Lung cancer is responsible for the most cancer deaths in both men and women throughout the world. The American Cancer Society estimates that in 2007, 213,380 new cases of lung cancer will be diagnosed in the U.S. and there will be 160,390 deaths due to lung cancer. Karl Thomas, MD, pulmonary specialist at University of Iowa Hospitals and Clinics, talks about lung cancer:
What are the different types of lung cancer?
There are two main categories of lung cancer—small cell cancer, which tends to be a pretty aggressive type of tumor, and everything else that we call non-small cell cancer. There can be several hundred different kinds of cancer, but we break them down into those two big groups.
What are the symptoms or signs of lung cancer?
There are many different symptoms that a patient can have. We break those into things that are related to problems inside the chests and lungs, and then the symptoms they may have if the cancer spread beyond their chest.
For the chest symptoms, we’re generally looking for things like shortness of breath or coughing that doesn’t go away. Some other symptoms include chest pain—a rib, for example, that just won’t stop hurting—or sometimes coughing up of a bit of blood. Sometimes patients with lung cancer will have symptoms outside of the chest and those are more general and they’re a harder to get a handle on. Those can be things like weight loss, loss of energy, sometimes muscle and bone joint pain. And sometimes unusual headaches can be a sign of lung cancer.
How is lung cancer diagnosed?
The cornerstone for diagnosis in lung cancer is something we call a biopsy. We look throughout the body to find where the cancer could be and then take a small piece of it with something that looks like a needle or tweezers on the end of a wire, called biopsy forceps. Basically we take a tiny piece of the tissue and we look at it underneath the microscope.
What is “staging” of lung cancer?
Like all tumors, we try to make decisions about what to do for treatment based on how much cancer the patient has and where the cancer is located. That’s what we call staging. So staging will include things like how big the tumor is and then whether or not it has spread to the lymph nodes. And whether or not it has spread outside of the chest—like a bone for example—it’s what we call metastasis. The stage is a combination of how big the tumor is, are the lymph nodes involved, and whether or not it has metastasized.
How is lung cancer treated?
For early stage cancers, we generally start talking about surgical therapy where we remove the part of the lung that contains the cancer. For a more advanced in stage, we generally talk about chemotherapy, which is medications that we give intravenously, and radiation therapy which is basically a high energy X-ray beam used to destroy the tumor.
What is the long-term prognosis for someone diagnosed with lung cancer?
It all comes down to the stage, again, so for early stage cancer, the long-term prognosis is actually quite good. We generally start talking about long-term cures if we can get it at an early stage and can remove it entirely by a surgery. Unfortunately for patients who have advance staged cancers, where they have a lot of lymph nodes that might be involved, or they have metastatic disease where the cancer has spread outside the chest, often we don’t talk about a cure. Sometimes we’ll talk about three- and five-year survivals in that group of patients.
Are there ways to prevent lung cancer from developing?
About 90 percent of cancers in the United States are directly related to cigarette smoking. The quickest and the shortest answer is if people could stop smoking, they would directly and dramatically reduce the risk of developing lung cancer. Unfortunately, there have been a number of studies looking at things like vitamins and supplements that you can take through your diet to prevent lung cancer. But at this time, it’s still too early to say whether or not any of those actually have benefit. And in fact, some of them did not show any benefit at all. So there’s nothing you can take pill-wise to prevent cancer.
Is University of Iowa Hospitals and Clinics involved in any research on lung cancer or its treatment?
We’re doing a lot of different kinds of clinical trials in lung cancer and they all involve things like treating cancer with chemotherapy and surgery and sometimes combining chemotherapy and surgery. There are other things that we’ve looked at. For example, screening for lung cancer has been a major research objective of our group in the past few years. So that’s trying to find cancer at an earlier stage before it metastasizes and before it spreads. |
