Lung Cancer

What Is Lung Cancer?

Lung cancer begins as abnormal cells in the lungs, and forms into malignant tumors. Early diagnosis is key to treating lung cancer, as its symptoms are often not apparent until it has already spread, or metastasized, to other parts of the body. Using the most comprehensive, clinically proven techniques, the caring oncologists and staff members at Orange County CyberKnife and Radiation Oncology Center are committed to help you understand the diagnosis and apply a treatment regimen customized for your distinct needs.

Lung cancer is the second most common form of cancer found in both men and women; respectively, prostate and breast cancer are more common. It is the leading cause of cancer-related death in both men and women in the U.S. with one in four cancer deaths attributed to it. Lung cancer is especially prevalent in people aged 60 or older who smoke and who are exposed to secondhand smoke and other toxins. Symptoms include coughing, chest pain, shortness of breath, and rapid weight loss.

Compared to other types of cancer, lung cancer has a lower five-year survival rate at 17.8%. However, this percentage increases dramatically when the disease is caught before it spreads to other parts of the body. More than half of people diagnosed with lung cancer die within a year; Orange County CyberKnife will chart out the best solution to fit your condition.

There are two major types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). During your consultation, your oncologist will plan out the best course of action depending on this distinction.

  • NSCLC is the most common form of lung cancer, accounting for 80 percent of all diagnoses. This type spreads more slowly than SCLC and is divided into three sub-categories: adenocarcinoma, which is found in the outer lung; squamous cell carcinoma, discovered in the center of the lung near an air tube; and large cell carcinoma, which can appear in any part of the lung and tends to spread faster than other types of NSCLC.
  • SCLC is the type of lung cancer that is mostly commonly associated with cigarette smoking. It is divided into two sub-categories: small cell carcinoma and combined SCLC, which includes large cells.

A less common third form of lung cancer, carcinoid tumors, develop more slowly than other forms and typically require surgery to treat.

Treatment options for lung cancer are varied and are dependent on the specific type of cancer, its stage, and individual treatment goals based on a patient’s specific needs. At Orange County CyberKnife we provide a comprehensive approach to treating lung cancer based on these criteria: options may include surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, clinical trials, and/or palliative care. Recent studies show patients have had more favorable results when their early stage operable lung cancer was treated with CyberKnife stereotactic radiation therapy (SABR) rather than surgery.

Lung Cancer Risk Factors

There are several risk factors for the development of lung cancer. Some are hereditary, but many are lifestyle choices that you make every day.

  • Smoking – Cigarette smoking is the primary risk factor for developing lung cancer, linked to 80% in women and 90% in men of lung cancers in the U.S. Male smokers are 23 times more likely to develop lung cancer compared to non-smokers; 13 times more likely in women. Smoking pipe tobacco and cigars also raise the risk. Tobacco smokers inhale a toxic blend of more than 7,000 chemicals, and the more they smoke, the greater the risk becomes. People who quit smoking can begin to slowly lower the risk of getting lung cancer.
  • Secondhand Smoke If you are exposed to secondhand smoke at work, home, or school, you are increasing your chances of getting lung cancer by 20% to 30%. Secondhand smoke causes more than 7,300 non-smoker deaths each year.
  • Radon Radon is a naturally occurring carcinogen found in the earth that causes lung cancer, and can be difficult to detect as it is invisible and odorless. Because it is a byproduct of the radioactive decay of uranium in the soil, the levels that you may be exposed to in your home or at work can vary depending on your geographic location. It is the second leading cause of lung cancer. One in 15 homes is thought to have excessive radon levels. The USDA recommends testing your home from radon and implementing strategies to lower it if it is too high. Smoking significantly increases the risk of mortality in cancer patients who are exposed to radon.
  • Personal Or Family History – If there is a history of lung cancer in your immediate family, you are at an increased risk. If you have had lung cancer before and you still smoke, there is a chance it will reappear.
  • Chest Radiation Therapy – If you have had radiation therapy to your chest area previously, there is a greater chance you could develop lung cancer.
  • Diet – Research continues to try to connect any food or beverages that may cause cancer. They have determined that smokers who take beta-carotene supplements are at a greater risk. Additionally, low levels of arsenic in well water has been linked to cancer.

