Lung cancer is the most common cause of cancer death, not only in the United States, but also around the world. Lung cancer is responsible for an estimated 160,000 deaths in the United States annually. It is one of the most preventable malignancies affecting modern man. There are two major types: non-small cell lung cancer and small cell lung cancer, so named because of how the cells look under a microscope. Non-small cell lung cancer is more common, and it generally grows and spreads more slowly. There are three main types of non-small cell lung cancer, named for the type of cells in which the cancer develops: squamous cell carcinoma, adenocarcinoma, and large cell lung cancer. Small cell lung cancer grows more quickly and is more likely to spread to other organs in the body.
Signs and Symptoms
What Causes It?
Exposure to carcinogens (cancer causing agents) damages DNA in the cells of the body. The major cause of lung cancer is cigarette smoking. Other contributing factors include environmental tobacco smoke, occupational exposure to carcinogens, and diet.
Who Is Most At Risk?
Tobacco smoke is the biggest carcinogen, responsible for 85% of all lung cancers in the United States. Risk increases with the amount of tobacco used, and the amount of time it has been used. Non smokers exposed to tobacco smoke are also at risk of developing lung cancer. Other forms of tobacco use, such as cigar smoking and pipe smoking, are also associated with lung cancer. Other risk factors include:
What to Expect at Your Doctor's Office
If you are having symptoms associated with lung cancer, see your health care provider. Your health care provider will evaluate your medical history, smoking history, exposure to environmental and occupational substances, and family history of cancer. You will also have a physical exam, and your provider may analyze your breath to determine if you have lung cancer.
You may be sent for a chest x-ray and other tests. These include a sputum cytology, the microscopic examination of cells obtained from a deep cough sample of mucus in the lungs. In some cases, your doctor may order a computed tomography (CT) scan. Research suggests these scans may reduce deaths from lung cancer by 20%. A biopsy -- the removal of a small sample of tissue for examination under a microscope by a pathologist -- can confirm whether you have cancer.
If you have cancer, your health care provider will want to learn the stage (or extent) of the disease to find out whether the cancer has spread, particularly to the brain or bones, using tests such as CT scan, magnetic resonance imaging (MRI), radionuclide scan, positron emission tomography (PET), and bone scan.
The best means of prevention is never start smoking or chewing tobacco, or to stop using tobacco products. A healthy diet is also an important part of prevention.
A treatment plan depends on the cell type, stage of disease, possibility for removing the tumor, and the patient's ability to survive surgery.
Various therapies can treat lung cancer.
Surgical and Other Procedures
Surgery is the only treatment capable of curing non-small cell lung cancer. Removal of a small part of the lung is a segmental or wedge resection, removal of an entire lobe of the lung is a lobectomy, and removal of an entire lung is a pneumonectomy. Doctors may prescribe radiation therapy before surgery to shrink a tumor, or after surgery to destroy remaining cancer cells. They may also use radiation therapy instead of surgery, or to relieve symptoms, such as shortness of breath.
Complementary and Alternative Therapies
A comprehensive treatment plan for lung cancer may include a range of complementary and alternative therapies (CAM). Studies show several CAM therapies may be helpful in improving the overall care of patients with lung cancer. Ask your team of doctors about the best ways to incorporate these therapies into your overall treatment plan. Some CAM therapies may be contraindicated in lung cancer, and some may interact negatively with medications or therapies used in conventional cancer care. Work with a qualified professional when deciding if and what CAM therpaies to use. Always tell your doctor about the herbs and supplements you are taking.
Nutrition and Supplements
These nutritional tips may help reduce symptoms:
You may address nutritional deficiencies with the following supplements:
Herbs may be an important part of an integrated cancer care strategy, but they should only be prescribed by a knowledgeable practitioner who is collaborating with all of your physicians.
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of gastritis symptoms (such as nausea and vomiting) based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for you as an individual.
