Frequently Asked Questions About Lung Cancer

At the Henry Ford Cancer Institute, we provide compassionate, expert care. We’ll guide you and your family through the process, including diagnosis, treatment and follow-up care as a survivor.
Our team of doctors, surgeons, interventional pulmonologists, radiation and medical oncologists and nurses will make sure you have all the information and support you need. However, at any point during your journey of care, you may have some questions – some of which come up more frequently than others, so we’ve compiled a list of frequently asked questions and answers to get you started.

Lung Cancer Basics

• What are the different types of lung cancer?
• Is lung cancer aggressive?
• Is lung cancer caused by smoking?
• Can non-smokers develop lung cancer?
• What are the risk factors for lung cancer?

Lung Cancer Symptoms and Diagnosis

• How is lung cancer diagnosed?
• What are lung cancer symptoms?
• Can lung cancer be detected early?
• What tests are needed to stage the cancer?
• Can lung cancer show up as pneumonia?
• Can lung cancer be detected in blood work?

Lung Cancer Treatment

• Can lung cancer be cured?
• How is lung cancer treated?
• What are the side effects of treatment? (medical, surgical and radiation)
• How will lung cancer surgery affect my breath and daily life?
• When is lung cancer inoperable?
• Will lung cancer come back?

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What are the different types of lung cancer?

There are two major types of lung cancer, non-small cell lung cancer and small cell lung cancer.

• Non-small cell lung cancer: About 85 percent of all lung cancers are non-small-cell. This group includes squamous cell carcinoma, adenocarcinoma and neuroendocrine tumors.
• Small cell lung cancer: About 15 percent of all lung cancers are small cell. This type of cancer tends to grow quicker than non-small cell lung cancer.

Is lung cancer aggressive?

Small cell lung cancer tends to grow quicker than non-small cell lung cancer and, as such, is often far more aggressive. Because of the rate at which small cell lung cancer metastasizes, it is usually diagnosed after it has spread outside of the lungs.

Is lung cancer caused by smoking?

Smoking causes the majority of lung cancers, in both smokers and those exposed to secondhand smoke, but it does not cause all cases of lung cancer. Individuals who do not smoke or have never been exposed to secondhand smoke can be diagnosed with lung cancer, although, in these cases, the exact cause is not always clear.

Can non-smokers develop lung cancer?

Although smoking causes the majority of lung cancers, nearly 20% of people who die from lung cancer in the United States have never smoked or used tobacco products. Sadly, this is enough to rank this population in the top ten most fatal cancers in the U.S., if non-smokers who developed lung cancer had their own category.

Aside from tobacco use or exposure to secondhand smoke, other causes of lung cancer include:

• Radon gas – leading cause of lung cancer in non-smokers
• Cancer-causing agents – includes carcinogens like asbestos and diesel exhaust
• Air pollution – risk of air pollution causing cancer has decreased due to environmental protection policies
• Gene mutations – research to determine what causes cells to become cancerous are ongoing

Be sure to limit your exposure to any of these causes of lung cancer through lifestyle changes, such as testing your home for radon and eliminating any possible hazards in your workplace.

What are the risk factors for lung cancer?

Aside from smoking, tobacco use or secondhand smoke, other risk factors for lung cancer include:

• Personal or family history of lung cancer
• Exposure to other cancer-causing agents such as radon, arsenic, air pollution or asbestos
• Certain dietary supplements such as beta carotene

How is lung cancer diagnosed?

If doctors suspect lung cancer, they may order one or more of the following diagnostic tests:

• Imaging tests: These tests take pictures of the inside of the body. Doctors may use chest X-rays, computed tomography (CT) scans, positron emission tomography (PET) scans or bone scans to help find cancer. Imaging test results also guide your doctors’ treatment decisions, based on how the cancer is changing.
• Biopsy: To diagnose cancer, we must perform a biopsy — sending a tissue sample from your lung for further testing. If something in the lung looks suspicious, the doctor may recommend this test. Many minimally invasive methods for sampling tissue are quick and painless, including bronchoscopy and interventional pulmonology.

What are lung cancer symptoms?

Unfortunately, you may not notice any signs of lung cancer until the disease is advanced. However, some people with early lung cancer do have symptoms, which may include:

• Coughing up blood
• Persistent cough that won’t go away
• Shortness of breath
• Unexplained weight loss
• Feeling tired or weak
• Infections such as bronchitis and pneumonia that don’t go away or keep coming back
• New onset of wheezing

Can lung cancer be detected early?

Usually symptoms of lung cancer don’t appear until the disease is already at an advanced, non-curable stage, which makes early detection difficult. However, Henry Ford’s Lung Cancer Screening Clinic uses computed tomography (CT) scans to identify potential lung cancer as early as possible in current or former smokers.

What tests are needed to stage lung cancer?

In order to determine the best and most effective treatment options, your doctor must first determine which stage your lung cancer is in. To do so, your doctor may administer staging tests, such as computerized tomography (CT) scans, magnetic resonance imaging (MRI), positron emission tomography (PET) and bone scans, each of which allow your doctor to determine the location and extent to which your lung cancer may have spread.