Lung cancer symptoms usually do not occur until later stages when it is harder to cure. Even when they do occur earlier, they are often mistaken for symptoms of other problems and not lung cancer. When lung cancer is found earlier, by accident, usually from testing for other illnesses, there is a good chance for survival. The American Cancer Society recommends lung cancer screenings for those who are more at risk to help find and beat the disease. After a medical examination and collection of family history, if you meet ALL of the criteria below, you and your doctors should discuss the benefits and potential harms of an annual lung cancer screening:

  • 55 to 74 years old
  • In fairly good health (discussed further on)
  • Have at least a 30 pack-year smoking history (see previous section)
  • Are either still smoking or have quit smoking within the last 15 years

Imaging Screenings For Lung Cancer

If your physical exam and medical history suggest you may have lung cancer, your doctor may order diagnostic screenings to look for the abnormal cell growth. Lung cancer screenings should only be performed at facilities like Orange County CyberKnife’s imaging center that have years of experience using LDCT scans for lung cancer screening and that have a team of experienced radiation oncology specialists available to follow up with possible treatment options should the need arise. The following imaging services are available on-site to confirm if you have lung cancer:

  • Chest X-ray – This test will show images of the lungs and surrounding tissue and is usually the first test your doctor will order to determine if you have any signs of lung cancer. If the X-rays show any cell abnormalities (usually as shaded areas), your doctor will order additional tests.
  • CT Scan – The CT scan will combine many X-ray pictures to make a detailed cross-sectional image of your chest. A CT scan is more likely to show tumors than a routine X-ray and it can also show more details such as the shape, size, and position of the tumor. CT scans can also show any enlarged lymph nodes that might contain cancer.  A low-dose CT scan, called a LDCT screening, is available to help people with no symptoms of lung cancer ensure that they remain cancer-free. Radiology oncologists at Orange County CyberKnife use CT scans to monitor the growth and movement of cancer in patients.
  • MRI Scan – Like CT scans, an MRI can show precise images of the tissue in your lungs. The difference is an MRI uses a magnetic field and pulses of radio wave energy to make the pictures, giving doctors different information about what can be seen.
  • PET/CT Scan – This type of scan goes beyond the 3D images provided by a CT scan to show what is happening in the tissue of your lungs at a cellular level. A PET scan can also show cancerous cells before any structural changes appear. PET scans are also used to show if cancer has spread to the bones. Using this scan, CyberKnife’s radiology oncologists can properly diagnose the stage of your lung cancer and work with you to develop the best focus treatment for your individual situation.

Diagnosing Lung Cancer

Once doctors determine from your screenings that you may have lung cancer, they will order additional tests that involve actually looking at your cells through a microscope to confirm the diagnosis and determine the stage of the cancer.

  • Sputum Cytology – This test examines mucus you cough up from your lungs (called sputum) under a microscope to check for abnormal cells. Doctors usually get samples from you for three days in a row. This test is most likely to diagnose cancers existing in your lung’s major airways.
  • Thoracentesis – If you have fluid built up around your lungs, doctors can use this procedure to relieve your symptoms and see if it is caused by cancer spreading to the lining of the lungs. The buildup could be caused by other ailments, such as heart failure or an infection. Doctors use a hollow needle inserted between the ribs to drain the fluid. Then, a microscope is used to find out if the fluid has cancer cells. Sometimes chemical tests are used to find out if the cancer is malignant.
  • Needle Biopsy – When abnormal tissue or a tumor is suspected, doctors will often use a tiny needle to extract a sample of the tissue. A pathologist examines these cells under a microscope to determine if they are cancerous and if the cancer is malignant (spreading) or benign (contained). This test often provides the most precise analysis for lung cancer. These procedures do not require an incision, but sometimes the sample is so small, they do not have enough to get a good test.
  • Bronchoscopy (Blue-Light Bronchoscopy & Autofluorescence Bronchoscopy) A test that helps doctors find tiny tumors or blockages in the larger airways of the lungs. The procedure involves inserting a small, flexible fiber optic tube into the lungs and then a video camera using both a blue light and white light capture images. The blue light shows healthy tissues as green and abnormal tissues as reddish-brown. This procedure can also guide a tiny biopsy needle to grab a sample of the abnormal tissue.

Find Out More By Contacting Us Today

Our Orange County CyberKnife and Radiation Oncology Center staff want you to know that our doctors are here to help you find the best treatment option available to you at our comprehensive cancer center.

Use these links to find out more about lung cancer:

You can also contact us today by calling (714) 962-7100 with your questions. Orange County CyberKnife is your comprehensive cancer center in Southern California that offers multiple advanced radiation treatments, including the CyberKnife Robotic Radiosurgery system. You can trust us to help choose a treatment option that is right for you.

