Quick Reference: Lung Cancer

INITIAL DIAGNOSIS

The very natural act of taking a breath has whole new meaning when you have been diagnosed with lung cancer. This diagnosis can result in feelings of fear, uncertainty and anxiety. One powerful strategy for managing this initial wave of anxiety is to become better informed about the disease. Arming yourself with knowledge about lung cancer, its effects, and its treatments is a wise way to prepare for the challenges and choices the illness often brings. This quick reference guide is designed to be a first stop on the road to self-education about lung cancer.

The Facts
Cancer is a disruption in the body’s ability to keep the growth of certain cells in check. Lung cancer occurs when certain cells in the lungs have become damaged or malformed and begin to grow at an inappropriately fast pace. The American Cancer Society estimates there will be about 213,000 new cases of lung cancer in 2007 in the United States. The vast majority of lung cancer cases are thought be the result of exposure to tobacco smoke.

Causes
While the exact causes of lung cancer are not clear, a number of risk factors have been identified by the medical community. They include:

Smoking: more than 80% of lung cancers are thought to result from smoking or passive exposure to cigarette smoke.
Radon: this is the natural gas produced by the natural breakdown of uranium and can be a possible risk for cancer; this risk may be present in some homes built on soil with natural uranium deposits.
Exposure to asbestos: asbestos workers are about seven times more likely to die from lung cancer than are other people, with a risk of contracting cancer that is 50 to 90 times greater than that of people in general.
Age: the chances of developing lung cancer sharply increase over the age of 65, while fewer than 3% of all cases are found in people under the age of 45.
Heredity: brothers, sisters, and children of people who have had lung cancer are at slightly higher risk of contracting lung cancer.
Vitamin A: a deficiency or overabundance of vitamin A may increase the risk of lung cancer.
Air Pollution: air pollution in some cities might slightly increase the chance of getting lung cancer.

Types of Lung Cancer
There are two broad categories of lung cancer: small cell lung cancers (SCLC) and non-small cell lung cancers (NSCLC). These categories are based upon the microscopic appearance of the tumor cells. There is also a class of lung cancers called bronchial carcinoids and cancers that affect supporting lung tissue such as smooth muscles and other parts of the lung. These make up only a small percentage of all lung cancer cases.

Breaking each major category down further, SCLC comprises about 20% of lung cancer cases and are the most aggressive and rapidly-growing ones. Cases of SCLC are strongly related to cigarette smoking, with only 1% of these cases occurring in non-smokers.

Meanwhile, NSCLC cancers are the most common, representing about 80% of all lung cancer cases. Typical NSCLC cancers include adenocarcinomas, squamous cell carcinomas, large cell carcinomas, and various combinations of these types of NSCLC cancers. Adenocarcinomas are seen in both smokers and nonsmokers who develop cancer and account for about 50% of NSCLC cancer cases. Squamous cell carcinomas arise most frequently in the bronchi in the central chest area and account for about 30% of NSCLC cases.

Key Terminology (Initial Diagnosis)

Adenocarcinoma: This form of non-small cell lung cancer can occur in the glandular cells lining the lungs. About 35% of U.S. lung cancer patients have this form of cancer

Alveoli: Small air sacs in the lungs that transfer oxygen into the bloodstream and expel carbon dioxide from it

Bronchi: Tubes that branch from the trachea into the separate lobes of the lungs. The bronchi branch further into bronchial tubes within the right and left lobes of the lungs

In Situ Cancer: Cancer that has not spread to other areas of the body

Invasive Cancer: Cancer that has spread locally to other parts of the lung, or metastasized (spread to other areas of the body). Compared to in situ cancer, invasive cancer is the more aggressive type

Large Cell Lung Cancer: Undifferentiated large cell carcinoma produces tumors along the bronchi and is identified by the large, round shape of the cancer cells

Mesothelioma: A rare form of lung cancer caused by exposure to asbestos. Mesothelioma affects the pleura of the lungs, often over a period of many years

Metastasis: The spread of cancer from the site of origin to other parts of the body, or a secondary cancer growth

Non-Small Cell Lung Cancer: A lung cancer in the form of squamous cell carcinoma, adenocarcinoma, or large cell carcinoma. Non-small cell lung cancers affect about 80% of lung cancer patients

Pleura: A serous (or "serum containing") membrane that encloses the lungs. The pleura contains two tissue layers that are separated by serous fluid.