An experienced homeopath may prescribe a regimen to support general health during lung cancer. Acute remedies may be useful to relieve symptoms associated with complications. You should only take homeopathic remedies under the direction of an experienced homeopath, and in consultation with all of your treating physicians.
Homeopathy may help reduce symptoms and strengthen overall constitution, reduce the effects of stress during cancer, and also help reduce the side effects of chemotherapy.
While acupuncture is not used as a treatment for cancer itself, evidence suggests it can be a valuable therapy for cancer-related symptoms (particularly nausea and vomiting, which often accompany chemotherapy treatment). Studies indicate that acupuncture may help reduce pain and shortness of breath. Acupressure (pressing on rather than needling acupuncture points) has also proved useful in controlling breathlessness. Patients can treat themselves using this technique.
Some acupuncturists prefer to work with a patient only after the completion of conventional medical cancer therapy. Others will provide acupuncture or herbal therapy during active chemotherapy or radiation. Acupuncturists treat cancer patients based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In many cases of cancer-related symptoms, a qi deficiency is usually detected in the spleen or kidney meridians.
The outlook varies by cell type and stage of the disease. In general, the prognosis is better for squamous cell cancers than for adenocarcinomas. Early detection improves chances of survival.
Periodic follow up is useful to help to detect recurrence of the lung cancer or other smoking-related cancers. Frequent follow up and rehabilitation for loss of lung function from cancer, surgery, or other treatment may be necessary.
Aberle Dr, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409.
Alberg AJ, Nonemaker J. Who is at high risk for lung cancer? Population-level and individual-level perspectives. Semin Respir Crit Care Med. 2008:29(3):223-232.
Amichai T, Grossman M, Richard M. Lung cancer patients' beliefs about complementary and alternative medicine in the promotion of their wellness. Eur J Oncol Nurs. 2012; 16(5):520-527.
Bar-Sela G, Wollner M, Hammer L, Agbarya A, Dudnik E, Haim N. Mistletoe as complementary treatment in patients with advanced non-small-cell lung cancer treated wit hcarboplatin-based combinations: a randomised phase II study. Eur J Cancer. 2013; 49(5): 1058-1064.
Bast A, Haenen GR. Lipoic acid: a multifunctional antioxidant. Biofactors. 2003;17(1-4):207-213.
Bauer JD, Capra S. Nutrition intervention improves outcomes in patients with cancer cachexia receiving chemotherapy -- a pilot study. Support Care Cancer. 2005;13(4):270-274.
Baur JA, Sinclair DA. Therapeutic potential of resveratrol: the in vivo evidence. Nat Rev Drug Discov. 2006;5(6):493-506.
Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr. 2006;25(2):79-99.
Chan HP, Lewis C, Thomas PS. Exhaled breath analysis: novel approach for early detection of lung cancer. Lung Cancer. 2009;63(2):164-168.
Cross AJ, Leitzmann MF, Gail MH, et al. A prospective study of red and processed meat intake in relation to cancer risk. PLoS Med. 2007;4(12):e325.
de Torres JP, Casanova C, Marin JM, et al. Exploring the impact of screening with low-dose CT on lung cancer mortality in mild to moderate COPD patients: a pilot study. Respir Med. 2013; 107(5):702-707.
de Torres JP, Marin JM, Casanova C, Cote C, Carrizo S, Cordoba-Lanus E, et al. Lung cancer in patients with chronic obstructive pulmonary disease--incidence and predicting factors. Am J Respir Crit Care Med. 2011;184(8):913-919.
Dela Cruz C, Tanoue L, Matthay R. Lung Cancer: Epidemiology, Etiology, and Prevention. Clinics in Chest Medicine. W.B. Saunders. Philadelphia, PA: 2011;32(4).
Deng GE, Rausch SM, Jones LW, et al. Complementary therapies and integrative medicine in lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013; 143(5 Suppl):e420S-36S.
Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther. 2006;4(2):261-275.
