Lung Cancer 101: Full Overview
Updated: Jan 27
In the United States, an individual 65 years or older is considered a senior and is at a higher risk of developing disorders that become more common as you age. Lung cancer is fairly common in seniors. Roughly half of all lung cancer cases occur in seniors. Less than 0.5% of lung cancer-related deaths occur under the age of 40 years old.
Did you know: Lung cancer makes up almost 25% of all cancer deaths. Each year, more people die of lung cancer than colon, breast, and prostate cancers combined.
What is Lung Cancer?
According to the CDC, "cancer is a disease in which cells in the body grow out of control." This means that the cells in the lungs stray from their specific or "normal" growth pattern and death cycle. These changes are called mutations and can lead to uncontrolled cell division. The mutation or multiplying cells can create a tumor, neoplasm, or lesion, and in the case of lung cancer, it's called a nodule. When the origin of the nodule is in the lungs, it's called Lung Cancer. There are two main types of lung cancer; non-small cell and small cell. According to the American Cancer Society (ACS), about 13% of all lung cancers are SCLC, and 84% are NSCLC.
Did you know: About 236,000 lung cancer cases are diagnosed every year. Secondhand smoke from tobacco may cause about 7,000 lung cancer cases each year.
Lung Cancer Risk Factors
Many risk factors can increase your chances of developing lung cancer. Some of these factors you can change or avoid, and others, unfortunately, can't be avoided.
Risk Factors You Can Avoid
Smoking (number one leading cause)
Secondhand smoking (third leading cause)
Exposure to radon (second leading cause)
Risk Exposure to Asbestos
Work-related carcinogens (arsenic, beryllium, cadmium, etc.)
Risk Factors You Can't Avoid
Pollution and air quality
Exposure to radiation
Other Risk Factors
Research is still ongoing and not all studies done have found a link between cancer and the following risk factors.
Lung Cancer Tests
If you are someone who is at high risk of developing lung cancer, consider visiting your doctor to discuss possible tests and screening options. Screening offers a chance to catch cancer early on when it’s easier to treat. Noticeable symptoms of lung cancer don't arise until the later stages when the tumor gets big enough to cause problems.
When you schedule an appointment with your doctor, he/she will want to review your medical and family history. Your doctor will also examine you to look for signs of lung cancer or other health problems. If there is any indication that suggests you might have lung cancer further tests will be conducted.
Types of Lung Cancer Tests
Computed Tomography (CT) Scan
CT Guided Needle Biopsy
Magnetic Resonance Imaging (MRI) Scan
Positron Emission Tomography (PET) Scan
Types of Lung Cancer
There are two main classifications of lung cancer, non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC and SCLC have subtypes to help doctors distinguish the origin of cancer and determine the best treatment plan. NSCLC and SCLC are very different so, it is important to know which type you have to know the best treatment plan.
Non-small cell lung cancer subtypes include lung adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. Small cell lung cancer subtypes include small cell carcinoma and combined small cell carcinoma.
Other types of lung cancer include lung carcinoid tumors, typical carcinoids, and atypical carcinoids. Some cancer patients may develop a rare type of lung cancer.
Lung Cancer Stages
Every cancer patient has a unique experience. When an individual is diagnosed with lung cancer, doctors will run tests to determine if cancer has spread and how much. This process is referred to as staging.
The staging system used for lung cancer is Tumor Node Metastasis (TNM). TNM is based on identifying three important factors in establishing the severity of cancer.
Depending on the TNM findings, lung cancer may be diagnosed from stage zero to stage four. The higher the stage, the more advanced cancer.
Non-Small Cell Lung Cancer Stages
The most common way to stage an NSCLC tumor is by using the TNM system with the numbers X, 0, 1, 2, 3, or 4 after each letter. Number and letter combinations describe:
Tumor’s width (cm)
Number of tumor's
Spread of the tumor
Stage 0 Lung Cancer
The tumor is small and cancer cells haven’t spread into the deeper lung tissues or outside your lungs.
Stage 1 Lung Cancer
Stage 1 or early-stage lung cancer is when abnormal cells have developed in the lung tissue. The cancerous cells have not spread to the lymph nodes yet.
Stage I non-small-cell lung cancer can be broken down into two main subtypes. This helps doctors to determine how serious the cancer is and decide on the best treatment.
