Lung Cancer

If you’ve been recently diagnosed with lung cancer, you and your family might be overwhelmed with questions and concerns. Your first decision is where to get treatment.

You want a place where you can get the most advanced treatment options available. A place where you are supported by a team of compassionate experts. A place where you are treated as a whole person.

MultiCare Regional Cancer Center is that place. We have the region’s best health care providers in the field of oncology. Our world-class treatment facility offers cutting-edge technology in a welcoming and positive healing environment.

Learn about our comprehensive treatment approach, our cancer care team or more about lung cancer in the tabs below. We also have information about lung cancer screening.

Lung Cancer Facts

According to the National Cancer Institute, lung cancer is the second most common cancer among both men and women, second only to colorectal cancer. Cigarette smoking accounts for nearly 90 percent of all lung cancers, and it is therefore the single most preventable cancer in existence.

Lung cancer is the rapid growth of abnormal cells in the lung. It can start anywhere in the lungs and affect any part of the respiratory system.

Causes

Most lung cancer is caused by smoking. Secondhand smoke also can cause lung cancer. Lung cancer is the leading cause of cancer deaths.

Being exposed to arsenic, asbestos, radioactive dust, or radon can increase your chances of getting lung cancer. People who are exposed to radiation at work or elsewhere have a higher chance of getting lung cancer.

Symptoms

Early lung cancer doesn't usually cause any symptoms. This is why it's not usually found early. In its advanced stage, cancer may affect how your lungs work. The first signs of lung cancer may include:

• Coughing
• Wheezing
• Feeling short of breath
• Having blood in any mucus that you cough up

If you have these symptoms and are worried about lung cancer, call your doctor.

Lung cancer may spread within the chest and then to other parts of the body. For example, if it spreads to the spine or bones, it may cause pain in the back or other bones or weakness in the arms or legs. If it spreads to the brain, it may cause seizures, headaches, or vision changes.

Prevention

Early lung cancer doesn't usually cause any symptoms. This is why it's not usually found early. Changing your lifestyle can, over time, gradually reduce some of your risk for lung cancer.

Tobacco

Tobacco use is the leading cause of lung cancer. More than 85% of lung cancers are caused by smoking.

To prevent lung and other cancers, do not use tobacco. If you do use tobacco, you can reduce your risk of lung cancer by quitting. Your risk will gradually decrease with time as your lungs recover. Quitting smoking reduces your risk for cancer, and your risk continues to decrease as long as you do not smoke.

Even cutting down how much you smoke may reduce your risk (but not as much as quitting completely). In one study, cutting in half the number of cigarettes smoked each day significantly reduced the risk of getting lung cancer during a 5- to 10-year period.

Other Risk Factors

Other things that increase your risk of lung cancer include asbestos, secondhand smoke, and radon exposure. Certain occupations, such as mining and farming, expose people to fumes, radioactive dust, or other chemicals that may be harmful. Taking precautions to reduce your exposure to harmful substances in your environment can reduce your risk of developing lung cancer.

Radiation therapy to the chest area can also increase your risk.

Diet

Recent studies on the connection between diet and lung cancer have shown mixed results. Antioxidants, phytoestrogens (found in a wide variety of whole grains, legumes, vegetables, and soy products), and cruciferous vegetables (like broccoli) may reduce the risk of lung cancer.

Other research shows that taking supplements of beta-carotene, vitamin E, and retinoids may actually be harmful and increase the risk of lung cancer in people who continue to smoke.

Detection and Diagnosis

Early Detection

A large lung cancer screening study sponsored by the National Cancer Institute found that screening for lung cancer using a low-dose CT scan may help people who are at a higher risk for lung cancer. As a result, national groups, such as the American Lung Association and the National Comprehensive Cancer Network, recommend yearly lung cancer screening tests for high-risk patients.

Learn more about lung cancer screening, including who is eligible for screening, by reading our handout, Lung Cancer Screening: Information for Patients.

Initial Tests

Initial exams and tests for suspected lung cancer include:

• Medical history to find out your risk factors for developing lung cancer.
• Physical examination to find any lung problems or swollen lymph nodes.
• Chest X-ray to look for any abnormalities that may be causing your symptoms, such as pneumonia or a lung mass (tumor).
• Complete blood count (CBC) to see whether you have abnormal values of red blood cells, white blood cells, or platelets.
• Calcium, creatinine, alkaline phosphatase, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) to find out about your electrolyte and liver function.