Lung Cancer: Treatment Options

Types Of Radiation Therapy For Lung Cancer

Radiation therapy is often used to treat lung cancer, sometimes in conjunction with chemotherapy and surgery. When it comes to treating your lung cancer with radiation therapy, Orange County CyberKnife and Radiation Oncology Center is your expert choice.

Advanced Image Guided Radiation Therapy (IGRT)

Orange County CyberKnife and Radiation Oncology Center houses the most advanced equipment including the IGRT which can track and capture your tumor as it moves or adjusts from day-to-day. This treatment option pinpoints exactly where your tumor is so that you can focus the treatment on only that area, leaving the rest of the surrounding tissue unharmed. Your initial CT scan can be updated using IGRT each time your visit to ensure your treatment is focused.

Electronic Brachytherapy (eBx)

The eBx is an advanced treatment therapy that sends radiation directly in the tumor cavity from inside the body. This is accomplished by inserting a balloon catheter into the cavity. It enlarges with fluid to fill the space and stays there throughout the treatment. During your approximately 10 minutes of treatment, a radiation oncologists inserts a tiny piece of radioactive material through the catheter tube and into the balloon. It releases radiation based on your treatment plan. Depending on the stage of cancer, this can be a high dose (HDR) or a low dose (LDR) of radiation. Radiation treatment is completed in five days, rather than the weeks required for traditional radiation treatments. When you are finished, the radiation oncologist drains and removes the balloon so the cavity can heal.

Intraoperative Brachytherapy (Xoft)

This type of internal treatment uses a miniaturized high dose of X-ray source targeted directly on the tumor. The X-ray can be turned on or off, while a radioactive isotope is always emitting radiation. Because of this, no special shields are needed and you are not isolated during treatment.

CyberKnife (Stereotactic Body Radiation Therapy, or SBRT)

Orange County CyberKnife was one of the first cancer treatment centers to offer this advanced radiation therapy that can pinpoint small tumors and shoot beams of radiation directly to the tumor with little exposure to the surrounding tissue. Much shorter than traditional radiation treatment, CyberKnife treatment is administered in one to five days.

RapidArc Intensity-Modulated Radiation Therapy (IMRT)

RapidArc delivers treatments two to eight times faster than our other dynamic treatments and it increases precision. This volumetric arc therapy delivers precise 3D doses with a single 360° rotation of the machine. It uses your treatment planning algorithm to simultaneously change the rotation speed, the shape of the treatment aperture, and the delivery dose rate. The shape and position of the tumor are determined from computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) diagnostic studies. This permits improved dose sculpturing over 3D conformal radiation therapy.

Contact Us To Find Out More

Find out more about the radiation options available to you at our comprehensive cancer center, Orange County CyberKnife.  Give us a call today at (714) 962-7100 and we will answer all of your questions about the treatment methods for lung cancer including our CyberKnife cancer treatment. Our team of oncology radiologists is ready to work with you on treatment options for your lung cancer using the most advanced non-surgical and non-invasive radiation therapy systems available. Other patients agree,  you can trust us to help choose a treatment option that is right for you.

Use these links to find out more about lung cancer:

Lung Cancer: Types & Stages

Internationally-renowned radiation oncologists are equipped to develop a lung cancer treatment plan for you at Orange County CyberKnife based on the type of cancer you have been diagnosed with and its stage. Orange County CyberKnife is the only cancer treatment center in Orange County with such a comprehensive array of radiation procedures. With all of the advanced treatment options in one center, our patients feel safe knowing that our doctors can choose the best lung cancer treatment option or combination of treatment options for your individual circumstance.

Types Of Lung Cancer

Lung cancer treatment is based on the three types you may be diagnosed with:

