Lung Cancer

Lung Cancer

Lung cancer does not usually cause symptoms until it has spread. Although early detection is key to improving the chances of survival of a lung cancer patient, only high-risk individuals (such as smokers) may be eligible for screening due to safety reasons. At Baptist Health System in San Antonio, Texas, our lung cancer program aims to provide potentially life-saving opportunities for current and former smokers.

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What is Lung Cancer?

Lung cancer is the leading cause of cancer deaths in the US. Lung cancer occurs when cells in the lung mutate or change. They can grow uncontrollably and clump into a tumor that destroys surrounding healthy lung tissues. Lung cancer cells can spread to other body parts and prevent organs from properly functioning. There are two main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).

What is Small Cell Lung Cancer (SCLC)?

Small cell lung cancer (SCLC) is an aggressive lung cancer characterized by uncontrolled and rapid lung cell growth. Smoking is the major risk factor for developing SCLC. The two types of SCLC are oat cell cancer (small cell lung carcinoma) and combined small cell carcinoma or mixed large cell/small cell cancer.

What is Non-Small Cell Lung Cancer (NSCLC)?

Non-small cell lung cancer (NSCLC) is more common, taking up 80 percent of lung cancer cases. It usually grows and spreads more slowly than SCLC. NSCLC types are:

  • Adenocarcinoma lung cancer – often found in the lung’s outer area, adenocarcinoma develops in the epithelial tissue cells that line the surfaces and cavities of the body and form glands
  • Squamous cell carcinoma – found in the lung’s center next to a bronchus (air tube)
  • Large cell carcinoma – can develop in any part of the lung and tends to spread and grow faster than the first two NSCLC types

Other Types of Lung Cancer

  • Superior sulcus tumor – also known as Pancoast tumor, this rare lung cancer type grows in the lung’s upper part and interferes with the surrounding structures
  • Lung carcinoid tumor – very rare and tends to grow slower than other lung cancer types

Lung Cancer Stages

After a lung cancer diagnosis, the extent of cancer cells spreading in the body can be described using the following lung cancer stages:

  • Stage 0 (carcinoma in situ) – Abnormal cells are detected and may develop into cancerous cells
  • Localized – Cancer stays in one place
  • Regional – Cancer has spread to tissues nearby
  • Distant – Cancer has reached other internal organs and parts of the body
  • Late-stage (metastatic) lung cancer – Cancer has spread to other areas of the body

Doctors usually describe the progress of NSCLC using a four-stage system:

  • Stage 1 – Cancer stays only in the lungs
  • Stage 2 – Cancer has extended to lymph nodes nearby
  • Stage 3 – Cancer has reached other chest lymph nodes
  • Stage 4 – Cancer has spread to other body parts, two lungs or both

SCLC has two stages:

  • Limited stage disease – potentially treatable in about 20-25 percent of people with SCLC
  • Extensive stage disease – more challenging to treat

Classifying a lung cancer stage can provide doctors with information needed to plan treatment.

What Causes Lung Cancer?

How do you get lung cancer? Various factors can cause mutations in lung cancer cells, permanently altering their DNA sequence. Inhaling dangerous and toxic substances may cause lung cancer. If you have been exposed to any of the substances below, talk to our lung doctors:

If you have immediate family or close relatives with a history of lung cancer, it may increase your risk of developing the disease. Mention this to your lung doctor so you can be assessed appropriately.

Drinking water with high arsenic levels can increase a person’s risk of lung cancer.

Two extensive studies found that smokers who take beta carotene supplements had an increased risk of lung cancer. Based on these results, these studies suggested that people who smoke should not take these supplements.

The air we breathe may contain very tiny liquid and solid particles that increase our risk of lung cancer.

Radon exposure is the second-leading cause of lung cancer. Radon is a naturally occurring odorless, colorless radioactive gas found in soil and can enter structures through small cracks and gaps. One in fifteen homes in the US is exposed to radon.

Working with materials such as arsenic, asbestos, cadmium, nickel, chromium, uranium and some petroleum products can be dangerous to lung health.

Smoking is the top cause of lung cancer, making up about 90 percent of lung cancer cases. Cigarette smoke has chemicals that can cause cancer in the lungs. Nonsmokers also risk lung cancer if they breathe in secondhand smoke.

What Are the Signs of Lung Cancer?

How do you know if you have lung cancer? Many people may not display symptoms of lung cancer until this disease is in its advanced stages. A tumor could grow in the lungs without causing discomfort or pain since these organs have very few nerve endings. Signs and symptoms of lung cancer are different among people but may include:

  • A persistent cough that gets worse
  • Constant chest pain
  • Coughing up blood
  • Frequent lung infections such as pneumonia or bronchitis
  • Hoarseness
  • Wheezing or shortness of breath

Other lung cancer symptoms that are not related to breathing or lung problems include:

  • Appetite loss
  • Blood clots
  • Fractures or bone pain
  • Headaches
  • Weight loss

Consult with one of our lung cancer doctors in San Antonio, TX if you experience any of these symptoms.

