Lung Cancer: The Facts

What is it?

As the name implies, Lung Cancer is a disease that begins in the tissue of the lungs. The lungs are sponge-like organs that are part of the respiratory system. During breathing, air enters the mouth or nasal passage and travels down the trachea. The trachea splits into two sets of bronchial tubes that lead to the left and right lung. The bronchi branch off into smaller and smaller tubes that eventually end in small balloon-like sacs known as alveoli. The alveoli are where oxygen, carbon dioxide, and other substances are exchanged between the lungs and the blood stream. The vast majority of Lung Cancer cases fall into one of two different categories: Small Cell Lung Cancer makes up about 20% of all Lung Cancer cases. It is associated with cancer cells smaller in size than most other cancer cells. These cells may be small, but they can rapidly reproduce to form large tumors. Their size and quick rate of reproduction allows them to spread to the lymph nodes and to other organs of the body. This type of Lung Cancer is almost always caused by smoking or second hand smoke.

Non-Small Cell Lung Cancer is the most common type of Lung Cancer, making up almost 80% of all cases. This type of Lung Cancer grows and spreads more slowly than small cell lung cancer. Non-small cell lung cancer is divided into three different subcategories. Squamous cell carcinoma originates in the thin, flat cells that line the passages of the respiratory tract. Adenocarcinoma begins in the cells that form the lining of the lungs. Large cell carcinomas make up a group of cancers that look large and abnormal under a microscope.

Who gets it?

The majority of people that develop Lung Cancer are over the age of 50, with the average age of onset being about 60 years old. This year in the U.S., there will be about 164,000 new cases of Lung Cancer diagnosed and 156,900 deaths from the disease. Males have about a one third higher probability of developing Lung Cancer than do females. Race also seems to be a factor in determining who is at risk. African-Americans have a significantly higher rate of incidence for Lung Cancer than do Caucasians. Overall, Americans have about a 7% chance of developing Lung Cancer at some point during their lifetimes.

Residents of Rhode Island develop and die from Lung Cancer at a rate that is significantly higher than the national average. Compared to the national average, Rhode Island males have a 17% higher chance of developing the disease and Rhode Island females have a 24% higher chance. Rhode Islanders also have a higher probability of dying from Lung Caner after they develop the disease. In fact, Rhode Island has the 7th highest death rate in the nation for Lung Cancer.

There are other certain risk factors that increase the chances of developing Lung Cancer. Some of the most common factors are:

• SMOKING - Studies have shown that smoking is responsible for 90% OF ALL LUNG CANCER CASES. Risks from smoking depend on the amount smoked, duration of smoking, and type of tobacco. Pipes and cigars present the greatest danger, but cigarettes are also a deadly threat.
  
• Second Hand Smoke
  
• Asbestos Exposure - Exposure can lead to a 3-4 times increased risk.
  
• Pollution - The extent of the increased risk has not been fully assessed.
  
• Radon Exposure - High levels of radon can occur in certain work environments and in homes.
  
• History of Lung Disease - Certain diseases, such as TB, can leave scar tissue that can develop into Lung Cancer
  

How is it detected?

• Imaging tests: X-rays, CT scans, MRI, and PET scans are used to find Lung Cancer and to see where in the body it may have spread. Images of the internal structures of the body are obtained by using different types of waves.
  
  
• Sputum cytology: Phlegm, or spit, is studied to see if Cancer cells from the lungs are present.
  
  
• Needle biopsy: A small piece of tissue is removed from the tumor using a needle. The sample is studied to determine if and what type of Cancer is present.
  
  
• Bronchoscopy: A thin flexible tube is inserted into the bronchi through the mouth. The lighted end of the tube allows the physician to see cancerous areas and remove tissue if necessary.
  
  
• Mediastinoscopy: Tissue sample from lymph nodes along the trachea are examined for signs of Cancer. The procedure involves a small incision along the neck.
  
  
• Bone marrow biopsy: Bone marrow is examined for signs of Cancer. A needle is used to extract marrow from the bone (normally the hipbone).
  
  
• Blood tests: Certain tests can be done to see if the Cancer has spread to the liver or bones.
  

There are certain symptoms commonly associated with onset of Lung Cancer. However, these symptoms are not unique to Lung Cancer alone and can be caused by a number of factors. If you experience any of these symptoms consult your physician so that the cause can be determined.

Symptoms:

• A cough that doesn't go away and gets worse over time
  
• Constant chest pain
  
• Coughing up blood
  
• Shortness of breath, wheezing, or hoarseness
  
• Repeated problems with pneumonia and bronchitis
  
• Swelling of the neck and face
  
• Loss of appetite or unexplained weight loss
  
• Fatigue
  

Is it curable?

Lung Cancer is a very difficult disease to treat and is often not diagnosed until it is in a later stage. It is possible for Lung Cancer to be treated, but in many cases the cancer is too far along to be completely removed. The national five-year survival rate after diagnosis of Lung Cancer is 11-14%. In Rhode Island, death rates are 10% higher for men and almost 30% higher for women.

Like most cancers, survivorship dramatically increases with early diagnoses. Report any symptoms to your physician immediately, especially if you are in one of the high-risk groups mentioned above. The seriousness of this disease is a major reason why smoking should be avoided. Even if you've smoked for a long time, quitting has almost immediate beneficial results.

It's easier to prevent cancer than to treat it....

Certain lifestyle and dietary habits can greatly reduce your risk of developing Lung Cancer (as well as other cancers). Some of these include:

• Not smoking
  
• Regular exercise
  
• Low fat, high fiber diet*
  
• Moderate, if any, consumption of alcohol
  

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