  • Non-Small Cell Lung Cancer (NSCLC) By far the most common type of lung cancer, 80% to 85% of diagnosed lung cancer is attributed to this type. NSCLC usually grows and spreads at a slower rate than other types of cancer. Some tumors are made up of cells from more than one type of NSCLC, but the most commonly diagnosed types of NSCLC are:
    • Adenocarcinoma This type of cancer has gland-like properties and begins in early versions of the cells that make up the lining of the lungs. It is the most common form of cancer for both men and women in the U.S., making up about 40% of those diagnosed with lung cancer. It occurs most often in smokers or former smokers, but it is also the most common type of cancer in nonsmokers and younger people. One type of adenocarcinoma, called adenocarcinoma in situ, is more treatable than the others.
    • Squamous Cell Carcinoma Cancer begins in the thin, flat cells that line the inside airways of the respiratory tract. It accounts for about 25% to 30% of those diagnosed with lung cancer. These abnormal cells can usually be found near a main airway toward the central part of the lungs.
    • Large Cell Carcinoma This is a faster-growing form of NSCLC that can appear on any part of the lung and does not fit into the other categories. It makes up about 10% of lung cancer diagnoses.
    • Large Cell Neuroendocrine Tumors – These fast growing tumors make up only about 2% of lung cancer diagnoses.
  • Small Cell Lung Cancer (SCLC) This much faster growing and spreading cancer looks like tiny oats under a microscope, and so is termed “oat cell” cancer. The cells in this neuroendocrine tumor are smaller in size than most other cancer cells. This type of cancer represents the other 15% of lung cancers in the U.S. and is usually caused by smoking tobacco. Chemotherapy is often the best treatment for this type of cancer, but advanced radiation treatments are providing favorable outcomes.
  • Metastatic Lung Cancer When lung cancer cells break away from a tumor and spread to other parts of your body through your lymph nodes or your blood, you have what is called metastatic lung cancer. This can happen before or after treatment.This is different than recurrent cancer because it spreads to a different part of the body than was previously infected.

Stages Of Non-Small Cell Lung Cancer (NSCLC)

The stages of lung cancer vary based on the types outlined above. However, the stages correspond with the methodology TNM – tumor, node, metastasis.

  1. Tumor – The larger the primary tumor or abnormal growth, the more serious.
  2. Node – The more lymph nodes that have cancerous cells, the more serious the cancer.
  3. Metastasis – Serious stages involve the spreading of cancer to other parts of the body.

Doctors assign levels for each of the above factors and then combine these levels into stages. They stages of lung cancer are:

  • Stage 0 – This is a non-invasive cancer when the disease is very small, remains in place (in situ), and has not spread into deeper lung tissue or to other surrounding tissue.
  • Stage I – A lung cancer that includes a small tumor that might have spread into the underlying lung tissue, but that has not spread to any lymph nodes in other parts of the body. The surgeon is able to remove the tumor.
    • Stage Ia – The tumor is smaller than 3 cm. wide.
    • Stage Ib – The tumor is between 3 cm. and 5 cm. wide.
  • Stage II – There are two substages of Stage II cancer. A surgeon may or may not be able to remove the entire tumor.
    • Stage IIa – In this stage, the tumor is between 5 cm. and 7 cm. wide and has not spread to nearby lymph nodes; OR the tumor is less than 5 cm. and HAS spread to nearby lymph nodes.
    • Stage IIb – If the tumor is between the 5 cm. and 7 cm. as in the earlier stage, but it HAS spread to nearby lymph nodes, it is considered Stage IIb. Or, if the tumor is larger than 7 cm. wide but has not spread, it falls into this stage. The tumor may also be partly blocking the airways.
  • Stage III – Stage IIIa lung cancers and almost all of stage IIIb cancers include a tumor that is difficult, sometimes impossible, to remove. The lung cancer may have spread into the lymph nodes in the center of the chest, but outside the lung. Or, the tumor might have grown into nearby structures in the lung. It is less likely, in these cases, that the surgeon can completely remove the cancer because it has to be taken out piece by piece.
  • Stage IV Surgery is not usually successful for most Stage III or Stage IV lung cancers. If the cancerous cells have become Stage IV and have spread to lymph nodes above the collarbone or if the cancer has grown into fluid surrounding the lung, or vital structures within the chest like the heart, large blood vessels, or primary airways, it can be impossible to remove. If the cancer spreads to the blood, it can easily travel to the brain, bones, liver, and adrenal glands.
    • Stage IVa – Cancer has spread within the chest.
    • Stage IVb – Cancer has spread outside the chest to other parts of the body.
  • Recurrent – This stage of cancer is used when the cancer returns to the originally infected place after treatment. Once that happens, doctors run more tests to establish a current stage.

Stages Of Small Cell Lung Cancer (SCLC)

  • Limited stage: There are cancerous cells found on just one side of the chest, affecting only one part of the lung and nearby lymph nodes.
  • Extensive stage: Cancer has spread to other areas of the chest or other parts of the body.

Call Us Today To Find Out More

Still have questions about cancer types and stages? Do not hesitate to contact us today at (714) 962-7100. Our team of internationally renowned radiotherapy and radiosurgery specialists at Orange County CyberKnife are ready to work with you on a treatment plan to meet your individual needs. We can treat tumors throughout your body using the most advanced non-surgical and non-invasive radiation therapy systems available. Let us make sure you know all the radiation options available to you at our comprehensive cancer treatment center, including the CyberKnife Robotic Radiosurgery system. Use these links to find out more about lung cancer:

 

Lung Cancer: FAQs

With almost a quarter of a million people likely to be diagnosed with lung cancer this year, there are many questions about how to deal with this disease. The expert radiation oncologists at Orange County CyberKnife can help alleviate some of your fears by making sure you understand lung cancer and the treatments available to help. We are knowledgeable, compassionate, and caring professionals who are ready to provide hope for your situation at our top cancer care center.

