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Learning About Lung Cancer: Top 10 Questions

Q&A With Linda Ferris, DO

Lung cancer is a major health problem in American society and the second most common cancer in both men and women. Providing optimal care involves raising awareness of the multifaceted forms of lung cancer treatment, such as clinical trials and collaboration with oncology specialists. Linda Ferris, DO, medical oncologist and lung cancer specialist with Northwestern Medicine, answered our top 10 questions about lung cancer and treatment.

1. What are the risk factors for lung cancer?

Cigarette smoking is the greatest risk factor for lung cancer and accounts for roughly 85 percent of all cases. Risk is 30 times greater for smokers than non-smokers and increases with amount and duration of smoking.

Previous radiation treatment, such as for another cancer, can cause lung cancer, as can environmental exposures such as second hand smoke, radon, asbestos, diesel exhaust and metals like arsenic, chromium and nickel.

Chronic obstructive pulmonary disease also carries an increased risk of lung cancer, and a small percentage of people inherit risk.

2. Who is most susceptible to lung cancer?

Current or former smokers are at the greatest risk for lung cancer and incidence increases with age. Two thirds of people with lung cancer are 65 or older; fewer than 2 percent are younger than 45. Nonsmokers are also at an increased risk with age, representing 20 percent of all lung cancer diagnoses in women.

3. How can you prevent lung cancer?

The greatest action someone can take to prevent lung cancer is to never start smoking. If you or someone you know does smoke, smoking cessation is the best form of prevention.

4. Can nonsmokers or former smokers still get lung cancer?

Yes. Risk for lung cancer in those who have never smoked and those who have quit smoking is viewed in somewhat different contexts.

Approximately 20 percent of women with lung cancer have never smoked. Similarly, 10 percent of men with lung cancer never smoked.

For those who used to smoke but have quit, risk of lung cancer will always be higher than for the never smokers. However, risk is reduced within five years of quitting, and those who have not smoked in 15 years have an 80 percent to 90 percent lower risk of cancer than those who smoke.

If you have been diagnosed with lung cancer, quitting smoking is still encouraged as it can decrease the risk of dying from other smoking related diseases, lung cancer recurrence or a second lung cancer.

5. What are the signs and symptoms of lung cancer?

  • Cough
  • Shortness of breath
  • Chest pain
  • Hoarse voice
  • Coughing up blood
  • Swelling of the face, neck or arms
  • Arm, shoulder or neck pain

6. What are the options for lung cancer screening?

The United States Preventive Services Task Force recommends screening by annual, low dose chest CT scan for high-risk adults who are healthy enough to undergo treatment if lung cancer is diagnosed.

Lung cancer screening may be appropriate if you are an adult aged 55 to 80 with a 30 pack* year history of smoking and currently smoke or quit within the past 15 years. 

*“Pack years” of smoking is the number of packs of cigarettes smoked per day times the number of years of smoking.

7. What are the stages of lung cancer?

The four stages of lung cancer incorporate the standard elements in staging types of cancer. This includes the extent of the main tumor, lymph node involvement and spreading from the original site, in this case the lung. Treatment depends on the stage at diagnosis – the earlier the diagnosis, the better chances of a cure.

8. What are the treatment options for lung cancer?

Surgery, radiation therapy and chemotherapy may all be involved in lung cancer treatment. At its earliest stage, lung cancer treatment may only require the surgical removal of the tumor. For more advanced disease, multiple types of therapy are used to formulate a treatment plan. This may include enrollment in a clinical trial.

9. What ways are there to stay inspired or optimistic during treatment?

It is imperative to have a good support system during treatment, though support can be defined differently for different people. Friends and family can provide the foundations for support, and your oncologist and office staff will be resources as well.

With a cancer diagnosis, you may discover other needs that make it difficult to stay positive. Cancer resource centers can help with community groups, support services, and wellness classes for individuals and families dealing with a diagnosis.

10. What are some tips for living well after diagnosis?

Living well after a lung cancer diagnosis can vary by individual. A cancer diagnosis will require a complex team approach to treatment and the cancer journey. In all cases, ongoing involvement of your physicians and medical monitoring will be needed. Working closely with your oncologist to identify and overcome barriers as well as communicate questions and concerns will be essential components of living well with cancer.

We encourage you to discuss risk factors for lung cancer with your physician and, if appropriate, take steps to quit smoking or pursue a screening for you or a loved one.