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Balch, MD, FACS 8 Understanding & Interpreting Your Pathology Report Co-Editor-in-Chief Paul A. Bunn, MD Senior Vice President Debby Easum 9 Types of Treatment for Lung Cancer Vice President, Operations Leann Sandifar Managing Editor Matt Smithmier 12 Treatment Options by Stage Writers Lori Alexander, MTPW, ELS Ashley Tsue Graphic Designer Michael St. George 14 Side Effects of Lung Cancer Treatment Production Manager Jennifer Hiltunen 15 Survivor Story: Paul and Barbara Bell Vice Presidents, Amy Galey Business Development Stephanie Kenney Account Executive Kathy Hungerford 16 Managing Symptoms of Dyspnea Office Address 8455 Lenexa Drive Overland Park, KS 66214 17 Smoking & Lung Cancer: It’s never too late to quit For Additional Information [email protected] Advisory Board Visit our website at PatientResource.com to read bios of 18 Finding Relief From Lung Cancer Pain our medical and patient advisory board. 20 Advocacy & Assistance Resources For Additional Copies: To order additional copies of Patient Resource Cancer Guide: Lung Cancer, visit www.patientresource.com, call 913-725-1600, or email [email protected]. Editorial Submissions: Editorial submissions should be sent to [email protected]. PATIENT RESOURCE CANCER GUIDE Disclaimer: Information presented in Patient Resource Cancer Guide: Lung Cancer Lung Cancer is not intended as a substitute for the advice given by your health care provider. The opinions expressed in Patient Resource Cancer Fourth Edition Guide: Lung Cancer are those of the authors and do not necessarily reflect the views of the publisher. Although Patient Resource Cancer Guide: Lung Co-editors-in-chief Cancer strives to present only accurate information, readers should not consider it as professional advice, which can only be given by a health Charles M. Balch, MD, FACS care provider. Patient Resource, its authors, and its agents shall not be responsible or in any way liable for the continued currency of the infor- Professor of Surgery, University of Texas mation or for any errors, omissions or inaccuracies in this publication, Southwestern Medical Center whether arising from negligence or otherwise or for any consequences Editor-in-Chief, Patient Resource LLC arising therefrom. Patient Resource, its authors, and its agents make no representations or warranties, whether express or implied, as to the ac- curacy, completeness or timeliness of the information contained herein or the results to be obtained from using the information. The publisher Paul A. Bunn, MD is not engaged in rendering medical or other professional services. The publication of advertisements, whether paid or not, and survivor stories is James Dudley Endowed Professor not an endorsement. If medical or other expert assistance is required, the of Lung Cancer Research, services of a competent professional person should be sought. University of Colorado School of Medicine © 2014 Patient Resource LLC. All rights reserved. Past President of American Society ® of Clinical Oncology PRP PATIENT RESOURCE PUBLISHING For reprint information, email [email protected]. ORDER AT PatientResource.com PatientResource.com 1 OVERVIEW of lung cancer An estimated 224,210 new cases of lung cancer will be diagnosed difficult to detect early, primarily because there are no early symptoms of lung can- in 2014, making lung cancer one of the most common types of can- cer. In addition, many of the first symp- toms, such as a cough, are also symptoms cer in both men and women in the United States. The rate of new of chronic lung disease caused by tobacco cases of lung cancer varies according to gender and race/ethnicity, products. This means there’s nothing to alert a person to seek medical care. but the disease occurs more often in men than women and occurs However, a method to screen for lung cancer – low-dose spiral computerized most frequently in black and white men. However, advances in tech- tomography (CT) – now exists and is nology and knowledge about the disease have led to new treatment recommended for people at high risk for lung cancer. A person is at high risk if he options that may be a possibility for many people. or she is 55 to 74 years old, has smoked the equivalent of a pack of cigarettes dai- How lung cancer develops cigarettes a person smokes, and the more ly for 30 or more years, and has stopped Lung cancer is the uncontrolled growth of years a person smokes, the greater the smoking fewer than 15 years previously. abnormal cells lining the airways (bronchi) chance for lung cancer. Once a person stops A large study showed that among a group of the lung (Figure 1). Researchers believe smoking, the risk becomes lower each year, of high-risk people, fewer people died of lung cancer develops slowly over the course but the risk is still higher than for people lung cancer when they were screened with of many years after exposure to cancer- who have never smoked. low-dose spiral CT compared with people causing substances (carcinogens), resulting As many as one in five lung cancers devel- who were screened with standard chest X- in more and more genetic abnormalities that op in people who have never smoked, most rays. The International Association for the accumulate in the cells. Over time, the ab- often women. In some of these cases, un- Study of Lung Cancer (IASLC) and other normal cells become malignant (cancerous), known factors are responsible. Exposure to organizations suggest that high-risk in- divide and spread. secondhand smoke, asbestos and radon also dividuals should discuss a screening CT The overwhelming cause of lung cancer increase the threat of lung cancer, and family scan with their doctor. is the use of tobacco products such as ciga- history and ethnicity are other factors as well. rettes, pipes or cigars. The earlier in life a Even though lung cancer grows slowly, Types of lung cancer person starts smoking, the more packs of it spreads through the bloodstream and is Lung cancer is classified into four main types: small cell carcinoma, large cell car- cinoma, adenocarcinoma and squamous TABLE 1 CLASSIFICATION OF LUNG CANCER cell carcinoma (see Table 1). The type is Frequency (among Where it’s usually determined by the pathologist – a doctor Type all lung cancers) found Comments who specializes in the examination of tis- Non-small cell lung 80-85% (See subtypes) The exact type of NSCLC must now be sue to determine disease – who looks at cancer (NSCLC) distinguished for optimal therapy. a sample of tumor tissue under a micro- scope and sometimes uses special stains to • Adenocarcinoma 35-50% Glands of the lungs This is the most common type of lung that produce mucus; cancer overall, in women, and in people allow some otherwise transparent tissue often in the outer who have never smoked.