Everything You Need to Know About Lung Cancer

The symptoms of lung cancer depend on the type and stage of your cancer:

What does stage 1 lung cancer feel like?

The early stages of lung cancer don’t always cause symptoms. When early symptoms do occur, they can include shortness of breath as well as unexpected symptoms, such as back pain.

Back pain can occur when tumors cause pressure in your lungs or when they spread to your spinal cord and ribs.

Other early signs of lung cancer may include:

• a lingering or worsening cough
• coughing up phlegm or blood
• chest pain that worsens when you breathe deeply, laugh, or cough
• hoarseness
• wheezing
• weakness and fatigue
• loss of appetite and weight loss
• recurrent respiratory infections such as pneumonia or bronchitis

What do later stages of lung cancer feel like?

Additional symptoms of lung cancer depend on where new tumors form. Not everyone with late-stage lung cancer will experience every symptom.

Late-stage symptoms might include:

• lumps in your neck or collarbone
• bone pain, especially in your back, ribs, or hips
• headaches
• dizziness
• balance issues
• numbness in arms or legs
• yellowing of skin and eyes (jaundice)
• drooping of one eyelid and shrunken pupils
• lack of perspiration on one side of your face
• shoulder pain
• swelling of your face and upper body

Additionally, lung cancer tumors can sometimes release hormones, leading to a wide variety of symptoms known as paraneoplastic syndrome. Symptoms include:

• muscle weakness
• nausea and vomiting
• high blood pressure
• high blood sugar
• confusion
• seizures

There are several different types of lung cancer. Most types of lung cancer are either non-small cell lung cancer (NSCLC) or small-cell lung cancer (SCLC). However, some people have tumors that contain both kinds of cells.

• Non-small cell lung cancer (NSCLC): NSCLC makes up about 80–85% of all cases. There are several types of NSCLC. Most types of NSCLC respond well to treatment if caught in the early stages.
  • Squamous cell lung carcinoma: About 30% of all cases of NSCLC begin in the cells that line the passages of your respiratory tract. This is called squamous cell carcinoma.
  • Adenocarcinomas: This type usually forms in the outer part of your lungs.
    • Adenocarcinoma in situ (AIS): This rare subset of adenocarcinoma begins in the tiny air sacs in your lungs. It’s not aggressive and may not need immediate treatment.
  • Adenosquamous carcinoma: This cancer develops in a mixture of squamous cells and mucus-producing cells.
  • Large cell carcinoma: Large cell carcinoma is a fast-growing group of NSCLCs that does not classify under other cancer types.
• Small-cell lung cancer (SCLC): About 15–20% percent of lung cancers are SCLC. This type of lung cancer is more aggressive than NSCLC. Although SCLC often initially responds better to chemotherapy, it is less likely to be cured than NSCLC.
• Mesothelioma: This type of lung cancer has links with asbestos exposure. It occurs when carcinoid tumors start in hormone-producing (neuroendocrine) cells. Mesothelioma is aggressive and fast-growing. It does not respond well to treatment.

Learn how lung cancer type can affect survival rates.

Cancer stages tell how far cancer has spread and help guide treatment.

The chance of successful or curative treatment is much higher when lung cancer is diagnosed and treated early. Because lung cancer may not cause obvious symptoms in the earlier stages, people usually receive a diagnosis after it has spread.

Non-small cell lung cancer (NSCLC) stages:

• Hidden (occult): For unknown reasons, doctors cannot identify the tumor, but cancer cells are visible in sputum or other fluid tests. Testing also suggests the cancer has not spread to nearby lymph nodes or other places.
• Stage 0: The cancer is only present in the epithelial layer of cells covering the airway, with no evidence that it has gone deeper into the lung tissues, nearby lymph nodes, or any other parts of the body.
• Stage 1: Cancer is found in the lungs but has not spread to the lymph nodes or anywhere else.
• Stage 2: Cancer is in the lung and nearby lymph nodes.
• Stage 3: Cancer is in the lung and lymph nodes in the middle of the chest.
• .Stage 4: Cancer has spread to both lungs, into the area around the lungs, or to distant organs.

