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NIH MedlinePlus the Magazine, Trusted Health Information from the National Institutes of Health

Feature:
Lung Cancer

Lung Cancer: Symptoms, Diagnosis, Treatments & Research

Symptoms

Person receiving chest xray

X-ray of the chest. X-rays are used to take pictures of organs and bones of the chest. X-rays pass through the patient onto film.
Photo:2007 Terese Winslow U.S. Government has certain rights

Possible signs of non-small cell lung cancer include a cough that doesn't go away and shortness of breath. Check with your doctor or other health professional if you have any of the following problems:

  • Chest discomfort or pain.
  • A cough that doesn't go away or gets worse over time.
  • Trouble breathing.
  • Wheezing.
  • Blood in sputum (mucus coughed up from the lungs).
  • Hoarseness.
  • Loss of appetite.
  • Weight loss for no known reason.
  • Feeling very tired.
  • Trouble swallowing.
  • Swelling in the face and/or veins in the neck.

Diagnosis

Tests that examine the lungs are used to detect (find), diagnose, and stage non-small cell lung cancer. Tests and procedures to detect, diagnose, and stage non-small cell lung cancer are often done at the same time. Some of the following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits, including smoking, and past jobs, illnesses, and treatments will also be taken.
  • Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.
  • Chest X-ray: An X-ray of the organs and bones inside the chest. An X-ray is a type of energy beam that can go through the body, making a picture of areas inside the body.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, taken from different angles. The pictures are made by a computer linked to an X-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • Lung biopsy. The patient lies on a table that slides through the computed tomography (CT) machine, which takes X-ray pictures of the inside of the body. The X-ray pictures help the doctor see where the abnormal tissue is in the lung. A biopsy needle is inserted through the chest wall and into the area of abnormal lung tissue. A small piece of tissue is removed through the needle and checked under the microscope for signs of cancer.
  • Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.

Treatments

Certain factors affect prognosis (chance of recovery) and treatment options.

  • The stage of the cancer (the size of the tumor and whether it is in the lung only or has spread to other places in the body).
  • The type of lung cancer.
  • Whether there are symptoms such as coughing or trouble breathing.
  • The patient's general health.

For patients with advanced non-small cell lung cancer, current treatments do not cure the cancer. The treatment that's right for you depends mainly on the type and stage of lung cancer. You may receive more than one type of treatment.

Surgery

Surgery may be an option for people with early-stage lung cancer. The surgeon usually removes only the part of the lung that contains cancer. Most people who have surgery for lung cancer will have the lobe of the lung that contains the cancer removed. This is a lobectomy. In some cases, the surgeon will remove the tumor along with less tissue than an entire lobe, or the surgeon will remove the entire lung. The surgeon also removes nearby lymph nodes.

man receiving radiation therapy

Man receiving radiation therapy for lung cancer

Radiation Therapy

Radiation therapy is an option for people with any stage of lung cancer:

  • People with early lung cancer may choose radiation therapy instead of surgery.
  • After surgery, radiation therapy can be used to destroy any cancer cells that may remain in the chest.
  • In advanced lung cancer, radiation therapy may be used with chemotherapy.

The NCI booklet Radiation Therapy and You (www.cancer.gov/cancertopics/coping/radiation-therapy-and-you) has helpful ideas for coping with radiation therapy side effects.

Chemotherapy

Chemotherapy may be used alone, with radiation therapy, or after surgery.

Chemotherapy uses drugs to kill cancer cells. The drugs for lung cancer are usually given directly into a vein (intravenously) through a thin needle. Newer chemotherapy methods, called targeted treatments, are often given as a pill that is swallowed.

You'll probably receive chemotherapy in a clinic or at the doctor's office. People rarely need to stay in the hospital during treatment.

The side effects depend mainly on which drugs are given and how much. Chemotherapy kills fast-growing cancer cells, but the drugs can also harm normal cells that divide rapidly:

  • When drugs lower the levels of healthy blood cells, you're more likely to get infections, bruise or bleed easily, and feel very weak and tired.
  • Chemotherapy may cause hair loss. If you lose your hair, it will grow back after treatment, but the color and texture may be changed.
  • Chemotherapy can cause a poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Your healthcare team can give you medicines and suggest other ways to help with these problems.

The NCI booklet Chemotherapy and You (www.cancer.gov/cancertopics/coping/chemotherapy-and-you) has helpful ideas for coping with chemotherapy side effects.

Targeted Therapy

People with non-small cell lung cancer that has spread may receive a type of treatment called targeted therapy. Several kinds of targeted therapy are used for non-small cell lung cancer. One kind is used only if a lab test on the cancer tissue shows a certain gene change. Targeted therapies can block the growth and spread of lung cancer cells.

Depending on the kind of drug used, targeted therapies for lung cancer are given intravenously or by mouth.

Lung Cancer Research

  • The large-scale National Lung Screening Trial, supported by the National Cancer Institute (NCI), has shown that screening current or former heavy smokers with low-dose helical computed tomography (CT) decreases the risk of dying from lung cancer. That finding was only for heavy smokers.
  • Another recent study showed that low-dose nicotine does not enhance lung cancer development. This suggests that nicotine replacement therapy is safe for former smokers.
  • Results of a 2011 research trial revealed that annual chest X-ray screening of people ages 55 to 74 years does not reduce lung cancer deaths compared with usual care.
  • Researchers have identified genetic regions that predispose Asian women who've never smoked to lung cancer. The finding provides evidence that lung cancer between smokers and never-smokers can differ on a fundamental level.

Winter 2013 Issue: Volume 7 Number 4 Page 6-7