Lung Cancer

Lung cancer

Before 1950, lung cancer in women was still an uncommon occurrence. However, over the latter half of the 20th century, an epidemic of lung cancer in women occurred, mirroring the rapid rise of lung cancer among men witnessed earlier. Since 1988, lung cancer has killed more women than breast cancer each year in the United States. Since 1991, lung cancer mortality rates have been declining in men, while in women they appear to be plateauing. Lung cancer is unfortunately likely to remain the leading cause of cancer death in both men and women in this country for the near future.

What we are learning about the disease

The pathophysiology of lung cancer is best described as a “multi-hit” event. Carcinogens, most commonly those in cigarette smoke but also including many different environmental exposures, can result in DNA damage or mutation. The cumulative effect of several “hits” may result in irreversible effects on the biologic mechanisms that control growth, proliferation, vascular supply, and death of normal cells. Collective dysregulation of these mechanisms is felt to lead to lung cancer.

Lung Cancer Symptoms 

      A cough that does not go away or gets worse

• Coughing up blood or rust-colored sputum (spit or phlegm)
• Chest pain that is often worse with deep breathing, coughing, or laughing
• Hoarseness
• Weight loss and loss of appetite
• Shortness of breath
• Feeling tired or weak
• Infections such as bronchitis and pneumonia that don’t go away or keep coming back
• New onset of wheezing 

If lung cancer spreads to distant organs, it may cause:

• Bone pain (like pain in the back or hips)
• Nervous system changes (such as headache, weakness or numbness of an arm or leg, dizziness, balance problems, or seizures), from cancer spread to the brain or spinal cord
• Yellowing of the skin and eyes (jaundice), from cancer spread to the liver
• Lumps near the surface of the body, due to cancer spreading to the skin or to lymph nodes (collections of immune system cells), such as those in the neck or above the collarbone

Radiation therapy

Radiation therapy, or radiotherapy, delivers high-energy x-rays that can destroy rapidly dividing cancer cells. It has many uses in lung cancer: 

As primary treatment 

Before surgery to shrink the tumor 

After surgery to eliminate any cancer cells that remain in the treated area

To treat lung cancer that has spread to the brain or other areas of the body 

Besides attacking the tumor, radiotherapy can help to relieve some of the symptoms the tumor causes such as shortness of breath. When used as an initial treatment instead of surgery, radiotherapy may be given alone or combined with chemotherapy. Today, many patients who have a small localized lung cancer, but who are not candidates for surgery, are being treated with a radiation treatment technique known as stereotactic body radiation therapy (SBRT). Patients who are poor candidates for surgery include the elderly, patients with chronic heart failure, and patients receiving a blood thinning drug that puts them at risk of surgical bleeding. SBRT involves treatment with a multitude of small, focused radiation beams tracking the lung tumor along with its respiratory movement, typically in three to five treatments. This treatment delivers very high doses of radiation therapy to the lung cancer in patients where surgery is not an option. SBRT is primarily used in the setting of early stage, localized disease.

symptoms of lung cancer

What are possible side effects of radiation therapy?

Most patients tire easily after receiving their first radiation treatments. This fatigue gradually

increases as treatment continues and may become severe, seriously limiting the ability to engage in

normal daily activities. Typically, fatigue lessens one to two months after radiotherapy is

completed. If you experience fatigue it is important to get enough rest, but at the same time your

physician may suggest that you stay as active as possible.

Some patients experience hair loss in the area of the chest wall included in the radiation field.

Depending on how much radiation is delivered, this may be temporary or permanent.

Skin irritation is the rule after a few weeks of radiation therapy. The affected area may be

reddened, dry, tender and itchy. This reaction can become quite severe during a long course of

treatment. It helps to keep the skin clean with gentle soap and warm water, to dry it well and to

avoid very hot water while bathing.