Answer :

Unfortunately, most lung cancer is not detected until it has advanced into later stages since symptoms are not always apparent. Because of this, screening for lung cancer can be a good idea for people who are at high risk. In a 2011 study, researchers showed that CT scans reduced lung cancer mortality by 20%. Medicare and Medicaid services, and many private insurance companies, will pay for yearly screenings but only for people who qualify using this criterion:

  • Aged 55 to 77 (or 80 for some private insurers)
  • Have at least a 30 pack-year history of smoking
  • Currently smoke or have quit within the past 15 years

However, because of the low doses of radiation you will experience when having an LDCT scan, there are risks involved. The American Cancer Society recommends that if you are at a high risk for lung cancer, you discuss the risks and benefits of screenings with your doctor.

Answer :

Most people who are diagnosed with lung cancer do not realize they have any symptoms until late into the stages of the cancer. At that time, you may experience:

  • Coughing that will not quit
  • Shortness of breath or becoming winded easily, accompanied by wheezing
  • Chest pain
  • Weight loss
  • Hoarse voice
  • Bone pain
  • Headache

If you have a high risk of symptoms of lung cancer, your doctor may order a CT scan and possibly X-rays to look for abnormal cell groupings in your lungs. If found, additional testing and, likely, a biopsy will be taken to confirm the diagnosis. Then, Orange County CyberKnife will team with your physicians to develop a treatment plan that is right for you.

Answer :

Lung cancer survival rates are lower than many other cancers because it is often not detected in the early stages. Only 15% of lung cancer cases are diagnosed at this early stage. According to the American Cancer Society, the five-year survival rate for lung cancer is 17.8%. If the disease is caught before moving out of the lungs, the survival rate rises to 54%. However, if the cancer spreads to distant organs, the five-year survival rate is only 4%. More than half of the people with lung cancer die within one year of being diagnosed.

Answer :

Yes, smoking is a serious contributing factor in causing small cell and non-small cell lung cancer. Smoking contributes 80% of lung cancer deaths in women and 90% in men. Men who smoke are 23 times more likely to develop lung cancer. Women are 13 times more likely, compared to people who have never smoked. Between 2005 and 2010, an average of 130,659 Americans died of lung cancer from smoking each year (source: American Cancer Society).

Answer :

Yes. Researchers believe that nonsmokers have a 20% to 30% greater chance of developing lung cancer if they are exposed to secondhand smoke at home or work.

Answer :

Radon, a naturally occurring gas produced by decomposing uranium in the earth, is the culprit for about 20% of lung cancer deaths each year. This tasteless, odorless gas, is the second-leading cause of lung cancer and often combines with smoking to increase risk even more. Lung cancer risks can also increase for those who are exposed at work to asbestos, uranium, and coke (a fuel made from coal). The combination of asbestos exposure and smoking greatly increases the risk of developing lung cancer.

Answer :

There are several treatments for lung cancer including surgery, chemotherapy, and a variety of radiation therapies. The treatment options vary depending on your type and stage of lung cancer. You will find a comprehensive array of radiation therapy at Orange County CyberKnife. Visit ourDetection and Treatment page to find details about the radiology services available to you.

Answer :

High doses of radiation are used to kill cancer cells during cancer treatment. This radiation can also affect surrounding tissue and organs. Because of the advanced technology at Orange County CyberKnife, the damage to surrounding tissue is greatly minimized, giving you fewer side effects. However, general side effects from radiation include fatigue and skin irritations (itching, peeling, dryness, redness) at the site of the radiation. Side effects from lung cancer radiation treatment may also include difficulty swallowing, shortness of breath, lung or nipple soreness, stiff shoulder, fever and cough, and fibrosis (scarring of the lungs).

Answer :

We are ready to answer any questions you have about your lung cancer treatment options at Orange County CyberKnife. Give us a call today at (714) 962-7100. Our oncology team of cancer specialists can explain the different ways they can treat tumors throughout your body using the most advanced non-surgical and non-invasive radiation therapy systems available. More than 100 area doctors trust Orange County CyberKnife for their patients’ radiation oncology needs. We look forward to your questions.

Use these links to find out more about lung cancer: