Lung Cancer


Lung cancer is the uncontrolled growth of abnormal cells in one or both lungs. These abnormal cells do not carry out the functions of normal cells and do not develop into healthy lung tissue. As they grow, the abnormal cells can form tumors and impede the function of the lung, which is to provide oxygen to the body via the blood.

The signs and symptoms of lung cancer can take years to develop and they may not appear until the disease is advanced.
Some symptoms of lung cancer include:

  • Coughing, especially persistent or intense cough
  • Pain in the chest, shoulder, or back unrelated to pain from coughing
  • A change in color or volume of sputum
  • Shortness of breath
  • Changes in the voice or being hoarse
  • Harsh sounds with each breath (stridor)
  • Recurrent lung problems, such as bronchitis or pneumonia
  • Coughing up phlegm or mucus, especially if it is tinged with blood
  • Coughing up blood

If the original lung cancer has spread, a person may feel symptoms in other places in the body. Common places for lung cancer to spread include other parts of the lungs, lymph nodes, bones, brain, liver, and adrenal glands.
Some symptoms of lung cancer that may have spread elsewhere in the body:

  • Loss of appetite or unexplained weight loss
  • Muscle wasting (also known as cachexia)
  • Fatigue
  • Headaches, bone or joint pain
  • Bone fractures not related to accidental injury
  • Neurological symptoms, such as unsteady gait or memory loss
  • Neck or facial swelling
  • General weakness
  • Bleeding
  • Blood clots

Any unusual symptoms should be reported to your doctor.

If your physician believes you should be screened for lung cancer and refers you to Good Samaritan, he or she has a number of tests to choose from that can help determine if cancer is present. The information from these diagnostic tests enables the physician and your cancer team to determine the type and stage of the cancer, as well as the best way to treat it.
Tests include:

The newer imaging scans (CT, PET, and MRI) are very sensitive and can reveal cancerous growths not seen by conventional chest X-rays. Clinical trials are underway to determine the effectiveness of screening to permit the early detection of cancer based on these new advances.  Even with all the tests available, a biopsy is the only way to make a definitive diagnosis of lung cancer.

Surgery
Surgery removes a tumor and nearby lymph nodes and may offer the greatest chance for significant survival for some types of lung cancer. This is especially true for the early stage (I, II) cancers that have not spread to other parts of the body. Surgery may be the first step in treating lung cancer or it can be considered after chemotherapy and radiation.
Good Samaritan’s board certified thoracic surgeons are specially trained to perform lung cancer surgery. The surgeon will remove the tumor and a surrounding margin of tissue. This margin will be evaluated under a microscope to see if it contains any cancer cells. A "negative margin" means that no cancer is found in the tissue surrounding the tumor. A "positive margin" may require the surgeon to remove more of the lung tissue until a clear margin can be identified.
There are two possible goals of surgery:

  • Curative surgery: The removal of a tumor when it appears to be confined to one area, which means an early stage cancer. This type of surgery aims to completely remove the cancerous tumor.
  • Palliative surgery: The goal of this surgery is to make the patient more comfortable, by removing an obstruction or opening an airway.

 

Chemotherapy
Chemotherapy uses strong chemicals or drugs to eliminate cancer cells, stop their reproduction, or slow their growth. Good Samaritan’s cancer team may suggest chemotherapy in combination with surgery and radiation. The hospital’s skilled medical oncologists prescribe chemotherapy, which may be given by an oncology nurse specially trained in cancer care.
Most chemotherapy for lung cancer is given intravenously. Chemotherapy is called systemic therapy, because it treats the entire body, or system. Chemotherapy can eliminate cancer cells that have metastasized, from the original tumor, or spread.

The amount of chemotherapy a patient receives depends on the type of cancer, the drugs, and the patient's overall response to treatment. This therapy may be given daily, weekly, or monthly, and can continue for months or possibly years. Some drugs may be given in cycles, with rest periods between treatments to allow the body to recover.


Radiation Therapy
Radiation therapy may be effective for the treatment of lung cancer. Good Samaritan’s Department of Radiation Oncology uses the Varian TrueBeam system to provide high-energy rays and eliminate or shrink cancer cells. Usually, lung cancers are treated from an external source of energy.

Good Samaritan’s radiation oncologists are the physicians who administer radiation therapy. The TrueBeam focuses the radiation in precise locations in the body. This reduces the risk of damage to normal tissue surrounding the tumor. TrueBeam imaging technology can produce three-dimensional images to fine-tune tumor targeting in 60% less time using 25% less radiation than other systems.

External beam radiation (given from a source that is external, or outside, of the body) may be used as the main treatment for lung cancer for some patients. For other patients, radiation may be used after surgery to kill remaining cancer cells or to treat metastases (disease that has spread beyond the site of origin).