Lung Cancer

.. . There are three subtypes within this group. Some types grow more quickly than others. Ask your doctor to explain which of these you have. There are a few other rare types of lung cancer not covered in this document.

Staging is the process of finding out how far the cancer has spread. This is very important because your treatment and the outlook for your recovery depend on the stage of your cancer. There are different staging systems for small cell and non-small cell lung cancer. Small cell lung cancer staging For small cell lung cancer a two-stage system is most often used. These are limited stage and extensive stage. Limited stage usually means that the cancer is only in one lung and in lymph nodes on the same side of the chest. If the cancer has spread to the other lung, to lymph nodes on the other side of the chest, or to distant organs, it is called extensive. Small cell lung cancer is staged in this way because it helps to determine the best treatment for each group.

Many people with small cell lung cancer will already have extensive disease when it is found. The staging system most often used for non-small cell lung cancer is the TNM system, also known as the American Joint Committee on Cancer (AJCC) system. T stands for tumor (its size and how far it has spread within the lung and to nearby organs) N stands for spread to lymph nodes M stands for metastasis (spread to distant organs) All of this information is combined and a stage is assigned. The stages are described using Roman numerals 0-IV (1-4). In general, the lower the number, the less the cancer has spread.

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A higher number, such as stage IV (4), means a more serious cancer. After looking at your test results, the doctor will tell you the stage of your cancer. Be sure to ask your doctor to explain your stage in a way you understand. This will help you both decide on the best treatment for you. There is a lot for you to think about when choosing the best way to treat or manage your cancer.

There may be more than one treatment to choose from. You may feel that you need to make a decision quickly. But give yourself time to absorb the information you have learned. Talk to your doctor. Look at the list of questions at the end of this piece to get some ideas.

Then add your own. You may want to get a second opinion. Your doctor should not mind your doing this. In fact, some insurance companies require you to get a second opinion. You may not need to have tests done again since the results can often be sent to the second doctor.

If you are in an HMO (health maintenance organization), find out about their policy concerning second opinions. The treatment options for lung cancer are surgery, radiation therapy, and chemotherapy, either alone or in combination, depending on the stage of the tumor. Depending on the type and stage of the cancer, surgery may be used to remove the tumor and some of the lung tissue around it. If a lobe (section) of the lung is removed, the surgery is called a lobectomy. Removing only part of the lobe is called a wedge resection. If the entire lung is removed, the surgery is called a pnuemonectomy. These operations are done with the patient asleep. A hospital stay of one or two weeks is usually needed.

There will be some pain after the surgery because the surgeon has to cut through the ribs to get to the lungs. People whose lungs are in good condition (other than the cancer) can often return to normal activities after a lobe or even an entire lung is removed. However, if they also have diseases such as emphysema or chronic bronchitis (common among heavy smokers), then they may have long-term shortness of breath. For people who can’t have the usual surgery because of lung disease or other medical problems, or because the cancer is widespread, other types of surgery (for example, laser surgery) can be done to relieve symptoms. Chemotherapy refers to the use of drugs to kill cancer cells.

Usually the drugs are given into a vein or by mouth. Once the drugs enter the bloodstream, they spread throughout the body.Often several drugs are given at the same time. Depending on the type and stage of lung cancer, chemotherapy may be given as the main treatment or in addition to surgery. Chemotherapy can have some side effects. These side effects will depend on the type of drugs given, the amount taken, and how long treatment lasts. Common side effects could include nausea and vomiting, loss of appetite, temporary hair loss, mouth sores, an increased risk of infections, and fatigue.

Anyone who has problems with side effects should talk with their doctor or nurse as there are often ways to help. Radiation therapy is treatment with high energy rays (such as x-rays) to kill or shrink cancer cells. The radiation may come from outside the body (external radiation) or from radioactive materials placed directly in the tumor (internal or implant radiation). External radiation is the type most often used to treat lung cancer. Radiation is sometimes used as the main treatment of lung cancer, for example, for those people who may not be healthy enough to have surgery. For other patients, radiation might be used after surgery to kill small areas of cancer that can’t be seen and removed during surgery. Radiation can also be used to relieve symptoms such as pain, bleeding, and trouble swallowing.

Side effects of radiation therapy could include mild skin problems, nausea, vomiting, and tiredness. Often these go away after a short while. Chest radiation may cause lung damage and difficulty breathing. Side effects of radiation therapy to the brain (to treat metastasis) usually become most serious one or two years after treatment, and include headaches and trouble with thinking. Be sure to talk with your doctor if you have any side effects. Studies of new treatments in patients are known as clinical trials.

A clinical trial is only done when there is some reason to believe that the treatment being studied may be of value to the patient. The main questions the researchers want to answer are: Does this treatment work? Does it work better than the one we’re now using? What side effects does it cause? Do the benefits outweigh the risks? Which patients are most likely to find this treatment helpful? During your course of treatment, your doctor may suggest that you look into a clinical trial. This does not mean that you are being asked to be a human guinea pig. Nor does it mean that your case is hopeless. However, there are some risks. No one knows in advance if the treatment will work or exactly what side effects will occur. That’s what the study is designed to find out.

Keep in mind that standard treatments, too, can have side effects. Clinical trials are carried out in steps called phases. Each phase is designed to answer certain questions. Ask your doctor if there is a clinical trial that might be right for you. Then learn all you can about that trial. Because you volunteer to take part in a clinical trial, you can leave the trial at any time.

As you cope with cancer and cancer treatment, you need to have honest, open discussions with your doctor. You should feel free to ask any question that’s on your mind, no matter how small it might seem. Here are some questions you might want to ask. Be sure and add your own. Would you please write down the exact type of lung cancer I have? Has my cancer spread? What is the stage of my cancer and what does that mean in my case? What treatment choices do I have? What do you suggest and why? What is the goal of this treatment? What risks or side effects are there to the treatment you suggest? If I will lose my hair, what can I do about it? Based on what you’ve learned about my cancer, how long do you think I’ll survive? What are the chances of the cancer coming back after treatment? What should I do to get ready for treatment? Remember that your body is unique, and so are your emotional needs and your personal circumstances. In some ways, your cancer is like no one else’s.

No one can predict how your cancer will respond to treatment. Statistics can paint an overall picture, but you may have special strengths such as a healthy immune system, a strong family support system, or a deep spiritual faith. All of these have an impact on how you cope with cancer. Cancer treatment can make you feel tired. Give some time to recover. Don’t feel the need to rush back to work or resume all of your normal activities right away.

The doctor will let you know what follow-up tests need to be done and when. Chest x-rays and blood tests may be done to see if the cancer has come back or if a new tumor has formed. Be sure to report any new or recurring symptoms to the doctor right away. Even after lung cancer has developed, it is very important to quit smoking. Quitting helps improve appetite and overall health and can reduce the chance of a new cancer.

Ask theyour doctor or nurse for ideas about how to quit smoking. Do as much as you can to stay healthy and active. Eat a balanced diet of healthy foods, including plenty of fruits, vegetables, and whole grains. Once you get your strength back, try to exercise a few hours each week. Check with the doctor before you start an exercise program.

The doctor can suggest the types of exercise that are right for you. The doctor or nurse can suggest other.