More than 87 percent of lung cancers are related to smoking. Some smokers will never develop lung cancer and if a person quits smoking, it will significantly reduce their risk of this disease. Exposure to other carcinogens such as asbestos and radon gas also increase the risk of lung cancer, especially when combined with cigarette or cigar smoking.

Smoking cessation programs

Symptoms of lung cancer
The signs and symptoms of lung cancer can take years to appear, and can be confused with symptoms of less serious conditions. Signs of lung cancer may not become clear until the disease has reached an advanced stage. For this reason, and because no specific screening tools have been developed for the early detection of lung cancer, it is essential to be aware of the symptoms and to consult your healthcare provider if you have any doubt as to the cause of symptoms you are experiencing.

Respiratory symptoms

• Persistent or intensified smoker's cough
• Cough that persists for more than two weeks in a non-smoker
• Persistent chest, shoulder, or back pain unrelated to pain from coughing
• Change in color of sputum
• Increase in volume of sputum
• Blood in sputum
• Wheezing
• Recurrent pneumonia or bronchitis

Non-respiratory symptoms

• Fatigue
• Loss of appetite
• Headache, bone pain, or aching joints
• Bone fractures not related to accidental injury
• Neurologic symptoms (e.g., unsteady gait and/or episodic memory loss)
• Neck and facial swelling
• Unexplained weight loss

Diagnosis
Detecting lung cancer as early as possible is critical to improving chances of survival. There are a number of tests physicians use to detect and diagnose this disease, which allow physicians to determine the type and stage of the cancer as well as the best options for treatment. At Oakwood Hospital & Medical Center, we provide the following services, under the direction of your physician:

• Chest X-ray - are "flat" pictures of the lungs, which help doctors to identify abnormal growths.
• CT Scan - Computed Tomography also known as CAT scan is a sophisticated instrument that uses a computer to create a two-dimensional scan from a series of X-ray images; the newest version of the CT is called a helical (or spiral) scan. CT scans reveal much more detail than x-rays.
• MRI - Magnetic Resonance Imaging is similar to a CT scan except it uses a magnetic field in place of X-rays to create an image.
• PET/CT Scan - is the most advanced medical imaging technique available today, combining Positron Emission Tomography with Computed Tomography.
• Sputum Cytology - coughed-up phlegm from the lungs which is examined under a microscope to check for abnormal or cancerous cells.
• Bronchoscopy - Viewing of the lungs through a hollow, flexible tube (bronchoscope) that is passed through the nose and throat into the main airway of the lungs. If abnormal areas or tumors are seen, biopsies can be obtained through the bronchoscope.
• Biopsy - is the removal of a lung tissue sample for examination under a microscope. Biopsies are obtained in different ways depending on the location of the tumor:
  - through a bronchoscopy
  - by inserting a needle through the chest into the lung
  - by removal and examination of an enlarged lymph node in the neck
  - through a small surgery on the lung

Treatments
There are several new treatment options for lung cancer that have been developed over the last few decades. To assure quality patient care, Oakwood offers a thoracic multidisciplinary program. This program, which includes team members such as radiation oncologists, medical oncologists and thoracic surgeons, meets on a weekly basis at tumor board to discuss patient cases and treatment options. These tumor boards provide the patient and referring physician with recommendations from several disciplines of care. Three areas of treatment that are commonly used for lung cancer are provided at Oakwood, by experienced staff and physicians:

• Surgery - an operation is performed to remove any tumors as well as surrounding tissue. This can mean the removal of a section of the lung or an entire lung, depending on the individual's stage and progression of lung cancer.
• Chemotherapy - a systemic therapy that uses anti-cancer drugs to shrink or destroy tumor cells.
• Radiation Therapy - a treatment that uses high-energy rays (x-rays, radium, neutrons) targeted on cancerous tumors.
  

Lung cancer screening

• No organizations currently recommend routine screening with either chest radiographs or sputum cytology.
• All patients should be counseled against tobacco use.
• Lung cancer is the leading cause of cancer deaths in men and women. Most striking is the rising incidence and mortality among women in the last decade.
• Over 80 percent of cancers of the lung are smoking-related.
• Only 10 to 12 percent of all new lung cancer patients survive five years.
• Surgical resection is the most important treatment modality from the perspective of cure. Survival is best at earlier disease stages.
• Only 20 to 30 percent of patients with lung cancer are candidates for potentially curative operations.
• Thus, early diagnosis should be beneficial.
• Unfortunately, studies of screening for lung cancer with chest radiographs and sputum cytology have not proven beneficial.