Lung Cancer Key Facts

• Lung cancer is the number one cause of cancer deaths in both men and women in the U.S. and worldwide.
• Cigarette smoking is the principal risk factor for development of lung cancer.
• Passive exposure to tobacco smoke also can cause lung cancer.
• The two types of lung cancer, which grow and spread differently, are the small cell lung cancers (SCLC) and non-small cell lung cancers (NSCLC).
• The stage of lung cancer refers to the extent to which the cancer has spread in the body.
• Treatment of lung cancer can involve a combination of surgery, chemotherapy, and radiation therapy as well as newer experimental methods.
• The general prognosis of lung cancer is poor because doctors tend not to find the disease until it is at an advanced stage. Five-year survival is 40% to 50% for early stage lung cancer, but only 1% to 5% in advanced, inoperable lung cancer.
• Smoking cessation is the most important measure that can prevent the development of lung cancer.

Mortality

• Lung cancer is the leading cancer killer in both men and women in the United States. In 1987, it surpassed breast cancer to become the leading cause of cancer deaths in women.1

• Lung cancer causes more deaths than the next three most common cancers combined (colon, breast and pancreatic). An estimated 159,260 Americans are expected to die from lung cancer in 2014, accounting for approximately 27 percent of all cancer deaths.2

• The number of deaths due to lung cancer has increased approximately 4.3 percent between 1999 and 2010 from 152,156 to 158,318. The number of deaths among men has reached a plateau but the number is still rising among women. In 2010, there were 87,740 deaths due to lung cancer in men and 70,578 in women.3

• The age-adjusted death rate for lung cancer is higher for men (60.3 per 100,000 persons) than for women (38.1 per 100,000 persons). It also is higher for Blacks (51.4 per 100,000 persons) compared to Whites (48.3 per 100,000 persons). Black men have a far higher age-adjusted lung cancer death rate than White men, while Black and White women have similar rates.3

Prevalence and Incidence

• Approximately 399,431 Americans are living with lung cancer.4 During 2014, an estimated 224,210 new cases of lung cancer were expected to be diagnosed, representing about 13 percent of all cancer diagnoses.2

• The majority of living lung cancer patients have been diagnosed within the last five years. Lung cancer is mostly a disease of the elderly. In 2010, 82 percent of those living with lung cancer were 60 years of age or older.4

• In 2010, Kentucky had the highest age-adjusted lung cancer incidence rates in both men (121.7 per 100,000) and women (79.6 per 100,000). Utah had the lowest age-adjusted cancer incidence rates in both men and women (30.5 per 100,000 and 23.6 per 100,000, respectively).5 These state-specific rates were parallel to smoking prevalence rates.

• Lung cancer is the most common cancer worldwide, accounting for 1.37 million deaths annually. Cancer accounted for 7.6 million deaths annually, or about 13 percent of the total worldwide deaths.6

• The National Institutes of Health estimate that cancer care cost the United States an overall $124.6 billion in 2010, $12.1 billion of which is due to lung cancer. Lost productivity due to early death from cancer lead to an additional $134.8 billion in 2005, $36.1 billion of which was due to lung cancer.7

Gender Differences

• Each year more men are diagnosed with lung cancer, but more women are living with the disease. The rate of new cases in 2010 showed that men develop lung cancer more often than women (66.8 and 49.2 per 100,000 respectively).4

• The rate of new lung cancer cases (incidence) over the past 36 years has dropped for men (24% decrease), while it has risen for women (100% increase). In 1975, rates were low for women, but rising for both men and women. In 1984, the rate of new cases for men peaked (102.1 per 100,000) and then began declining. The rate of new cases for women increased further, did not peak until 1998 (52.9 per 100,000), and has now started to decline.4

Racial/Ethnic Differences

• Blacks are more likely to develop and die from lung cancer than persons of any other racial or ethnic group. The age-adjusted lung cancer incidence rate among Black men is approximately 26 percent higher than for White men, even though their overall exposure to cigarette smoke, the primary risk factor for lung cancer, is lower.4,8

• The lung cancer incidence rate for Black women is roughly equal to that of White women, despite the fact that they smoke fewer cigarettes.4,8

Survival Rates

• The lung cancer five-year survival rate (16.6%) is lower than many other leading cancer sites, such as the colon (64.2%), breast (89.2%) and prostate (99.2%).4

