Everything To Know About Lung Cancer: Symptoms, Diagnosis, And Treatment

The average person has a one in 15 chance of getting lung cancer. It is the second most prevalent cancer in the US, and nearly 149,000 Americans die of it every year, says the Prevent Cancer Foundation. But how much do you know about this deadly disease?

Lung cancer spreads to other organs more often than other diseases. Some people believe that lung cancer only results from smoke, but that isn’t true. Common symptoms, such as a chronic cough and fatigue, are often ignored. Read on to learn everything about lung cancer–symptoms, diagnosis, and treatment.

What Causes Lung Cancer?

There are several different causes of lung cancer. According to the American Lung Association, 90% of all cases stem from tobacco use. Research suggests that smoke changes DNA in the lungs, which develops into tumors. If you quit smoking, your risk of cancer lowers, but it does not vanish completely.

A doctor points at a lung x-ray.
Courtesy of the American Cancer Society via Getty Images
Courtesy of the American Cancer Society via Getty Images

Radon–an odorless, radioactive gas in the soil–is the second highest cause of lung cancer. Exposure to chemicals such as arsenic, uranium, and asbestos can also kickstart lung cancer. If your home is exposed to chemicals or air pollution, you have a heightened risk.

You Have A Higher Risk If…

Certain factors won’t necessarily cause lung cancer, but they may increase your risk. Genetics is one factor. According to John Hopkins Medicine, you are twice as likely to develop lung cancer if a family member has had it before.

A labeled diagram shows the human lungs.
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In the same vein, non-smokers can have a higher cancer risk from secondhand smoke. The Centers for Disease Control (CDC) asserts that a poor diet may also contribute to cancer. In particular, beta carotene supplements–which were once thought to reduce cancer risk–are now shown to contribute to lung cancer.

There Are Several Types Of Lung Cancer

Although many people know about lung cancer, they may not be familiar with the different types. The Cancer Treatment Centers of America divides lung cancer into two main varieties: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).

A pathologist scans pictures of lung disease.
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SSPL/Getty Images

SCLC develops small, oat-sized cancer signs throughout the lungs. Often, you can detect SCLC early on. NSCLC, which accounts for 90% of all lung cancer cases, creates larger tumors. This cancer progresses slowly, and it may not develop symptoms until it approaches the advanced stages.

When Coughing Could Be Cancer

Perhaps the most well-known symptom of lung cancer is a persistent, intense cough. But how can you tell when your cough is cancer? The biggest red flag is the rust-colored spit or phlegm, says the American Cancer Society. Cancer may also create cases of bronchitis or pneumonia that keep coming back.

A man coughs.
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BSIP/UIG Via Getty Images

Most coughs do not last longer than a few weeks. If yours does, you may want to see a doctor. Lung cancer coughs may also accompany shortness of breath and chest pain. If the cough occurs alongside other cancer symptoms, definitely see a doctor.

Back Pain: An Unexpected Symptom

Believe it or not, 25% of patients with lung cancer suffer from chronic back pain. Although the symptom is not usually associated with lung cancer, it could happen for several reasons. In short, the pressure of a tumor may strain the spine and structure of the back.

An illustration shows a man clutching his back in pain.

As tumors spread, it may cause pain along the neck, back, shoulders, and even legs. Lung cancer travels to the spine and bones in 30% of patients. If your back pain progresses into weakness of the arms and legs, see a doctor.

Fatigue May Be An Early Sign

An early, often-overlooked symptom of lung cancer is fatigue. Fatigue manifests as weakness, tiredness, and an overall lack of energy. In 2016, a study in Lung Cancer: Targets and Therapy reported that 57% of patients experience fatigue. It can also be one of the crippling symptoms for cancer patients.

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BSIP/Universal Images Group via Getty Images

The American Cancer Society explains that “cancer-related fatigue” is different from the tiredness that patients felt before their disease. They may feel too exhausted to eat, think, walk around, or even sleep. If fatigue interrupts your daily life, consult a doctor.

Chest Pain From Your Lungs, Not Your Heart

Like heart disease, lung cancer can cause chest pain, but for different reasons. In 21% of cases, metastasis could spread to the bones or chest wall, creating pain. In 31% of cases, tumors infect the nerves of the lungs, resulting in chronic aches.

