What is lung cancer?
Understanding chest anatomy and physiology
What are the different types of lung cancer?
What is staging for lung cancer?
Risk factors for lung cancer
Help to stop smoking
What is lung cancer?
Cancer is an abnormal growth of cells. The whole body is made of cells that act and grow in controlled ways as the body needs them. The cells are controlled by genes. The genes in any one of these cells can become damaged. Then the cell can grow out of control and become cancer.
Cancer cells quickly grow and divide. This happens even when there's not enough space and nutrients. They also grow despite signals sent from the body telling them to stop.
Cancer cells don't look the same as healthy cells. They don't work the way they should. They can spread to other parts of the body. Tumors, masses, or lesions are names for abnormal growths of cells that can become cancer.
When a person is diagnosed with lung cancer, the abnormal growth of cells is happening in the lungs or the cancer is somewhere else in the body and has traveled to the lungs. This process of spreading through the body to a secondary organ or site is metastasis.
Understanding chest anatomy and physiology
In order to understand some things about lung cancer, let's review what organs are in the chest.
The chest contains a trachea, commonly called windpipe, which carries air to the lungs. It has two main branches. Each branch of the trachea is called a bronchus. These two branches connect to the lungs. Each bronchus continues to divide into smaller branches and tiny air sacs called alveoli.
Everyone has two lungs, which are divided into sections called lobes. The right lung is divided into three lobes: upper, middle, and lower. The left lung is divided into two lobes: upper and lower. There is a large muscle that divides the chest from the abdomen called the diaphragm. The lungs are surrounded by a tissue lining called the pleura.
The chest also contains the heart and aorta (main artery that carries blood to the heart), as well as other blood vessels and nerves. All these organs are protected by the rib cage and breastbone, also known as the sternum.
There is a lymphatic system throughout the body, which is part of the circulatory (blood) system. In the chest and other parts of the body, there are lymph nodes (pea-sized "glands") that filter impurities from the body. Different terms are used to describe their locations in the chest, such as mediastinal (area between pleural sacs), hilar (area near opening through which bronchus, blood vessels, and nerves pass), or paratracheal (area near trachea).
What are the different types of lung cancer?
What is staging for lung cancer?
Staging is the process of finding out how far the cancer has spread (metastasized). This information will determine the treatment options and the probable course of the cancer and the chance of your recovery from it (prognosis). Numerous tests may be performed to determine the stage.
The TNM system is commonly used. Each letter, together with a number after it, gives more details.
• "T" describes the tumor size and whether the cancer has spread to nearby tissues.
• "N" describes if, or how far, the cancer has spread to the lymph nodes (pea-sized "glands" that filter impurities from the body).
• "M" tells whether the cancer has spread to other organs of the body.
These TNM descriptions are the grouped together into stages 1 (early) through 4 (advanced). In general, the lower the number the better prognosis.
For small-cell lung cancer, a two-stage system is most often used. Limited stage means that the cancer is confined to one area in the chest. Extensive stage means that the cancer has spread beyond the chest.
Risk factors for lung cancer
The number one risk factor for lung cancer is smoking. Smoking causes 8 out of every 10 cases of lung cancer. The longer someone has smoked increases the risk of getting lung cancer, as does the number (packs) of cigarettes he or she smokes every day.
The good news? Quitting at any age lowers the risk.
Second-hand smoke is also a risk factor. Non-smoking spouses of smokers have a 30 percent greater risk of developing lung cancer than non-smoking spouses of non-smokers.
Smoking alone causes one-third of all cancer deaths. Environmental exposure to certain substances, such as asbestos, is another risk factor for lung cancer. Family history of a mother or father or sibling may give a person have a slightly higher risk.
Not smoking and avoiding those who do in combination with eating a diet rich in fruits and vegetables could lower one's risk of getting lung cancer.
Many cases of lung cancer are found in their early stages because a test was ordered for something else. The average age of people diagnosed with lung cancer is 70.
Many people with lung cancer do not have any signs or symptoms, but some may include:
| • a cough that doesn't go away | • shortness of breath | • chest pain |
| • hoarseness | • wheezing | • pneumonia that keeps coming back |
| • unexplained weight-loss | • bloody or rust-colored sputum | • bronchitis |
Help to stop smoking
Making the commitment to quit smoking is one of the best choices that smokers can make for themselves, but also a difficult one. There are various opportunities for support available. Here is an overview of them.
Nicotine is the addictive chemical in tobacco. Many people experience withdrawal symptoms such as:
| • Anger | • Difficulty concentrating | • Irritability |
| • Anxiety | • Frustration | • Restlessness |
| • Cravings | • Headaches | • Weight gain |
| • Depressed mood | • Insomnia |
Nicotine replacement therapy
There are various forms of nicotine replacement therapy available to assist with minimizing these symptoms. They are nicotine gum, nicotine patch, nicotine nasal spray, nicotine inhaler, and nicotine lozenge.
A doctor or nurse can help a person decide which kind of nicotine replacement therapy is best for his or situation. There are pros and cons for each.
Non-nicotine replacement therapy is also available. Bupropion (Wellbutrin®, Zyban®) is a mild antidepressant that is also effective in helping people to quit smoking. It can be used alone or with nicotine replacement therapy. Older medications sometimes still used like Nortripline to help with withdrawal symptoms and Clonidine also has been seen to assist in helping people quit
Additional options
Varenicline (Chantix®) is another medication that helps people who what to quit. This medication is not a form of nicotine replacement therapy, but it helps with the withdrawal symptoms.
Studies have shown that the best success rates for people trying to quit include counseling and/or support groups.
Nicotine Anonymous is a support group. Call (631) 665-0527.
The Suffolk County Department of Health offers an excellent program that involves a series of classes to help people understand the best strategies to help break the smoking habit. Call (631) 853-4017 or visit their website.
New York State offers a hotline, 1-866-NY-QUITS or 1-800-QUIT-NOW, and a website nysmokefree.com that offers free kits that include nicotine replacement therapy.
Some helpful hints include:
| • Avoidance. Stay away from smokers and places where you are tempted to smoke. | • Change of habits. For example, if you usually smoke during a coffee break, then go for a walk instead. | • Discussion. Call a friend for support. |
| • Activities. Exercise or do hobbies that keep your hands busy. | • Deep breathing. When you have the urge to smoke, do a deep breathing exercise and remind yourself why you quit. | • Drink of water. Use as an oral substitute such as water. |
| • Alternatives. Use oral substitutes such as sugarless gum, hard candy, and carrot sticks. | • Delay tactic. If you feel that you are about to light up, delay. Tell yourself you must wait 10 minutes. Often this simple trick will allow you to move beyond the urge. |
Many people say the reason they smoke is to deal with stress. Unfortunately, stress is a part of all our lives. When quitting, you will need to find new strategies to deal with stress. There are stress-management classes, and self-help books that can help you discover new ways to reduce and deal with stress.
The bottom line is: Don't just try to go it alone! Reach out for support to help you achieve your goal.