• The five-year survival rate for lung cancer is 53.5 percent for cases detected when the disease is still localized (within the lungs). However, only 15 percent of lung cancer cases are diagnosed at an early stage. For distant tumors (spread to other organs) the five-year survival rate is only 3.9 percent.4

• Over half of people with lung cancer die within one year of being diagnosed.4

Smoking-Attributable Lung Cancer

• Smoking, a main cause of small cell and non-small cell lung cancer, contributes to 80 percent and 90 percent of lung cancer deaths in women and men, respectively. Men who smoke are 23 times more likely to develop lung cancer. Women are 13 times more likely, compared to never smokers.9

• Between 2005 and 2010, an average of 130,659 Americans (74,300 men and 56,359 women) died of smoking-attributable lung cancer each year. Exposure to secondhand smoke causes approximately 7,330 lung cancer deaths among nonsmokers every year.10

• Nonsmokers have a 20-30 percent greater chance of developing lung cancer if they are exposed to secondhand smoke at home or work.11

Other Causes

• It has been estimated that active smoking is responsible for close to 90 percent of lung cancer cases; radon causes 10 percent, occupational exposures to carcinogens account for approximately 9 to 15 percent and outdoor air pollution 1 to 2 percent. Because of the interactions between exposures, the combined attributable risk for lung cancer can exceed 100 percent.12

• Exposure to radon is estimated to be the second leading cause of lung cancer, accounting for an estimated 21,000 lung cancer deaths each year (range of 8,000 to 45,000). Radon is a tasteless, colorless and odorless gas that is produced by decaying uranium and occurs naturally in soil and rock. The majority of these deaths occur among smokers since there is a greater risk for lung cancer when smokers also are exposed to radon.13

• Lung cancer can also be caused by occupational exposures, including asbestos, uranium, and coke (an important fuel in the manufacture of iron in smelters, blast furnaces, and foundries). The combination of asbestos exposure and smoking greatly increases the risk of developing lung cancer.14

• Nonsmoking asbes­tos workers are five times more likely to develop lung cancer than non­smokers not ex­posed to asbestos; if they also smoke, the risk factor jumps to 50 or higher.12 Environmental exposures also can increase the risk of lung cancer death.15

Source:http://www.lung.org/

How is lung cancer treated?

Lung cancer treatments depend on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. As there is usually no single treatment for cancer, patients often receive a combination of therapies and palliative care. The main lung cancer treatments are surgery, chemotherapy, and/or radiation. However, there also have been recent developments in the fields of immunotherapy, hormone therapy, and gene therapy.

Surgery

Surgery is the oldest known treatment for cancer. If a cancer is in stage I or II and has not metastasized, it is possible to completely cure a patient by surgically removing the tumor and the nearby lymph nodes. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells.

Lung cancer surgery is performed by a specially trained thoracic surgeon. After removing the tumor and the surrounding margin of tissue, the margin is further studied to see if cancer cells are present. If no cancer is found in the tissue surrounding the tumor, it is considered a "negative margin." A "positive margin" may require the surgeon to remove more of the lung tissue.

Lung cancer surgery can be curative or palliative. Curative surgery aims to cure a patient with early stage lung cancer by removing all of the cancerous tissue. Palliative surgery aims to remove an obstruction or open an airway, making the patient more comfortable but not necessarily removing the cancer.

Surgery carries side effects - most notably pain and infection. Lung cancer surgery is an invasive procedure that can cause harm to the surrounding body parts. Doctors will usually provide several options for alleviating any pain from surgery. Antibiotics are commonly used to prevent infections that may occur at the site of the wound or elsewhere inside the body.

Radiation

Radiation treatment, also known as radiotherapy, destroys or shrinks lung cancer tumors by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Radiotherapy utilizes high-energy gamma-rays that are emitted from metals such as radium or high-energy x-rays that are created in a special machine. Radiation can be used as the main treatment for lung cancer, to kill remaining cells after surgery, or to kill cancer cells that have metastasized.

Source:http://www.medicalnewstoday.com/

What are the symptoms of lung cancer? How is lung cancer diagnosed and staged?

Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumor is. Lung cancer symptoms may take years before appearing, usually after the disease is in an advanced stage.