A senior man clutches his chest in pain as his wife comforts him.
John Greim/LightRocket via Getty Images
John Greim/LightRocket via Getty Images

According to the American Lung Association, chest pain from lung cancer is usually chronic. Sometimes, it appears in flare-ups that continue despite medication. One-fourth of lung cancer patients have chest pain upon diagnosis, often accompanied by a cough, wheezing, and shortness of breath.

A Swollen Face Is A Bad Sign

People with lung cancer may wake up with their faces and necks swollen. According to LungCancer.net, this symptom often occurs from cancer. A tumor pushes against the superior vena cava, the vein that connects the head to the heart. This is called superior vena cava syndrome (SVCS).

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BSIP/Universal Images Group via Getty Images

The University of Rochester Medical Center says that SVCS can also cause other symptoms. Shortness of breath, chest pain, hoarseness, and a bluish skin tint comes with SVCS. Although this condition isn’t limited to lung cancer, it is still severe enough to require medical attention.

How Lung Cancer Spreads Throughout The Body

Lung cancer can travel across the body, a process known as metastasis. This disease spreads more quickly during its early stages than other cancers. According to Moffitt Cancer Center, the most common metastasis locations are the brain, bones, adrenal glands, and liver.

A diagram shows cancer cells interacting with antigens.
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BSIP/Education Images/Universal Images Group via Getty Images

The lungs spread oxygen throughout the blood, explains the LUNGevity Foundation. When cells mutate, they travel through the blood as well. Usually, the body prevents specific cells from infecting other parts of the body, but cancer interrupts this. Metastatic lung cancer can cause unexpected symptoms.

Finding Cancer Through Imaging

Doctors who search for lung cancer may perform imaging tests. These tests include x-rays, CAT scan, PET scan, and MRI. Although they can’t confirm that you have cancer, they provide visible signs for medical experts, says the LUNGevity Foundation.

A doctor talks to a patient about her chest x-ray.
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BSIP/UIG Via Getty Images

Usually, health professionals start with an x-ray. Doctors may scan the chest and belly to see if the disease has spread. A CT scan provides more detail by taking cross-sectional images of your body. Sometimes, a doctor may combine a CT with a PET scan. A PET sends a radioactive form of sugar into your blood to collect cancer cells.

Staging During Diagnosis

As doctors try to diagnose lung cancer, they detect how far it has spread into other parts of the body. This process is called “staging.” According to the CDC, many experts perform exams to see if cancer cells have entered the lungs, lymph nodes, or other organs.

An x-ray shows the location of a tumor in the lung.
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BSIP/Universal Images Group via Getty Images

The National Cancer Institute divides staging into two steps: a physical exam and laboratory tests. Doctors may check a patient’s medical history and examine their bodies for lumps. X-rays, urine tests, and blood tests can also indicate if lung cancer has spread throughout the body.

How Doctors Confirm A Diagnosis

After the initial tests, doctors will work to confirm that diagnosis. This is why lung cancer diagnosis takes a long time. Cancer Council Victoria says that most doctors examine tissue samples under a microscope, a process called a biopsy.

A doctor examines a patient's breathing with a stethoscope.
Justin Sullivan/Getty Images
Justin Sullivan/Getty Images

Doctors can perform many different biopsies. If you’ve had a CT scan, doctors can use that to aid the biopsy. Another method is a bronchoscopy, where professionals examine the lungs through a camera. A specific type of bronchoscopy called endobronchial ultrasound (EBUS), uses sound waves to map out the tumor.

The Stages Of Lung Cancer

Like most cancers, lung cancer has five stages. According to the Cancer Treatment Centers of America, the lowest level is stage zero. Here, cancerous cells have not entered the lung tissues or other organs. In stage one, the disease has entered the lung tissues.

Professors observe cancer cells on a computer screen.
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BSIP/Universal Images Group via Getty Images

Stage two occurs when tumors travel to the lymph nodes. During stage three, cancerous cells attach to other organs such as the heart and esophagus. The worst is stage four; 40% of patients are diagnosed during this stage. Here, lung cancer has spread to other areas of the body, and patients have around five years to live.

Determining Which Stage The Cancer Is

Doctors use the TNM system to determine how advanced lung cancer is. TNM stands for tumor, nodes, and metastasis. According to Cancer Council Victoria, doctors examine each of these to decide whether the cancer has progressed to stage one, two, three, or four.

