor the need for further diagnostic studies.
How
is lung cancer diagnosed?
In addition to a complete medical history to
check for risk factors and symptoms, and a physical
examination to provide other information about
signs of lung cancer and other health problems,
procedures used to diagnose lung cancer may include:
- chest x-ray - to look for any mass or spot
on the lungs.
- computed tomography scan (also called a
CT or CAT scan) - a diagnostic imaging procedure
that uses a combination of x-rays and computer
technology to produce cross-sectional images
(often called slices), both horizontally and
vertically, of the body. A CT scan shows detailed
images of any part of the body, including the
bones, muscles, fat, and organs. CT scans are
more detailed than general x-rays.
- sputum cytology - a study of phlegm (spit)
cells under a microscope.
- needle biopsy - a needle is guided into
the mass while the lungs are being viewed on
a CT scan and a sample of the mass is removed
and evaluated in the pathology laboratory under
a microscope.
- bronchoscopy - the examination of the bronchi
(the main airways of the lungs) using a flexible
tube (bronchoscope). Bronchoscopy helps to
evaluate and diagnose lung problems, assess
blockages, obtain samples of tissue and/or
fluid, and/or to help remove a foreign body.
- mediastinoscopy - a process in which a small
cut is made in the neck so that a tissue sample
can be taken from the lymph nodes (mediastinal
nodes) along the windpipe and the major bronchial
tube areas to evaluate under a microscope.
- x-rays and scans of the brain, liver, bone,
and adrenal glands - to determine if the cancer
has spread from where it started into other
areas of the body.
- PET (positron emission tomography) scan –
a diagnostic imaging test which provides information
regarding metabolic activity in the body.
A small amount of radioactive tracer is injected
into a vein in the patient’s arm. The
PET scanner then records the energy given
off by the tracer and converts this information
into three-dimensional images which the doctor
can study to detect any functional problems.
PET scans are used for further evaluation
of lung lesions as well as for the staging
of lung cancer.
Other tests and procedures may be used as well.
Treatment for lung cancer:
Specific treatment for lung cancer will be determined
by your physician based on:
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications,
procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Surgery, radiation therapy, and chemotherapy
may be used in the treatment of lung cancer.
What
is the MTOP at Huntington Hospital?
The Multidisciplinary Thoracic Oncology Program
at Huntington Hospital offers patients a carefully
coordinated team approach to the treatment of
lung cancer. Each patient receives input from
a surgeon, medical oncologist, radiation oncologist,
pulmonologist, radiologist, pathologist and other
key support professionals. By working together,
the MTOP approach:
- Streamlines diagnosis and staging
- Guarantees cross-discipline consultation
to establish an optimal treatment plan
- Ensures convenience and a clear, consistent
message for patients
- Increases access to the latest treatment
options and clinical trials
How
does the MTOP Operate?
New patients with a possible thoracic malignancy,
or those who have already been diagnosed, are
presented to the MTOP team at the weekly meeting
held each Friday morning.
The team reviews the imaging studies, pathology
and staging work-up of each patient. Case management
is discussed, and recommendations for therapy,
or further work-up, are made based on the consensus
of the specialist team.
Because all specialists involved in the care
of lung cancer patients are present at the meeting,
a comprehensive plan of care is developed rapidly.
Coordination of different subspecialists is assured,
and patient care is improved.
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