Can lung cancer show up as pneumonia?

Although they are two separate conditions, lung cancer and pneumonia can often present with similar symptoms, causing some patients to be initially treated for pneumonia before further imaging tests reveal an underlying cancer.

Some of the shared symptoms between lung cancer and pneumonia include a cough, darker mucus, shortness of breath, low energy or fatigue, a loss of appetite, and pains in your chest that are worsened by respiration. Pneumonia will also present with more cold-like symptoms, such as fever, chills and headaches.

If your primary physician has diagnosed you with pneumonia, it is important to complete all medication as prescribed. Should your symptoms persist it is important to follow up with your primary care provider to reevaluate your treatment. At this time, your physician may recommend more advanced imaging to rule out any other underlying conditions including cancer.

Can lung cancer be detected in blood work?

Although there currently are not any blood tests available that can detect lung cancer with certainty, Henry Ford Health System has participated in tumor sampling research to assist in the development of future lab tests and better understand how to distinguish between malignant and benign tumors to determine overall risk factors.

Can lung cancer be cured?

Although lung cancer can technically be cured, it is very rare and can only occur in very specific circumstances, such as individuals who have stage 1A lung cancer with no vascular invasion.

However, lung cancer can be treated and managed in a variety of ways, especially given recent advancements in modern medicine and oncology. Although there is always a chance that lung cancer can recur, the longer someone lives without evidence of cancer the lower the likelihood that it will come back.

How is lung cancer treated?

Our thoracic cancer team, along with specialists from the Henry Ford Center for Lung Health, cares for more than 500 lung cancer patients every year. A team of specialists discusses each individual case then develops a treatment plan specific to their health, needs and priorities. Dependent upon which stage the lung cancer is in at diagnosis, treatment may include:

• Interventional pulmonology
• Targeted therapy
• Immunotherapy
• Chemotherapy
• Clinical trials
• Radiation therapy
• Lung cancer surgery
• Ablation techniques

What are the side effects of lung cancer treatment?

• Chemotherapy: Hair loss, increased risk of infection, difficulty eating, constipation, diarrhea, extreme fatigue, bleeding and bruising, low red blood cell count
• Surgical: Reactions to anesthesia, pain, excess bleeding, blood clots in the legs or lungs, wound infections, pneumonia, shortness of breath
• Radiation: Inflammation, tenderness and sensitive skin near site of radiation treatment

How will lung cancer surgery affect my ability to breath and daily life?

A common side effect of lung cancer surgery is shortness of breath and, dependent upon the extent of the surgery, lung health prior to surgery and time needed for chest wall to heal, it may linger. However, certain steps can be taken to minimize any shortness of breath that follows lung cancer surgery, including:

• Quitting smoking
• Gradually increasing exercise program, featuring pool or walking exercises

An important factor when considering lung cancer surgery is the patient’s quality of life, both before and after the procedure. Although a successful surgery can be one of the most effective treatments for lung cancer, it is important to be aware of what may lie ahead. Outside of the physical side effects of lung cancer surgery such as shortness of breath, pain or pneumonia, patients have reported emotional side effects such as stress, fear, worry or anger, all of which are normal responses to a life-altering event. For those who find themselves seeking assistance or guidance following lung cancer surgery, Henry Ford offers support services to help cope with any issues or concerns you may have.

When is lung cancer inoperable?

While many cases of lung cancer are considered ‘inoperable,’ that does not mean that treatment or long-term survival is no longer an option. It is important to remember that inoperable simply means that lung cancer surgery is not currently the best treatment option. However, chemotherapy and radiation therapy could reduce the size or location of the tumor, which could allow lung cancer surgery to become an option.

Factors that would qualify lung cancer as inoperable include:

• General health – Overall health and prior medical conditions may present too much of a risk for lung cancer surgery to be an option.
• Location of tumor - Lung cancer surgery may not be an option if the tumor is located near vital structures, such as the heart. 
• Stage of lung cancer – Lung cancer surgery is usually only an option for non-small cell lung cancer in stage 1, stage 2 and stage 3a, while non-surgical methods, such as chemotherapy and radiation therapy, are usually reserved for stage 3b and stage 4 lung cancer.
• Lung function – If it poses a risk to reduce lung function, especially if conditions such as chronic obstructive lung disease (COPD) have already compromised breathing, then surgery is usually not a feasible option.
• Type of lung cancer – While surgery is typically performed for non-small cell lung cancer, small cell lung cancer tends to spread earlier and surgery is usually only an option for small tumors.

Will lung cancer come back?

The chances of lung cancer recurring is dependent upon several factors, including the original treatment strategy, the type of lung cancer, and the stage at which it was diagnosed. While most instances of lung cancer recurrence are in the first five years post-diagnosis, there is, unfortunately, always a risk of recurrence. Dependent upon where the recurrence occurs, there are several ways to define it:

• Local – When the cancer comes back in the lungs and near the original tumor
• Regional – When the cancer recurs in the lymph nodes near the original tumor
• Distant – When the lung cancer recurs away from the original tumor, in sites such as the adrenal gland, liver, bones or brain.