Many symptoms of lung cancer affect the chest and air passages. These include:

• Persistent or intense coughing
• Pain in the chest shoulder, or back from coughing
• Changes in color of the mucus that is coughed up from the lower airways (sputum)
• Difficulty breathing and swallowing
• Hoarseness of the voice
• Harsh sounds while breathing (stridor)
• Chronic bronchitis or pneumonia
• Coughing up blood, or blood in the sputum

If the lung cancer spreads, or metastasizes, additional symptoms can present themselves in the newly affected area. Swollen or enlarged lymph nodes are common and likely to be present early. If cancer spreads to the brain, patients may experience vertigo, headaches, or seizures. In addition, the liver may become enlarged and cause jaundice and bones can become painful, brittle, and broken. It is also possible for the cancer to infect the adrenal glands resulting in hormone level changes.

As lung cancer cells spread and use more of the body's energy, it is possible to present symptoms that may also be associated with many other ailments. These include:

• Fever
• Fatigue
• Unexplained weight loss
• Pain in joints or bones
• Problems with brain function and memory
• Swelling in the neck or face
• General weakness
• Bleeding and blood clots

How is lung cancer diagnosed and staged?

Physicians use information revealed by symptoms as well as several other procedures in order to diagnose lung cancer. Common imaging techniques include chest X-rays, bronchoscopy (a thin tube with a camera on one end), CT scans, MRI scans, and PET scans.

Physicians will also conduct a physical examination, a chest examination, and an analysis of blood in the sputum. All of these procedures are designed to detect where the tumor is located and what additional organs may be affected by it.

Although the above diagnostic techniques provided important information, extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose lung cancer. This procedure is called a biopsy. If the biopsy confirms lung cancer, a pathologist will determine whether it is non-small cell lung cancer or small cell lung cancer.

After a diagnosis is made, an oncologist will determine the stage of the cancer by finding out how far the cancer has spread. The stage determines which choices will be available for treatment and informs prognosis. The most common cancer staging method is called the TNM system. T (1-4) indicates the size and direct extent of the primary tumor, N (0-3) indicates the degree to which the cancer has spread to nearby lymph nodes, and M (0-1) indicates whether the cancer has metastasized to other organs in the body. A small tumor that has not spread to lymph nodes or distant organs may be staged as (T1, N0, M0), for example.

For non-small cell lung cancer, TNM descriptions lead to a simpler categorization of stages. These stages are labeled from I to IV, where lower numbers indicate earlier stages where the cancer has spread less. More specifically:

• Stage I is when the tumor is found only in one lung and in no lymph nodes.
• Stage II is when the cancer has spread to the lymph nodes surrounding the infected lung.
• Stage IIIa is when the cancer has spread to lymph nodes around the trachea, chest wall, and diaphragm, on the same side as the infected lung.
• Stage IIIb is when the cancer has spread to lymph nodes on the other lung or in the neck.
• Stage IV is when the cancer has spread throughout the rest of the body and other parts of the lungs.

Small cell lung cancer has two stages: limited or extensive. In the limited stage, the tumor exists in one lung and in nearby lymph nodes. In the extensive stage, the tumor has infected the other lung as well as other organs in the body.

Source:http://www.medicalnewstoday.com/

What causes lung cancer & its classification?

Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide. This leads to a mass of abnormal cells that grows out of control.

Lung cancer occurs when a lung cell's gene mutation makes the cell unable to correct DNA damage and unable to commit suicide. Mutations can occur for a variety of reasons. Most lung cancers are the result of inhaling carcinogenic substances.

Carcinogens

Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. These free radicals damage cells and affect their ability to function and divide normally.

About 87% of lung cancers are related to smoking and inhaling the carcinogens in tobacco smoke. Even exposure to second-hand smoke can damage cells so that cancer forms.

Genes

Cancer can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life. Genetic predispositions are thought to either directly cause lung cancer or greatly increase one's chances of developing lung cancer from exposure to certain environmental factors.

How is lung cancer classified?

Lung cancer can be broadly classified into two main types based on the cancer's appearance under a microscope: non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer (NSCLC) accounts for 80% of lung cancers, while small cell lung cancer accounts for the remaining 20%.