Stage IA. This stage is broken down based on the size of the tumor, If a number 1 is after the letter this means the tumor is 1 cm or smaller. If a number 2 is after the letter, this means the tumor is between 1 cm and 2 cm. A number 3 after the letter means it's between 2cm and 3 cm.
Stage IB. This stage is broken down into two categories. The tumor is between 3 cm and 4 cm. The other category is, the tumor can be any size up to 4 cm, and falls under at least one of the following:
The tumor is in the bronchus
Cancer has spread to the membrane covering the surface of your lung
Your lung has collapsed or is inflamed (pneumonitis)
Stage 2 Lung Cancer
The disease may have spread to your lymph nodes near your lungs.
Stage IIA. The tumor is between 4cm and 5 cm. It also falls under at least one of the following:
Your cancer is in the bronchus
Cancer is in the membrane that covers your lung
Your lung has collapsed
Stage IIB. Your tumor may be no bigger than 5 cm and maybe in your lymph nodes (near your lung or your airway). Or, your tumor hasn’t spread to your lymph nodes, but one of the following is true:
The tumor is between 5 cm and 7 cm
There is more than one tumor in the lobe of the lung
Cancer has reached the:
chest wall or its membranes
the nerves connected to your diaphragm
the outer layer of the sac around your heart
Stage 3 Lung Cancer
It has spread further into your lymph nodes and to the middle of your chest.
Stage IIIA. At least one tumor is in one lung and is close to or in the lymph nodes. Cancer may be in certain nearby tissues, but it hasn’t advanced to distant organs yet.
Stage IIIB. At least one tumor is located in the same lung and cancer may have spread to the lymph nodes above the collarbone and may be in lymph nodes on the opposite side of the chest. Cancer may be in certain nearby tissues but not in distant organs.
Stage IIIC. This is the most advanced stage. At least one tumor is the same lung and cancer has spread to lymph nodes above the collarbone or to lymph nodes on the opposite side of your chest. Cancer may be in the chest wall, heart, breastbone, and other nearby tissues but hasn’t spread to distant organs.
Stage 4 Lung Cancer
This is the most advanced stage. Cancer has spread widely throughout the body, such as the brain, bones, or liver. Treatment may not cure cancer, but it can slow the growth rate and help manage symptoms.
Small Cell Lung Cancer Stages
If you are diagnosed with small cell lung cancer a doctor will categorize you in one of these two main stages.
Limited stage small cell lung cancer is when the origin of the tumor is in the lungs. Cancer may spread to the lymph nodes above the collarbone or between the lungs.
The extensive stage is when cancer has spread to other parts of the body beyond the limited stage.
Lung Cancer Symptoms
Everyone is different and will experience different symptoms due to the location of the tumor and type of lung cancer. Symptoms can be related to the lungs or other parts of the body where cancer has spread or have general symptoms of not feeling well. Most people with lung cancer won't experience symptoms until the cancer is advanced. If you are at high risk of developing lung cancer, paying attention to the early warning signs is critical.
Early Warning Signs of Non-Small Cell Lung Cancer
Non-small cell lung cancer metastasizes slower than small cell lung cancer.
Common warning signs include:
A new cough that is persistent or worsens, or a change in an existing chronic cough
Coughing up blood
Chest, back, or shoulder pain that worsens during coughing, laughing, or deep breathing
Shortness of breath
Feeling tired or weak
Lung infections such as bronchitis or pneumonia that don't go away
Hoarseness or wheezing
Early Warning Signs of Small Cell Lung Cancer
Small cell lung cancer progresses quickly, and symptoms typically appear when cancer has advanced to other organs.
Early signs can include:
A cough that is persistent or worsens
Coughing up blood or rust-colored phlegm
Pain in the chest, back, or shoulders that worsens during coughing, laughing, or deep breathing
Shortness of breath
Unexplained weight loss and loss of appetite
Feeling tired or weak
Bronchitis or pneumonia (or any other infections) that reoccur
Hoarseness or wheezing
Options for Lung Cancer Treatment
Treatment options for lung cancer depend on a few things like the progression and type of cancer you have, overall health, medical history, preference, and tolerance.
Treatment options for cancer patients diagnosed with non-small cell lung cancer include surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of these treatments. Radiation therapy and chemotherapy are the more common treatment options for patients with small-cell lung cancer.
Treatment Options for Lung Cancer