All of these stages can divide into substages depending on the type of tumor, its size, and the specific structures it affects.

Small-cell lung cancer (SCLC) stages:

There are two stages of SCLC: limited and extensive. In the limited stage, cancer is found in only one lung or nearby lymph nodes on the same side of the chest.

The extensive stage means cancer has spread:

• throughout one lung
• to the opposite lung
• to lymph nodes on the opposite side
• to fluid around the lung
• to bone marrow
• to distant organs

About 2 out of 3 people with SCLC are already in the extensive stage when they receive a diagnosis.

The following are the estimated 5-year survival rates for NSCLC and SCLC by SEER stage:

Small-cell lung cancer (SCLC) is very aggressive. Depending on how far the cancer has spread, the relative 5-year survival rate for mesothelioma is 7–24%.

Keep in mind that survival rates and other statistics provide a broad picture of what to expect. There are significant individual differences, and your doctor is in the best position to discuss your outlook.

Learn more about the prognosis for non-small cell lung cancer.

The U.S. Preventative Task Force (USPSTF) recommends people ages 50–80 years who currently smoke or those who have quit in the last 15 years undergo screening for lung cancer.

The screening is usually done with a low dose computed tomography (CT), though your doctor may want to conduct other imaging tests such as X-ray, MRI, and PET scans, which can also show an abnormal mass in your lungs.

In addition, they may conduct the following tests:

• Sputum cytology: If you produce phlegm when you cough, a microscopic examination can determine if cancer cells are present.
• Bronchoscopy: While under sedation, doctors pass a lighted tube down your throat and into your lungs, allowing closer examination of your lung tissue.
• Thoracentesis: If there is fluid in your lungs, this procedure can remove some of the fluid to see if the cancer has spread to the lining of your lungs.
• Lung needle biopsy: This involves obtaining a small sample of lung tissue, which is then examined under a microscope to see if tumor cells are cancerous. Your doctor inserts a needle through the chest wall and into the suspicious lung tissue. There are various sub-types of this procedure depending on your specific needs.

If the biopsy results are positive for cancer, you might need additional testing, such as a bone scan, to help determine if the cancer has spread and to help with staging.

Learn more about how doctors diagnose lung cancer.

The primary treatments for lung cancer include surgery to remove the tumor and chemotherapy and radiation treatments to kill cancer cells. Sometimes, doctors use newer cancer treatments such as targeted therapy and immunotherapy, but usually not until later stages.

As a rule, treatment for NSCLC varies from person to person. Your treatment plan will depend on specific details of your health and at what stage you received a diagnosis.

Treatment options for NSCLC by stage typically include:

• Stage 1 NSCLC: Surgery to remove a portion of the lung may be all you need. Your doctor may also recommend chemotherapy, especially if you’re at high risk of recurrence. Cancer is most treatable if caught at this stage.
• Stage 2 NSCLC: You may need surgery to remove part or all of your lung. Your doctor will usually recommend chemotherapy.
• Stage 3 NSCLC: You may require a combination of chemotherapy, surgery, and radiation treatment.
• Stage 4 NSCLC: Options include surgery, radiation, chemotherapy, targeted therapy, and immunotherapy.

The options for SCLC also include surgery, chemotherapy, and radiation therapy. In most cases, the cancer will be too advanced for surgery.

If you’re diagnosed with lung cancer, it’s likely that a team of doctors will manage your care, including:

• a surgeon who specializes in the chest and lungs (thoracic surgeon)
• a lung specialist (pulmonologist)
• a medical oncologist
• a radiation oncologist

Discuss all your treatment options before making a decision. Your doctors will coordinate care and keep each other informed. You may also want to discuss clinical trials with your doctor.

Clinical trials can provide access to promising new treatments and can be an option if your treatment plan has stalled.

