Although lung cancer is the leading cause of cancer death in the U.S. in both men and women, it is also one of the most preventable kinds of cancer. At least four out of five cases are associated with cigarette smoking. About 170,000 people in the United States are diagnosed with lung cancer each year, most between the ages of 40 and 70. The cure rate for lung cancer approximates 12% and the five-year survival is only slightly higher.  However, there is a marked difference when only stage I lung cancer is detected.  In that situation, the five-year survival may be as high as 70%.

Symptoms of lung cancer vary depending on the type, location, and size of the tumor. Many people with lung cancer have no symptoms until the disease has advanced into late stages. Some lung cancer symptoms are similar to those of other common illnesses. Advise your physician of your medical and social history at each physical examination to assist in a prompt and accurate diagnosis. When lung cancer does cause symptoms, the most common one is chronic cough. Other symptoms include shortness of breath, easy fatigue, wheezing, repeat infections of pneumonia or bronchitis, coughing up blood, hoarseness (if the nerves to the vocal cords are involved),  pain in the shoulder, chest, or upper back (if the tumor is growing to the chest wall), and swelling of the face and neck (if the central veins are occluded by tumor). If the cancer has spread to another part of the body, then the symptoms may be from these areas as well. Common sites of lung cancer metastasis include bone, brain, and liver.

A pulmonary nodule is a small, round or egg-shaped lesion in the lungs. These nodules are typically asymptomatic, and they are usually noticed by chance on a chest x-ray that has been done for another reason. They represent a build up of abnormal tissue and are usually identified in about one of every 500 chest x-rays. They can also be referred to as coin lesions because they look coin shaped on chest x-ray.

There is always the chance that a nodule on a chest x-ray is malignant. Most of these, however, are benign. Determining if a lung nodule is malignant is integral to the evaluation and sometimes the diagnosis can be challenging. Risk factors for cancer include men, age over 45, cigarette use, and a history of cancer elsewhere in the body. One of the goals of diagnosis is to avoid unnecessary invasive procedures, such as surgically removing part of the lung because of a benign disease. Benign diseases that may produce lung nodules include Histoplasmosis, Blastomycosis, Aspergillosis and Dirofilaria infections.

Further workup may include Computed Tomography scan, percutaneous lung biopsy, bronchoscopy, mediastinoscopy, thoracentesis,  thoracoscopy, and thoracotomy with lung biopsy to determine if cancer is present. A CT Scan gives a more detailed picture than a chest x-ray. These scans detect small tumors and help determine if the tumor has spread to lymph nodes surrounding the lungs. Benign lesions can be followed with serial examinations.

Lung Cancer is a disease that begins in the tissue of the lungs. The lungs are sponge-like organs that are part of the respiratory system. During breathing, air enters the mouth or nasal passage and travels down the trachea. The trachea splits into two sets of bronchial tubes that lead to the left and right lung. The bronchi branch off into smaller and smaller tubes that eventually end in small balloon-like sacs known as alveoli. The alveoli are where oxygen, carbon dioxide, and other substances are exchanged between the lungs and the blood stream.

The vast majority of Lung Cancer cases fall into one of two different categories:

Non-Small Cell Lung Cancer is the most common type of Lung Cancer, making up nearly 80% of all cases. This type of Lung Cancer grows and spreads more slowly than small cell lung cancer. Non-small cell lung cancer is divided into three different subcategories:

Squamous cell carcinoma originates in the thin, flat cells that line the passages of the respiratory tract. Squamous cell carcinoma usually starts in cells of the central bronchi, the largest branches of the bronchial tree. It is the most common type of lung cancer in men and in smokers; it is the easiest to detect early, since its distinctive cells are likely to show up in tests of mucus samples. It also tends to be most curable if found early because it spreads relatively slowly.
Adenocarcinoma begins in the cells that form the lining of the lungs. This is the most common type of lung cancer in women and nonsmokers and  tends to originate along the outer edges of the lungs in the small airways. Adenocarcinoma often spreads to spaces between the lungs and the chest wall, and its typical location makes early detection difficult.
Large cell carcinomas make up a group of cancers that look large and abnormal under a microscope. They tend to originate along the outer edges of the lungs. They are the least common of the non-small-cell lung cancers.

Small Cell Lung Cancer makes up nearly 20% of all Lung Cancer cases. It is associated with cancer cells smaller in size than most other cancer cells. These cells may be small, but they can rapidly reproduce to form large tumors. Their size and quick rate of reproduction allows them to spread to the lymph nodes and to other organs of the body. This type of Lung Cancer is almost always caused by smoking or second hand smoke. Small-cell lung cancer is the most aggressive form of the disease; it is also called oat-cell cancer because, under a microscope, its cells resemble oat grains. Like squamous cell carcinoma, this cancer usually originates in the large, central bronchi. It spreads quickly, often before symptoms appear, making it particularly threatening. It frequently spreads (metastasizes) to the liver, bone, and brain. Although responsive to chemotherapy, small-cell lung cancer is rarely ever cured because it usually is not discovered before it has spread.

Lung cancer is complex and so is its treatment. Treatment options for Lung Cancer (like all cancers) vary with the stage of development that the disease is in at the time of diagnosis. The type of Lung Cancer and the stage of the disease determine which treatments are normally used. Non Small Cell Cancer is normally treated with surgery while Small Cell Cancer is normally treated with chemotherapy or other non-surgical procedures. Treatment options are different for each individual case. When surgery is done, it is often followed by radiation or chemotherapy to destroy cancer cells that may have spread or may have been missed during surgery. The type of surgery performed for lung cancer depends on the location and size of the tumor.

Segmental Resection - Surgery to remove only a small part of the lung that the tumor is isolated in. Sometimes referred to as a "wedge resection."

Lobectomy - The surgical removal of an entire lobe of the lung; The right lung is divided into 3 lobes and the left lung is divided into 2 lobes.

Pneumonectomy - The surgical removal of an entire lung.

Other options in the management of lung cancer include chemotherapy (especially for small cell lung cancer), radiation therapy, and photodynamic therapy. These options are managed by the oncologist once the surgical therapy is complete.