This page was reviewed under our medical and editorial policy by Dan J. Raz, MD, MAS, Thoracic Surgeon, City of Hope | Duarte
This page was updated on June 2, 2023.
The lungs are two large organs that lie above the diaphragm and under the rib cage. When you breathe in, your lungs absorb oxygen and deliver it to the bloodstream, where it’s pumped throughout the body. When you exhale, the lungs remove carbon dioxide, a waste gas, from the bloodstream. Lung cancer interferes with this vital process and can make breathing more difficult.
The disease is the second most common non-skin cancer among men and women in the United States, after prostate cancer in men and breast cancer in women. A thorough and accurate cancer diagnosis is the first step in developing a lung cancer treatment plan.
At City of Hope, we understand the uncertainty that comes with a lung cancer diagnosis. Our oncologists and supportive care clinicians are committed to helping you understand the complexities of the disease and the array of treatment options available to you, so you can make informed decisions about your care.
Our cancer care experts offer a level of expertise that comes from working regularly with cancer patients—every stage, every day. The doctors tap that training and experience in designing a comprehensive care plan specific to your cancer, your stage and your individual needs. At City of Hope, we offer a wide range of lung cancer diagnostic tools and treatments, including immunotherapy, advanced genomic testing and other new options that may be available through clinical trials.
This overview will cover the basic facts about lung cancer, including:
If you believe you may be experiencing symptoms of lung cancer and want to schedule an appointment for diagnostic testing, or if you’re interested in a second opinion for lung cancer at City of Hope, call us or chat online with a member of our team.
About one in 15 men and one in 17 women will get lung cancer, according to the American Cancer Society (ACS). Lung cancer is the third most common cancer, after skin cancer, prostate cancer (men) and breast cancer (women).
Despite a decrease in cases due to less smoking, lung cancer remains the most common cause of death from cancer in both men and women. Smoking is most often the cause.
Lung cancer typically develops in people older than 65. The average age of diagnosis for lung cancer is 70, with men at slightly higher risk than women.
Radon, a radioactive gas that leaks from soil and rock, is the second leading cause of lung cancer. It may be the leading cause for patients who never smoked tobacco. Radon is most dangerous in basements where it’s concentrated, not out in open air.
Other much-less common risk factors for lung cancer include:
Most people with lung cancer don’t have early signs or symptoms. However, when symptoms develop, they are most likely to include:
Lung cancer patients may experience chest pain that worsens with deep breathing or coughing, and have frequent lung infections such as bronchitis or pneumonia.
When lung cancer spreads to other areas of the body, a process referred to as metastasis, symptoms may include bone pain, headache, weakness, numbness, jaundice or enlarged lymph nodes.
The diagnostic process may begin with or without symptoms.
A lung cancer screening, which is testing before the appearance of symptoms, involves a low-dose computed tomography (CT) scan. This type of imaging study is recommended only for people at high risk for lung cancer.
According to the U.S. Preventive Services Task Force (USPSTF), patients who meet all of the following criteria should undergo screening:
Diagnosing lung cancer typically starts with a history and physical exam. The next step may be an imaging study—such as a chest X-ray, CT scan or PET (positron emission tomography) scan—to search for cancer in your lungs. Some patients may undergo a bone scan, an imaging study of the bones, to determine whether cancer has spread there.
Doctors use a biopsy to identify cancer cells, removing a piece of lung tissue or cells to study under a microscope. Common methods to obtain these samples include:
In other instances, the care team may perform a bronchoscopy. During this procedure, the care team places a thin, flexible tube with a light and camera down the patient's throat and into his or her airways to look for tumors or blockages.
Before starting treatment, your care team needs to identify the stage of your lung cancer. Staging tells your care team the extent of your cancer and helps decide the appropriate treatment.
The two main types of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Knowing the type is important for staging and treatment.
To stage cancer, doctors use what’s called the TNM system. TNM stands for Tumor Node Metastasis, which are important factors in determining the severity of the cancer.
Depending on the TNM findings, lung cancer may be diagnosed from stage 0 to stage 4. The higher the stage, the more advanced the cancer.
For SCLC, doctors sometimes use a simplified system with just two stages. These two stages are limited and extensive.
As you learn more about your cancer and the available treatments, you’ll share in the decision-making process with your care team.
Treatments for NSCLC vary by stage and may include:
For limited-stage SCLC, treatment may include:
For extensive-stage SCLC, primary treatments include:
Patients with either limited- or extensive-stage disease may benefit from clinical trials for new treatments.
Each cancer and each person is different. To determine a cancer prognosis, researchers calculate how many people with the same type of cancer and stage of cancer are alive five years after diagnosis (aka the five-year survival rate).
According to the ACS:
Keep in mind that these rates are based on past years of statistics and may not reflect advances in treatment or new treatments that may be available in clinical trials.
No one treatment is one-size-fits-all. You need to work with your care team to find the right option for you.
Below are tips to help you prepare for your treatment conversation:
Learn more about the questions to ask about lung cancer treatment
At the Lung Cancer Centers at each of our City of Hope hospitals, located across the nation, our singular focus enables our oncologists to stay up to date on new and emerging treatments and technologies, allowing us to help you make informed decisions about the options available to treat not just the disease but the side effects that may result. Clinical trials in immunotherapy, cryotherapy and other areas of innovation may be among the options available. Having a team of lung cancer experts collaborating daily, all under one roof, allows us to assemble a detailed treatment plan more quickly and more efficiently.
Each patient’s Lung Cancer Center care team is led by a medical oncologist and coordinated by a care manager devoted to the many details needed to help patients achieve their treatment goals and maintain their quality of life. Our lung cancer pathologists also play a key role in diagnosing and staging the disease, to better pinpoint the treatment options available.
Depending on your lung cancer type, stage and recommended treatment plan, your care team may include surgical and/or radiation oncologists, interventional pulmonologists, oncology nurses and a host of supportive care clinicians, all joining together to craft a personalized care plan with a commitment to comprehensive care.
Lung cancer treatments may cause side effects such as dry mouth, difficulty swallowing and other challenges that may impact your quality of life. Our supportive care clinicians understand that treating the disease is only half the battle and that supporting your well-being is important to your recovery. They help you manage the side effects of cancer and its treatment. Supportive care therapies for lung cancer patients may include:
If you believe you may be experiencing symptoms of lung cancer and want to schedule an appointment for diagnostic testing, or if you’re interested in a second opinion for lung cancer at City of Hope, call us or chat online with a member of our team.