Some people with advanced lung cancer choose not to continue treatment. You can still choose palliative care treatments, which focus on treating the symptoms of cancer rather than the cancer itself.

Learn more about alternative treatments for lung cancer.

Home therapies for lung cancer symptoms

Home remedies won’t cure cancer. However, some may help relieve symptoms associated with lung cancer or the side effects of treatment.

Options may include:

• Massage: Massage can help relieve pain and anxiety. Some massage therapists have specific training to work with people with cancer.
• Acupuncture: When performed by a trained practitioner, acupuncture may help ease pain, nausea, and vomiting. However, it’s not safe if you have low blood counts or take blood thinners.
• Meditation: Relaxation and reflection may help reduce stress and improve overall quality of life.
• Yoga: Combining breathing techniques, meditation, and stretching, yoga can help you feel better overall and improve sleep.
• Cannabis oil: Some people claim that cannabis oil reduces pain, relieves nausea and vomiting, and improves appetite. However, scientists need to do more research into these claims. Additionally, state laws on cannabis vary, so this option isn’t available nationwide.

Diet recommendations for people with lung cancer

No diet can minimize lung cancer. However, it’s important to get all the nutrients your body needs.

Cancer treatments can cause you to lose your appetite. They can also make it hard for your body to absorb vitamins. If you’re deficient in certain nutrients, your doctor can advise you on foods or supplements as necessary.

Here are a few dietary tips:

• Eat whenever you have an appetite.
• If you don’t have an appetite, try eating smaller meals throughout the day.
• If you need to gain weight, supplement with low sugar, high calorie foods and drinks.
• Use mint and ginger teas to soothe your digestive system.
• If your stomach is easily upset or you have mouth sores, avoid spicy food.
• If you have constipation, try adding more high fiber foods.

As you progress through treatment, your tolerance to certain foods may change. So can the side effects you experience and your nutritional needs. It’s worth discussing nutrition with your doctor. You can also ask for a referral to a nutritionist or dietician.

Here’s how to meet your dietary needs if you have lung cancer.

Anyone can get lung cancer, but there are a few risk factors that make it a lot more likely.

Smoking

Smoke damages your lung tissue from the moment you inhale it. Once you have damage to your lung cells, they begin to behave abnormally. This increases your chance of lung cancer.

Smoking is the single biggest risk factor for lung cancer. This includes cigarettes, cigars, and pipes. Tobacco products contain thousands of toxic substances.

As many as 90% of lung cancer cases are the result of smoking. According to the Centers for Disease Control and Prevention (CDC), cigarette smokers are 15–30 times more likely to get lung cancer than nonsmokers.

While not all smokers get lung cancer, and not everyone who has lung cancer is a smoker, there’s no doubt that smoking is the biggest risk factor.

Plus, you don’t have to be a smoker to be affected. Secondhand smoke also increases your risk of lung cancer. Every year in the United States, about 7,300 people who’ve never smoked die from lung cancer resulting from secondhand smoke.

Former smokers are still at risk of developing lung cancer, but quitting can lower that risk considerably. Within 10 years of quitting smoking, your chance of dying from lung cancer drops by half.

SCLC is almost always associated with heavy smoking. When you stop smoking, your lungs may be able to heal, reducing your risk of lung cancer.

Radon

Exposure to radon is the second leading cause of lung cancer, according to the American Lung Association.

Your chance of lung cancer also increases by breathing in other hazardous substances such as:

• asbestos
• arsenic
• cadmium
• chromium
• nickel
• some petroleum products
• uranium

Other risk factors

Other risk factors for lung cancer include:

• Genetic mutations: This includes the TP53, EGFR, and KRAS, which can negatively affect cell growth, division, and repair.
• A family history of lung cancer: Having family members with lung cancer increases your chance of lung cancer.
• A personal history of lung cancer: You’re more likely to get lung cancer if you’ve had lung cancer in the past, especially if you’re a smoker.
• Previous radiation therapy to the chest: Radiation therapy can increase your risk of lung cancer.