Dryden GW Jr, Deaciuc I, Arteel G, McClain CJ. Clinical implications of oxidative stress and antioxidant therapy. Curr Gastroenterol Rep. 2005;7(4):308-316.
Gnagnarella P, Maisonneuve P, Bellomi M, et al. Nutrient intake and nutrient patterns and risk of lung cancer among heavy smokers: results from the COSMOS screening study with annual low-dose CT. Eur J Epidemiol. 2013; 28(6):503-511.
Goldman. Goldman's Cecil Medicine, 24th ed. Philadelphia, PA: Saunders; 2011.
Horvath I, Lazar Z, Gyulai N, Kollai M, Losonczy G. Exhaled biomarkers in lung cancer. Eur Respir J. 2009;34(1):261-275.
Humphrey LL, Deffebach M, Pappas M, et al. Screening for lung cancer with low-dose computed tomography: a systematic review to update the US Preventive services task force recommendations. Ann Intern Med. 2013; 159(6):411-420.
Jett JR, Midthun DE. Screening for lung cancer: for patients at increased risk for lung cancer, it works. Ann Intern Med. 2011;155(8):540-542.
Labinskyy N, Csiszar A, Veress G, et al. Vascular dysfunction in aging: potential effects of resveratrol, an anti-inflammatory phytoestrogen. Curr Med Chem. 2006;13(9):989-996.
Lichtenstein AH, Russell RM. Essential nutrients: food or supplements? Where should the emphasis be? JAMA. 2005;294(3):351-358.
Lis CG, Cambron JA, Grutsch JF, et al. Self-reported quality of life in users and nonusers of dietary supplements in cancer. Support Care Cancer. 2006;14(2):193-199.
Lissoni P, Rovelli F, Malugani F, et al. Anti-angiogenic activity of melatonin in advanced cancer patients. Neuro Endocrinol Lett. 2001;22(1):45-47.
MacLean CH, Newberry SJ, Mojica WA, et al. Effects of omega-3 fatty acids on cancer risk: a systematic review. JAMA. 2006;295(4):403-415. Review.
McWilliams A, Lam B, Sutedja T. Early proximal lung cancer diagnosis and treatment. Eur Respir J. 2009;33(3):656-665.
Miller MF, Bellizzi KM, Sufian M, et al. Dietary supplement use in individuals living with cancer and other chronic conditions: a population-based study. J Am Diet Assoc. 2008;108(3):483-494.
Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc. 2008;83(5):584-594.
Niederhuber: Abeloff's Clinical Oncology, 5th ed. Philadelphia, PA: Saunders, An Imprint of Elsevier; 2013.
Punturieri A, Szabo E, Croxton TL, Shapiro SD, Dubinett SM. Lung cancer and chronic obstructive pulmonary disease: needs and opportunities for integrated research. J Natl Cancer Inst. 2009;101(8):554-559.
Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin. 2001;17(1):239-247.
Slatore CG, Littman AJ, Au DH, Satia JA, White E. Long-term use of supplemental multivitamins, vitamin C, vitamin E, and folate does not reduce the risk of lung cancer. Am J Respir Crit Care Med. 2008;177(5):524-530.
Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.
Suvatne J, Browning R. Asbestos and Lung Cancer. Disease-a-Month. Mosby; Philadelphia, PA: 2011;57(1).
Tang NP, Zhou B, Wang B, Yu RB, Ma J. Flavonoids intake and risk of lung cancer: a meta-analysis. Jpn J Clin Oncol. 2009;39(6):352-359.
Velicer CM, Ulrich CM. Vitamin and mineral supplement use among US adults after cancer diagnosis: a systematic review. J Clin Oncol. 2008 1;26(4):665-673.
Wender R, Fontham ET, Barrera E, et al. American Cancer Society lung cancer screening guidelines. CA Cancer J Clin. 2013; 63(2):107-117.
Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-596.
Review Date: 5/26/2014
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by the A.D.A.M Editorial team.
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