CARE GUIDE Lung Cancer

Lung Cancer

Lung cancer is the top cause of cancer deaths worldwide.

It develops when abnormal cells grow in the lungs and form tumors. Untreated, lung cancer can spread anywhere in the body. Most often, it spreads to the other lung, the liver, bones, brain, or small glands called adrenal glands on top of your kidneys.

There are two main types of lung cancer and several subtypes. The main types are:

  • Non-small-cell lung cancer. This accounts for 80% to 85% of lung cancers. There are many subtypes, but the treatments and outlook are similar.
  • Small-cell lung cancer. This accounts for about 10% to 15% of lung cancers. It grows and spreads faster and usually returns after treatment.

The type of lung cancer you have determines the kind of treatment you’ll get and helps doctors predict your long-term outlook. 

Anyone can get lung cancer, but most cases have a link to smoking or secondhand smoke.  

Other risk factors for lung cancer include exposure to:

  • Radon, a naturally occurring radioactive gas
  • Asbestos, a naturally occurring mineral
  • Uranium and other radioactive materials
  • Inhaled chemicals, including arsenic, beryllium, cadmium, and others
  • Diesel exhaust
  • Arsenic in drinking water
  • Previous radiation to the chest
  • Air pollution

Family history plays a part in your risk, too.


In the early stages of the disease, you may not notice any symptoms. That’s why about 40% of people who have lung cancer get a diagnosis at an advanced stage.

For those who do notice symptoms, they may include:

  • A cough (with or without mucus) that doesn’t go away
  • Coughing up blood
  • Shortness of breath or feeling winded
  • Chest pain
  • Raspy, hoarse voice
  • Wheezing
  • Unexplained weight loss greater than 10 pounds
  • Headache
  • Bone pain or fractures

Tests and Diagnosis

When you go to your appointment, your doctor will do a complete physical exam and review your medical history. If the doctor suspects lung cancer, you’ll get a chest X-ray. Based on what the X-ray shows, you might need further tests, such as:

CT scan. This test creates an image with multiple X-rays taken from various angles around your body. You lie on a table that passes slowly through a large X-ray machine. Most scanners surround only parts of your body, not your whole body. The table remains motionless while the machine moves around you. You might hear whirring sounds. The technician might ask you to hold your breath at times throughout the process. The test could take a few minutes or up to 30 minutes.

PET scan. This one measures the activity of a mass, lump, or node to see how large it is or whether the cancer has spread to other body parts. It can also check how well treatment works. You lie on an exam table for the scan. You might get an IV in a vein in your arm or hand. Or you might have to swallow or inhale a chemical that helps the machine detect tumor activity in your body. The test takes 30 minutes to 3 hours depending on how much tissue the doctor wants to evaluate. You stay on the table while the technician looks at the images in case there’s a need for more. 

Bronchoscopy. This exam shows the inside of your airway. A doctor puts a tube with a light and camera attached into your airway through your nose or mouth. If there are any abnormal growths or tissue, the doctor can take a piece of it for testing.  

Thoracentesis. This test analyzes cells in the fluid around the lungs and relieves breathing trouble that the fluid may cause. A doctor inserts a long needle into your chest and into the space between your chest wall and lungs and draws fluid out. 

Sputum cytology. This is an analysis of cells found in the sputum -- a thick mucus that the lungs produce. You cough up mucus into a cup for this test. The sample goes out to a lab. If you can’t cough, you may need to inhale a saline mist to help you. 

Lung biopsy. A doctor removes tissue from your lungs for analysis. Similar to the thoracentesis, the doctor inserts a long needle into your chest. This time, the doctor draws out a small bit of lung tissue, which goes to a lab for testing. 

Video-assisted thoracoscopic surgery (VATS). You might have this surgery so a doctor can get lung tissue samples for analysis. You get medicine to numb part of your chest. Then the doctor cuts a small opening there. A tube with a camera on it (thoracoscope) goes into the opening, and a doctor removes a piece of tissue. After removing the scope, the doctor stitches the incision. 

Doctors and Specialists

Health care professionals work together to treat lung cancer. Your care team may include any or all of these specialists:

Your primary care doctor: Probably the first professional you’ll see about your symptoms and the one who refers you for further tests and follow-up with a specialist.

Pulmonologist: A doctor who focuses on breathing problems and conditions of the lungs and respiratory tract.

Thoracic surgeon: A specialist who performs surgery on the chest (thorax) to diagnose and treat diseases, including lung cancer.

Respiratory therapist: A professional who treats breathing disorders such as COPD, asthma, bronchitis, and other conditions, like cancer, that cause lung problems. They use mechanical ventilators and oxygen therapy to help your lungs work better.