Lung cancer can lead to complications. These include:

• High risk of infection: People with lung cancer have a higher chance of pneumonia, bronchitis, and other infections.
• Paraneoplastic syndromes: These are conditions resulting from the immune system overreacting to the tumor. These can cause hypercalcemia (increased calcium in your blood), for example. This can also cause various types of brain inflammation.
• Facial swelling: Tumors in your lungs can restrict blood flow to your upper body and result in facial swelling.
• Loss of lung function: Shortness of breath, difficulty breathing, and other symptoms of reduced lung function can occur in lung cancer patients.
• Blood clots: People with lung cancer are at a higher risk of clots, especially in their lower legs.
• Spitting up blood: Irritation in airways or from tumors can result in spitting up blood.
• Spinal compression: Tumors can press on the spine and cause pain, weakness, and trouble walking.
• Heart blockage: Tumors in your lungs can compress heart vessels and lead to multiple serious heart conditions.
• Nerve pain: Tumors can result in nerve pain along with numbness, tingling, and weakness.
• Trouble swallowing: Lung cancer can spread to your esophagus and cause trouble swallowing.
• Neutropenia: This is when your blood doesn’t have enough neutrophils, a type of white blood cell that helps protect you from infection.
• Kidney dysfunction: This can happen as a result of certain medications.

There is no guaranteed way to prevent lung cancer. However, you can reduce your risk if you:

• Quit smoking: Smoking is the number-one risk factor for lung cancer. Eliminating smoking greatly reduces your chance of developing lung cancer.
• Avoid radon: You can have your home tested for radon to help reduce your exposure and lung cancer risk.
• Avoid other cancer-causing chemicals: Limiting your exposure to other cancer-causing chemicals can reduce your risk.
• Eat a healthy diet: There is some evidence to suggest that eating a diet high in fruits and vegetables can reduce your chance of lung cancer.

Lung cancer is most treatable when you catch it early. Unfortunately, the early stages of lung cancer don’t always cause symptoms.

Your outlook depends on the type and stage of your cancer, as well as factors such as your age at diagnosis, overall health, and how well your cancer responds to treatment.

As a rule, the earlier your cancer is diagnosed, the better it will respond to treatment.

In recent years, new treatments have gained approval for stage 4 NSCLC. Some people are surviving much longer than previously seen with traditional treatments.

Treatments for lung cancer can be tricky. Options such as chemotherapy, surgery, radiation therapy, and targeted therapy all come with potential side effects that are hard to manage. Additionally, the stigma of having lung cancer often causes self-blame, mental health issues, and reduced quality of life.

To boost your ability to cope with these issues, it’s important to use strategies like quitting smoking, eating a healthy diet, and seeking out support networks. Don’t be afraid to ask your care team about anything you don’t understand — it’s perfectly reasonable to get a second opinion at any point during your journey.

It’s also beneficial to lean on family and friends for assistance with things like cleaning the house, running errands, taking you to appointments, and just engaging in enjoyable activities not related to cancer. You may find that connecting with patient advocacy groups or learning how to advocate for yourself helps ease some of the difficulties associated with managing your care.

Participating in mind-body therapies or hobbies may reduce stress and increase overall well-being. Moreover, if you are experiencing anxiety or depression, then it may help to reach out to your doctor for counseling or medication.

The ALA provides resources for finding support groups and other helpful advice.

Lung cancer begins in your lungs and can spread to other parts of the body. Your prognosis and treatment will depend on the type of cancer you have and the stage you’re diagnosed with.

Treatment often includes surgery, chemotherapy, and radiation. Newer treatments are helping increase survival odds for lung cancer patients, and participating in a clinical trial could offer promise when other treatments stall.

There is no guaranteed way to prevent lung cancer, but by quitting smoking and avoiding hazardous exposures, you can dramatically reduce your chance of developing lung cancer.