If your medical history, physical exam, or chest X-ray suggest that lung cancer is present, your doctor may recommend other tests, such as:

• CT scan of the lungs: sometimes with transthoracic needle aspiration biopsy (TNAB) of a lung nodule. A needle biopsy uses a needle inserted through the chest wall to remove a sample of lung tissue (biopsy). This usually is done if the abnormal lung tissue is located close to the chest wall. Imaging procedures such as ultrasound or fluoroscopy may also be used to help guide the needle to the right spot.
• Sputum Cytology: to evaluate the type of any abnormal cells that are present in your mucus.
• Thoracentesis: to take a sample of the fluid around your lungs to evaluate the type of any abnormal cells. Thoracentesis is done if you have a large collection of fluid around your lung (pleural effusion). Thoracentesis is sometimes used to find out why you have fluid collecting around your lung. Other times it is just to remove the fluid and make it easier for you to breathe.
• Bronchoscopy: to take a biopsy of cells from your airway.
• Lung Biopsy: to evaluate the type of any abnormal cells.
• Video-Assisted Thoracoscopy (VATS): to take a biopsy of lung tissue through a small incision between two ribs with the aid of a thin, lighted tube (videoscope) and small surgical instruments.
• Positron Emission Tomography (PET): PET scanning can help determine whether a lung mass (tumor) or enlarged lymph node is cancerous. PET may help determine whether surgery is a treatment option. PET scanning may also be used after treatment to see how well the treatment worked. PET scanning can be used to look for areas of the liver, adrenal gland, or bone that may show where lung cancer has spread.

After the type of lung cancer has been diagnosed, testing is done to find out whether the cancer has spread (metastasized) to other organs in your body and to determine the stage of the cancer. Treatment of lung cancer is based on the stage of the cancer.

Treatments

After diagnosis and staging, you and your doctor will work together to determine the best treatment options for you. You will also meet with a nurse navigator to help guide you through the process and to answer any questions you have. They are a crucial part of your team; your point guard, in essence. They can connect you with financial information, education and resources as well as provide emotional support on your healing journey.

Your quality of life is critical when considering your treatment choices. Discuss your personal preferences with your oncologist when he or she recommends treatment.

Lung Cancer Treatments Differ Per Type

There are two major types of lung cancer: small cell and non-small cell, and different subtypes of non-small cell lung cancer. Each type grows and spreads in different ways, and is treated differently. Non-small cell is the most common form of lung cancer, growing and spreading more slowly than the small-cell type, which is more likely to spread to other organs in the body.

Surgery

For many lung cancer patients, surgery is often one element of the treatment process. Surgery may involve removing the cancer (wedge resection), removing the affected lobe of lung (lobectomy), or removing the entire lung (pneumonectomy).

Radiation therapy

Radiation therapy is often used in combination with surgery or chemotherapy or both. A leader in providing the most advanced treatments and therapies available, MultiCare Regional Cancer Center offers intensity modulated radiation therapy (IMRT), which more precisely targets a cancerous tumor while sparing the healthy surrounding tissue.

Chemotherapy

Chemotherapy involves the use of anti-cancer drugs to treat cancer. These drugs are designed to work by interfering with the rapidly dividing cancer cells in your body. Your doctors may suggest chemotherapy as form of lung cancer treatment before or after surgery. Chemotherapy is usually administered intravenously (through the vein) or orally in the form of pills. Your doctor may recommend additional medications to help alleviate chemotherapy-related side effects.

Targeted Therapy

Targeted therapies use medicines or antibodies to block growth factors that allow some cancers to grow. At this time, targeted therapies are used for advanced stages of lung cancer.

Supportive and Integrative Therapies

In addition to the therapies described above, we offer integrative therapies such as acupuncture, nutritional therapy, physical therapy, yoga, massage and emotional counseling. Many of these therapies are remarkably effective in addressing the side effects of chemotherapy, surgery and radiation by easing tension, reducing pain and improving quality of life.

For people with lung cancer, studies have shown that mind-body treatments like those mentioned above may help you feel better and cope better with treatment. These treatments also may reduce chronic low back pain, joint pain, headaches, and pain from treatments. Acupuncture may also help with nausea and vomiting from chemotherapy.

Managing Side Effects

During and after your treatment for lung cancer, there are things you can do at home to help manage the side effects.

Quitting Smoking During Treatment

If you smoke and have lung cancer, quitting smoking will make your treatment more effective and may help you live longer. Smoking delays healing after surgery, so you may have a better recovery from lung cancer surgery if you have quit smoking.

People with early-stage lung cancer who continue to smoke during radiation therapy have been shown to have shorter survival times that those who do not smoke. It may also make chemotherapy less effective. The nicotine in tobacco seems to help the cancer cells and their blood supply multiply while also protecting the cancer cells from destruction.

Research and Clinical Trials

You may be interested in participating in research studies called clinical trials. Clinical trials are based on the most up-to-date information and are designed to find better ways to treat people who have cancer. People who do not want standard treatments or are not cured by standard treatments may want to participate in clinical trials.