Small Cell Lung Cancer: About 20% of lung cancer cases are caused by small cell carcinomas. Small cell lung cancer is more likely to metastasize -- or spread to other parts the body -- than is non-small cell lung cancer.

Squamous Cell Carcinoma: Squamous cell carcinoma originates in the bronchi and is slow to spread to other parts of the body; it is the most common type of lung cancer

Staging: Lung cancer is staged according to the extent to which it has spread. Non-small cell lung cancer stages are separated into Stage 0, IA, IB, IIA, IIB, IIIA, IIIB, and IV. Small cell lung cancer is normally staged as either limited or extensive

Tumor: Masses formed by cells that reproduce abnormally. A benign tumor remains in one position and is not cancerous. A malignant tumor is cancerous and will spread to or invade other parts of the body.

TREATMENTAND POST-TREATMENT SUPPORT

Typical Treatments and their Side Effects
There are three main types of treatment for lung cancer: surgery, radiation therapy, and chemotherapy.

Surgery is the primary treatment for most lung cancer patients. It involves the physical removal of part or all of the affected areas through incisions in the chest or other areas of the body.

Radiation therapy employs a beam of focused radiation designed to stop cancer cells from dividing. It is an effective treatment because it preferentially treats the more rapidly-dividing cells, such as cancer cells, in the body of the patient.

Chemotherapy is a lung cancer treatment that damages cancerous cells, causing them to stop dividing. Chemotherapy also affects normally dividing cells in the body, such as those in the skin, digestive tract and blood. For this reason, a patient may become quite ill as a result of chemotherapy treatment.

Links to Support Resources

American Lung Association:
http://www.lungusa.org/lung-disease/lung-cancer/

Cancer Consultants - Cancer Topics
http://www.texasoncology.com/cancer-blood-disorders.aspx

Cunio Lung Cancer Study Group:
http://www.alcase.it/en/

International Association for the Study of Lung Cancer:
http://www.iaslc.org/

Lung Cancer Alliance:
http://www.lungcanceralliance.org/

National Familiar Lung Cancer Registry:
http://www.path.jhu.edu/nfltr.html/

The Roy Castle Lung Cancer Association:
http://www.roycastle.org/

The Society of Thoracic Surgeons:
http://www.sts.org/

National Lung Cancer Partnership:
http://www.nationallungcancerpartnership.org/

Managing Treatment
Chemotherapy is a commonly-prescribed systemic therapy for treating cancer. While chemotherapy is a powerful technique, it is usually accompanied by a number of side effects. Here is a list of common chemotherapy side effects and some strategies for managing them:

Weakened Immune System:

Avoid crowds, especially those with children.
Wash your hands as frequently as possible.
Prevent breaks in the skin.

Nausea and Vomiting:

Eat smaller meals more frequently.
Avoid sweets and fatty, fried foods.
Eat foods only when they are at room temperature.
Avoid strong odors.
Take anti-emetic drugs.

Diarrhea:

Drink plenty of fluids.
Avoid dairy products.
Try foods that are low in fiber such as bananas, rice, and mashed potatoes.

Constipation:

Drink plenty of fluids.
Eat high fiber foods.

Sore Mouth:

Drink plenty of fluids.
Suck on ice chips.
Chew sugarless gum or eat hard candy.
Moisten dry foods before chewing.

Fatigue:

Plan fewer activities.
Rest whenever you can.

Hair Loss:

Try cooling your scalp during chemotherapy, as this may reduce hair loss.
Ask your cancer nurse about wigs and hairpieces, if you are interested in wearing one.

Key Terminology (Treatment)

Chemotherapy: A lung cancer treatment that damages cancerous cells, causing them to stop dividing. Chemotherapy also affects normally dividing cells in the body, such as those in the skin, digestive tract and blood. For this reason, a patient may become quite ill as a result of chemotherapy treatment.

Immunotherapy: A cancer treatment that is still under development, immunotherapy causes a body's immune system to react against foreign, cancerous cells.

Lobectomy: The lungs are divided into separate sections or "lobes." The left lung has two lobes and the right lung has three lobes. During a lobectomy a surgeon will remove an entire lobe of a patient's lung.

Pneumonectomy: The removal of an entire lung from the body of a cancer patient. Performed if the procedure may halt the spread of cancer.

Radiation Therapy: A treatment used to target cancer in specific areas of the body. Radiation therapy can be performed internally or externally and is usually used in combination with chemotherapy or surgery.

Systemic Treatment: Treatment to destroy or weaken cancer cells that may have spread to other parts of the body.