Medical oncologist: A specialist who diagnoses and treats cancer with medications rather than surgeries or other procedures. This specialist chooses and administers the right cancer drug, such as chemotherapy, and consults with other cancer doctors about your other treatments.

Mental health professional: This could be a psychologist, psychiatrist, or social worker who focuses on your mental and emotional well-being, including depression or anxiety that might arise from your diagnosis. This specialist can also help with smoking cessation and withdrawal symptoms.

Questions for Your Doctor

As you get ready for your appointment to talk about your symptoms, diagnosis, or treatment, it can be helpful to go in with a list of questions. Here are some topics you might want to cover:

Questions About My Diagnosis

  • What leads you to believe that I have lung cancer? Are there other conditions that have the same symptoms?
  • What caused this condition?
  • How extensive is my lung cancer? 
  • Do I need more tests to confirm the diagnosis?
  • What is my prognosis?
  • What type of lung cancer do I have?
  • Is this condition curable?

Questions About My Treatment

  • What medication will I get for my condition?
  • What are the side effects of the drugs?
  • Do I need surgery?
  • Will I be carrying an oxygen tank?
  • Is there a clinical trial that I can join that has newer treatments?

Questions About My Lifestyle and Family

  • Is this hereditary?
  • Can you help me stop smoking?
  • Would nicotine replacement therapy affect my condition?
  • Will I still be able to work?
  • Will I be able to have sex?
  • Can I sleep lying flat or do I need a special bed?
  • Is there a special diet I should be on?
  • Are there support groups that I can join?

Treatment Options: Surgery

There are three main treatments for lung cancer: surgery, chemotherapy, and radiation therapy. You may receive more than one of these or all three. 


People with early stage non-small-cell lung cancer whose lungs work well enough may be able to have surgery to remove the cancer.

Depending on the size and location of the tumor, the surgeon may be able to remove just a portion of the lung. In a lobectomy, the surgeon removes one lobe of the lung. (Between your two lungs, there are five lobes: two on the left and three on the right.) In a wedge resection or segmentectomy, the doctor removes only part of a lobe.

Sometimes, you’ll need surgery to remove an entire lung, called a pneumonectomy. You may need it if the tumor is in the center of your chest.

People who are not healthy enough for traditional surgery might get cryosurgery, also called cryoablation. In this procedure, a doctor destroys the tumor by freezing it.

Surgery is not an option for small-cell lung cancers (SCLC). It usually spreads too quickly so that it’s not possible to take the tumor out completely with surgery. 

Treatment Options: Radiation

People often get radiation along with surgery, chemotherapy, or both. Doctors point high-energy X-rays at the tumor to kill the cancer cells. Depending on your condition and the type of radiation you get, your treatment may last just a few sessions. Or you may need it daily for several weeks. 

Radiation can make tumors smaller so they are easier to remove with surgery. Or your doctor may use it to kill any cancer cells that they couldn’t remove in your operation.

This treatment can improve some of the symptoms of lung cancer, too. It can shrink tumors that are making it hard to breathe or are pressing on nerves and causing pain.

It can cause side effects, though, including fatigue, nausea, and skin redness or blistering where the radiation enters your body.

Treatment Options: Chemotherapy

Chemotherapy refers to medicine that goes through your bloodstream to kill cancer cells. You might get it by mouth or through an injection or infusion into a vein. There are many common chemotherapy drugs for lung cancer. You might get them before or after you have surgery. Or your doctor may recommend it if your cancer has spread to other parts of your body. You get chemotherapy over several weeks or months. It can cause side effects that can be tough to handle, including hair loss, nausea, and extreme fatigue.

Treatment Options: Additional Available Treatments

Targeted Therapy

This treatment is available for non-small-cell lung cancer. Targeted means that the medication aims for and shuts down a specific characteristic of your tumor that helps it grow, such as a protein made because of a change in a certain gene. Numerous targeted drugs are on the market today. You can take them as pills or injections.


This type of treatment gets your immune system to find and kill cancer cells. One type of immunotherapy, called checkpoint inhibitors, disables key proteins that lung cancer cells sometimes use to avoid an attack from the immune system. These medicines are options for some people with small-cell lung cancer or non-small-cell lung cancer.

Treatment Options: Complementary Therapies

Complementary therapies are things you can try along with the cancer treatments your doctor prescribes. They can help you ease the symptoms of your cancer or the side effects of your treatments. There are a few options you can consider:

  • Meditation: eases stress
  • Yoga: relaxes muscles, eases stress
  • Acupuncture: provides pain relief
  • Massage: releases muscle tension
  • Breathing exercises: bring relaxation
  • Biofeedback: helps release tension