Lung Cancer Risk Factors

The following may increase a person’s risk of developing lung cancer:

  • Smoking
  • Secondhand smoke
  • Radon exposure
  • Asbestos exposure
  • Exposure to carcinogens such as radioactive chemicals and diesel exhaust
  • Certain dietary supplements
  • Intaking arsenic
  • Air pollution
  • Family history of lung cancer

Lung Cancer Screening

Doctors may recommend yearly lung cancer screening to adults with a history of smoking that may show few or no symptoms. A low-dose CAT or CT scan (LDCT) can help doctors find lung abnormalities like cancer. It can detect even the smallest nodules, making it a great tool for catching lung cancer at its early, treatable stage. Lung cancer detected early may be treated with minimally invasive surgery.

LDCT is fast, non-invasive, painless and does not require contrast material. No radiation will remain in your body after the exam. To perform the LDCT, the technologist will ask you to lie on your back on the CT exam bed. You may use pillows and straps to remain still and maintain the correct position during the exam. Listen as your technologist instructs you to raise your arms over your head and hold your breath as your bed moves through the machine. Each scan may last five to ten seconds.

Who is Eligible?

Screening criteria are based on the National Comprehensive Cancer Network guidelines, which consider the following individuals to be at risk:

  • Current or former smokers ages 55 to 77 showing no signs or symptoms of lung cancer, who have a history of smoking one pack a day for at least 30 years OR current or former smokers with a history of smoking two packs a day for at least 15 years
  • A former smoker that quit within the last 15 years
  • People over 50 years of age and above with a history of smoking one pack a day for at least 20 years and have one of the following risk factors:
    • COPD or pulmonary fibrosis
    • Radon exposure
    • Occupational exposure to asbestos, silica, cadmium, arsenic, beryllium, chromium, diesel fumes or nickel
    • Personal or family history of cancer

Lung cancer screening is not recommended for people with a low risk of developing lung cancer due to the following risks:

  • A chance for a false-positive result
  • Overdiagnosis wherein a lung cancer screening finds a tumor that does not cause or has never caused a problem for the patient
  • Healthy people may develop cancer from repeated exposure to radiation in LDCT tests

Is Lung Cancer Curable?

Before treatment, a doctor will perform a biopsy, a test of sample tissue taken from the body. A biopsy can help determine the presence of cancer and its type. Medical imaging will be used to determine the tumor stage because this will be one of the bases for cancer treatment.

Patients may undergo cardiac and pulmonary function tests to determine if they can tolerate surgery. Blood tests can also help determine if a patient can tolerate immunotherapy, targeted therapy or chemotherapy.

Lung cancer treatment will depend on the type of lung cancer. People with SCLC can be treated with chemotherapy and radiation therapy. On the other hand, patients with NSCLC can be treated by any or a combination of the following:

  • Chemotherapy – Makes use of particular drugs to kill or shrink cancer. These medications can be taken orally, intravenously (via veins) or both.
  • Radiation therapy – The use of high-energy rays to eliminate cancer.
  • Surgery – Doctors cut out cancerous tissue.
  • Targeted therapy – The use of medications to prevent cancer cells from growing and spreading. These drugs can be taken intravenously or orally.

A lung cancer patient will undergo tests to determine which treatment is suitable for their cancer type. Other treatment options include:

  • Immunotherapy
  • Clinical trials
  • Lung cancer palliative care
  • Alternative and complementary lung cancer therapies

How to Quit Smoking: Resources" below Lung Cancer Stories

About Your Lung Cancer Team at Baptist Health System

We provide a high-quality, multi-disciplinary collaboration of area physicians and healthcare resources to provide a well-coordinated lung cancer treatment program. In addition to the below, we offer a dedicated nurse navigator to help you manage your cancer treatment journey.

Your team may consist of:

A medical oncologist is an internal medicine physician with additional specialty training in cancer patient management. Medical oncologists help plan the optimal treatment sequence for individuals and are responsible for long-term follow-ups and surveillance of cancer status.

A radiologist is a physician trained in interpreting imaging studies of the body, such as x-rays, CT scans, MRIs and PET scans. Radiologists play an essential role in properly staging, follow-up and measuring a patient's response to cancer therapy.

A pulmonologist is an internal medicine physician specializing in diagnosing and treating lung and respiratory diseases. Pulmonologists are a key component in optimizing lung health for our patients before and after cancer therapy.

Thoracic surgeons have additional specialty training in the chest surgery of the lung, esophagus, and other internal organs.

An Oncology Nurse Navigator can assist with many aspects of the cancer treatment journey, from providing patient education to assisting with the coordination of care. Learn more about our Oncology Nurse Navigators here.

A pathologist is a physician specialist who confirms a cancer tissue diagnosis and determines the disease's characteristics in a patient. Pathologists share information with the treatment team about what type of cancer the patient has and how it may behave.

A radiation oncologist is a physician specialist with expertise in radiation therapy. Many applications of radiation therapy require careful planning and coordination with other treatments. The goal is to optimize the benefit of radiation therapy for cancer patients.

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