A paper's headline says
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First, doctors observe the tumor. If the tumor is less than one centimeter, you’re in luck; if it’s over seven centimeters, that’s a bad sign. Then, professionals see if cancer cells have traveled to the lymph nodes. A metastasis analysis shows if lung cancer has spread to other parts of the body.

The Best Prevention Strategy: Avoiding Smoke

The most effective way to delay lung cancer is to avoid substance abuse. According to the Prevent Cancer Foundation, 90% of all lung cancer cases stem from smoking. Tobacco combines 7,000 chemicals, 70 of which are known carcinogens. Fortunately, quitting at any age will help your chances. Ten years after quitting, your risk lowers by 50%, says the National Health Service.

A factory in India emits smoke.
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SHAMMI MEHRA/AFP via Getty Images

Secondhand smoke harms the body more than some people think; 7,300 lung cancer cases come from secondhand smoke. Exposure to other chemicals, such as asbestos and radon, will also heighten your risk of lung cancer. Dodge all of these chemicals if you can.

Unlikely Prevention: Exercise

Although many people don’t associate exercise with lung cancer, it does help. Even smokers have a lower risk of cancer when they exercise consistently. According to a study in Cancer Epidemiology Biomarkers & Prevention, female smokers who work out frequently have a 23% lower chance of developing lung cancer.

A man sweats after running on a fitness trail.
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BSIP/Universal Images Group via Getty Images

Researchers still aren’t sure why exercise has such a significant impact on lung cancer. In 2019, an animal study suggested that physical activity can delay tumor growth. Earlier research in the Journal of the National Comprehensive Cancer Network reports that exercise can prevent lung cancer from reoccurring.

How To Treat Lung Cancer

Lung cancer has no surefire treatment. According to the CDC, doctors usually use a combination of surgery, radiation therapy, targeted therapy, and chemotherapy. The process depends on the stage of cancer, a patient’s medical history, and their personal preferences.

Chemotherapy treatments for cancer patients are displayed.
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GREG WOOD/AFP via Getty Images

Surgery is often performed for early-onset cases of lung cancer. Doctors may mix chemotherapy and radiation therapy to shrink tumors and kill cancer cells. Targeted therapy, which hits specific areas of the body, is often reserved for non-small cell lung cancers. Patients also have the choice of partaking in immunotherapy or alternative medicines.

Who Should Take A Yearly Lung Cancer Screening?

The U.S. Preventive Services Task Force advises some people to take a yearly screen for lung cancer. Because the disease spreads so quickly, early diagnosis is crucial. But only some people require an annual screening.

A man with chest pain visits the doctor to get an x-ray.
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BSIP/UIG Via Getty Images

The Prevent Cancer Foundation recommends that people with a history of smoking require screenings. If you have quit substances within the past 15 years, and if you are in between the ages of 55 and 80, ask for an annual test. Your chances of lung cancer are far higher than the average person’s, and you can never be too careful.

The Different Lung Cancer Doctors

As with many other diseases, lung cancer may require the attention of several doctors. The most common lung cancer doctors include oncologists, pulmonologists, and thoracic surgeons. Oncologists are perhaps the most well-known, as they handle medication, radiation therapy, and surgery for cancer patients.

An oncologist examines medical tests.
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Rick Friedman/Rick Friedman/Corbis via Getty Images

Patients with lung cancer may need to see a pulmonologist, a specialist in the respiratory system. Sometimes, pulmonologists will work with cardiologists to diagnose a disease, since many have similar symptoms. Thoracic surgeons are only required for surgery; they focus on internal organs, including the heart and lungs.

When To See A Doctor

Specific lung cancer symptoms call for a doctor visit. WebMD advises people to consult a professional after noticing any lung cancer symptoms, but a few stand out. A chronic severe cough that lasts for several weeks may require attention. Head to the hospital immediately if you cough up blood.

A doctor examines a patient.
Justin Sullivan/Getty Images
Justin Sullivan/Getty Images

Sudden weakness, blurry vision, and fatigue are also symptoms of lung cancer. Talk to a doctor if you have unexplained weight loss and pain, especially in the chest. Remember that symptoms of heart and lung diseases overlap, so always see a doctor before diagnosing yourself.