NSCLC can be further divided into four different types, each with different treatment options:

• Squamous cell carcinoma or epidermoid carcinoma. As the most common type of NSCLC and the most common type of lung cancer in men, squamous cell carcinoma forms in the lining of the bronchial tubes.
• Adenocarcinoma. As the most common type of lung cancer in women and in nonsmokers, adenocarcinoma forms in the mucus-producing glands of the lungs.
• Bronchioalveolar carcinoma. This type of lung cancer is a rare type of adenocarcinoma that forms near the lungs' air sacs.
• Large-cell undifferentiated carcinoma. A rapidly growing cancer, large-cell undifferentiated carcinomas form near the outer edges or surface of the lungs.

Small cell lung cancer (SCLC) is characterized by small cells that multiply quickly and form large tumors that travel throughout the body. Almost all cases of SCLC are due to smoking.

Source:http://www.medicalnewstoday.com/

What Is Lung Cancer?

Lung cancer is the uncontrolled growth of abnormal cells that start off in one or both lungs; usually in the cells that line the air passages. The abnormal cells do not develop into healthy lung tissue, they divide rapidly and form tumors. As tumors become larger and more numerous, they undermine the lung’s ability to provide the bloodstream with oxygen. Tumors that remain in one place and do not appear to spread are known as “benign tumors”.

Malignant tumors, the more dangerous ones, spread to other parts of the body either through the bloodstream or the lymphatic system. Metastasis refers to cancer spreading beyond its site of origin to other parts of the body. When cancer spreads it is much harder to treat successfully.

Primary lung cancer originates in the lungs, while secondary lung cancer starts somewhere else in the body, metastasizes, and reaches the lungs. They are considered different types of cancers and are not treated in the same way.

According to the National Cancer Institute, by the end of 2012 there will have been 226,160 new lung cancer diagnoses and 160,340 lung-cancer related deaths in the USA.

According to the World Health Organization (WHO), 7.6 million deaths globally each year are caused by cancer; cancer represents 13% of all global deaths. As seen below, lung cancer is by far the number one cancer killer.

Total deaths worldwide caused by cancer each year:

• Lung cancer - 1,370,000 deaths
• Stomach cancer - 736,000 deaths
• Liver cancer - 695,000 deaths
• Colorectal cancer - 608,000 deaths
• Breast cancer - 458,000 deaths
• Cervical cancer - 275,000 deaths

The American Cancer Society says that lung cancer makes up 14% of all newly diagnosed cancers in the USA today. It adds that annually, more patients die from lung cancer alone than prostate, breast and colon cancers combined (in the USA). An American man’s lifetime risk of developing lung cancer is 1 in 13; for a woman the risk is 1 in 16. These risk figures are for all US adults, including smokers, ex-smokers and non-smokers. The risk for a regular smoker is dramatically higher.

Most lung cancer patients are over the age of 60 years when they are diagnosed. Lung cancer takes several years to reach a level where symptoms are felt and the sufferer decides to seek medical help.

Female lung cancer rates set to rise rapidly

Over the next three decades, female lung cancers will increase thirty-five times faster than male lung cancers, scientists from King’s College London reported in October 2012.

In the UK, female lung cancer deaths will reach 95,000 annually in 2040, from 26,000 in 2010 – a rise of more than 350%. Male annual lung cancer deaths will increase by 8% over the same period, to 42,000 in 2040 from 39,000 in 2010.

The authors of the report say that lung cancer will continue being the largest cancer killer over the next thirty years. Twice as many people will be living with lung cancer in 2040 compared to 2010. The main reason for the increase will be longer lifespans - the older you are, the higher your risk of cancer is, including lung cancer.

Source:http://www.medicalnewstoday.com/

Which cancers spread where?

This is a brief description of where certain cancers are most likely to spread. It’s not a list of every place where a cancer could spread. For more details on these cancers, see our information on the specific cancer site.

Bladder

Bladder cancer tends to stay in the same area (the pelvis) and grow into nearby tissues such as the pelvic wall. It can also spread to the lungs, liver, and bone.

Brain

Brain tumors rarely spread outside the brain. They mainly grow within the brain and sometimes into the spinal cord.

Breast

Breast cancer most commonly spreads to the bones, but also can spread to the liver, lungs, and brain. As the cancer progresses, it may affect any organ. It can also spread to the skin of the chest (near where the cancer started).

