Aspirus Wausau Hospital

Lung Cancer

Lung cancer is the leading cause of cancer death in both men and women. The disease is believed to develop over a period of many years and usually starts in the lining of the bronchi (the main airways of the lungs), but also can begin in other areas of the respiratory system.

Nearly all lung cancers are carcinomas, a cancer that begins in the lining or covering tissues of an organ. More than 95 percent of lung cancers belong to the group called bronchogenic carcinoma.

Some risk factors for lung cancer include:

Smoking – This is the leading cause of lung cancer, with more than 90 percent of lung cancers thought to be a result of smoking. Secondhand smoke – Breathing the smoke of others. Recurring inflammation – This can include tuberculosis and some types of pneumonia.

Asbestos exposure Family history Personal history of lung cancer Vitamin A deficiency Air pollution

Types of lung cancer

Lung cancers are generally divided into two types:

Nonsmall cell lung cancer

This is the most common type of lung cancer and is divided into three main kinds that are named for the type of cells in the tumor. They are:

• Squamous cell carcinoma – Aslo called epidermoid carcinoma, this is the most common type of lung cancer in men. It often begins in the brochi and usually does not spread as quickly as other types of lung cancer.
• Adencarcinoma – This type of lung cancer 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 carcinoma – This group of cancers has 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 can look like oats when viewed under a microscope, this type of lung cancer grows rapidly and quickly spreads to other organs.

Symptoms of lung cancer

Lung cancer usually does not cause symptoms when it first develops, but they often become present after the tumor begins growing. Each individual may experience symptoms differently, but some of the most common symptoms of lung cancer include:

Coughing Constant chest pain Shortness of breath Wheezing Recurring lung infections, like pneumonia or bronchitis

Bloody or rust colored sputum (phlegm, mucus) Hoarseness Swelling of the neck and face Weakness in the shoulder, arm or hand Fever for unknown reason

How is lung cancer diagnosed?

In addition to a complete medical history and a physical examination, there are several procedures that can be used to diagnose lung cancer. Click below to learn about some of the more common diagnostic procedures for lung cancer:

Chest x-ray

This imaging test looks for any mass or spot on the lungs.

Other special x-rays

This diagnostic test uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film and can provide more precise information about the size, shape, and position of a tumor.

Computed tomography scan (CT or CAT scan)

This diagnostic imaging procedure 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

This is a study of phlegm (spit) cells under a microscope.

Needle biopsy

During a 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

This allows physicians to examin 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

This is 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

These are done to determine if the cancer has spread from where it started into other areas of the body.

Treatment for lung cancer

Specific treatment of lung cancer will be determined by your physician and the treatment plan can vary for different patients.

Lung cancer may be treated with one or any combination of the following:

Surgery

Three main types of surgery are most often used in lung cancer treatment. The choice depends on the size and location of the tumor in the lung, the extent of the cancer, the general health of the patient, and other factors.

• Segmental or wedge resection - removal of only a small part of the lung.
• Lobectomy - removal of an entire lobe of the lung.
• Pneumonectomy - removal of an entire lung.

Radiation therapy

Radiation therapy uses high-energy rays to kill or shrink cancer cells and decrease their ability to divide. To learn more about this treatment, please visit our section on radiation therapy.

Chemotherapy

Chemotherapy is the use of medicines to treat cancer. When cancer occurs, normal cells in the body divide without any control. Chemotherapy fights cancer by stopping these cells from growing and dividing. To learn more about this treatment, please visit our section on chemotherapy.

Photodynamic therapy (PDT)

This is a type of laser treatment that involves injecting photosensitizing chemicals into the bloodstream. Cells throughout the body absorb the chemicals, which collect and stay longer in the cancer cells, than in the healthy cells.

At the right time, when the healthy cells surrounding the tumor may already be relatively free of the chemical, the light of a laser can be focused directly on the tumor. As the cells absorb the light, a chemical reaction destroys the cancer cells. For lung cancer, the light is delivered through a bronchoscope (a small, flexible tube with a light on the end) that is inserted through the mouth or nose.

Clinical trials (research studies)

Clinical trials are studies, managed by government agencies, educational institutions, private not-for-profit organizations, or commercial businesses, to develop, produce, and evaluate the effectiveness of new treatments and therapies for diseases. Go to online listing of trials available at the Aspirus Regional Cancer Center.