Cervix

Cancer of the cervix tends to grow near where it started, into the vagina and uterus and then other parts of the pelvis, such as the rectum and bladder. It can also grow into the bones and nerves of the spine, and spread to the liver, lungs, and bones.

Colon and rectum

The most common sites for colon or rectal cancer spread are the liver and lungs. These cancers may also spread to nearly any other organ, including the bones and brain.

Rectal cancer can also spread within in the pelvis, where the cancer started. This can be painful because it often grows into nerves and bones in this area.

Esophagus

Esophageal cancer mostly grows near where it started (in the chest and belly). As it progresses, it may grow into nearby organs or major blood vessels, which can make it hard to treat.

Kidney

Kidney (renal) cancer can grow where it started and invade nearby tissues. It can grow from the kidney into the large vein that drains the blood from the kidney (the renal vein). From there it can grow into a large vein that empties into the heart (the inferior vena cava). It can also grow from the kidney into the adrenal gland, which sits on top of the kidney. When it spreads, the lungs and bones are the most common sites.

Leukemia

Because they are already in the blood, leukemias can be considered to have spread throughout the body when they are diagnosed. They can progress by filling the bone marrow with leukemia cells. The normal bone marrow is replaced and cannot make new blood cells.

Some leukemias may spread outside the blood and into the fluid that surrounds the brain and spinal cord. Tumors made up of leukemia cells can also occur in the skin or in other parts of the body, but this is not common. In some types of leukemia, the cancer cells collect in the spleen, causing it to become large. Less often, leukemia cells settle in the liver, causing it to enlarge. In one type of leukemia, the cells deposit in the gums, so that they become red and swollen.

Liver

Liver cancer doesn't often spread outside the liver. It tends to grow throughout the liver as it becomes advanced. If it does spread, it’s most often to the lungs or bones.

Lung

Lung cancer can spread to almost any organ of the body, but most often it will spread to the adrenal glands, liver, bones, or brain. It can also spread to the other lung.

Lymphoma

Lymphoma can affect any part of the body. While most start in the lymph nodes, spleen, and/or bone marrow, some start in lymph tissue in the stomach, intestines, or even the eye socket. Lymphomas can spread within the lymph system to distant parts of the body. Less often, they spread outside the lymph system to other organs, such as the lungs, liver, or bone. Lymphomas can affect the brain and spinal cord, either initially (called primary central nervous system lymphoma) or as spread to the fluid and tissues (the meninges) surrounding the brain and spinal cord. This is called lymphomatous meningitis.

Melanoma

Melanoma can spread anywhere in the body. It first tends to go to lymph nodes near where it started, but then can spread to the brain, lungs, liver, and bones. It can also spread to other areas of skin.

Mouth and throat

Cancers of the mouth, throat, or nasal passages tend to stay in the same area. When they spread, it’s usually to the lungs. Less often they may spread to the liver or bones.

Multiple myeloma

Multiple myeloma can cause tumors called plasmacytomas. These tumors can spread to the bones anywhere in the body, but they rarely spread to other organs.

Ovary

Ovarian cancer most often spreads to the lining of the abdomen (belly) and pelvis (this lining is called the peritoneum), the omentum (a layer of connective tissue that drapes the abdominal cavity like an apron), and organs in the pelvis and belly. It can cause a build-up of fluid and swelling in the abdomen. It can also spread to the outer lining of the lungs and cause fluid to build up there. As it becomes more advanced, it may spread to the lung and liver, or, rarely, to the brain or skin.

Pancreas

Pancreatic cancer mainly stays in the abdomen (belly). It tends to grow into nearby tissues and may spread to the liver or other nearby organs. It can also spread to the lungs.

Prostate

Advanced prostate cancer most often goes to the bones. Much less often, it will spread to other organs, including the lungs and liver.

Stomach

Stomach (gastric) cancer tends to spread to nearby tissues and stay within the abdomen (belly). It may also spread to the liver or distant lymph nodes. Spread to the lungs, bones, and brain is less common.

Uterus

Cancer that starts in the uterus can grow into the vagina as well as nearby tissues in the pelvis. It also commonly spreads to the peritoneum (the lining of the abdominal cavity and pelvis) and the omentum (a layer of connective tissue that drapes the abdominal cavity like an apron). Other sites of cancer spread include the liver, lungs, and, less often, bones.

Source:www.cancer.org