Lung Cancer

The team at Saint Luke’s Cancer Institute has deep experience in treating both early stages and complex cases of lung cancer. 

Saint Luke's offers low-dose computed tomography (LDCT) screening at multiple locations. The scan takes less than one minute. 

Talk to your doctor about your risk for lung cancer and discuss the risks and benefits of screenings to see if you’re eligible. 

Cancer is when certain cells grow even though your body doesn’t need them. In many cases, these cancerous cells form a lump or mass called a tumor.  

Since cancerous cells don’t act like normal cells, tumors can prevent your body from working correctly. Given time, they can also spread, or metastasize, to other parts of the body.  

Lung cancer is cancer that starts in the cells that make up the lungs. It isn’t cancer that spreads to the lungs from other parts of the body. This is key because treatment is based on the original site of the tumor. For example: If a tumor begins in the breast and spreads to the lungs, it would be treated as metastatic breast cancer—not lung cancer. 

There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Understanding the differences between these types may lessen anxiety about your diagnosis and treatment.  

Non-small cell lung cancer 

NSCLC accounts for 85% to 90% of lung cancer cases. There are 3 main subtypes. Each subtype is named for the type of cell it develops in:  

• Adenocarcinoma. This is the most common type of lung cancer—particularly among the minority of non-smokers who get the disease. It tends to appear on the outer edges of the lungs and grows more slowly than the other subtypes.   
• Squamous cell carcinoma (epidermoid carcinoma). This type of cancer develops more often in smokers or former smokers than lifetime nonsmokers. It tends to start in the center of the lungs near the bronchial tubes.  
• Large cell carcinoma.  The least common NSCLC, large cell carcinoma can begin anywhere in the lung. It tends to grow more quickly than the other subtypes, which can make it harder to treat.  

Despite minor differences, these cancers are often treated the same way.  

Small cell lung cancer  

Only about 1 in 10 to 3 in 20 people diagnosed with lung cancer have small-cell lung cancer (also called oat cell cancer). It's also almost exclusively found in smokers. It tends to grow more quickly than NSCLC. It often spreads to other parts of the body at an earlier stage. 

Lung cancer acts differently in different people. But when it spreads, it tends to go to the same places. First: lymph nodes in the center of the chest. It may also spread to lymph nodes in the lower neck. 

Lymph nodes are small clusters of immune system cells. 

During later stages, lung cancer may spread to more distant parts of the body, such as the liver, brain, or bones. 

If lung cancer is detected early, when it’s small and hasn’t had the chance to spread, it is more likely to be treated successfully. Unfortunately, lung cancer can be hard to catch at an early stage. People with lung cancer often don’t show symptoms until it’s more advanced. Even then, it’s easy to attribute those symptoms to other causes.  

This is where screening comes in. Simply put, screening is the process of looking for cancer and other diseases in people who don’t have symptoms. If you have a high risk for lung cancer, these tests could save your life.  

Studies have shown that low-dose CT (LDCT) scans can help detect lung cancer early in certain high-risk people. This specifically includes heavy smokers ages 55 to 74. 

LDCT scans use X-rays to create detailed 3-D images of your lungs. They are totally painless and require no special preparation. All you do is lie down on a narrow table as it passes through a ring-shaped CT scanner. At most, you may be asked to hold your breath a few times during the test. 

LDCT scans can spot abnormal areas that regular chest X-rays might miss. The benefit is significant: a lower risk of dying from lung cancer. Some potential downsides, however, include: 

• Many abnormalities surfaced in LDCT scans do not turn out to be cancer. These findings can cause unnecessary anxiety.
• More tests may determine whether the abnormal area is cancer. Sometimes, these exams can lead to complications.
• Each scan uses a small amount of radiation. 

Keep in mind: LDCT scans do not find all lung cancers. It’s also possible the cancers they do find may have already progressed to a later stage. 

The U.S. Preventive Services Task Force (USPSTF) and other expert groups have created specific guidelines for who should get screened. They recommend yearly LDCT scans for people who are:  

• Between the ages of 50 and 80  
  AND 
• Current smokers, or former smokers who have quit in the past 15 years  
  AND  
• Have a 20-pack year history of smoking. A pack-year is the equivalent of smoking an average of one pack of cigarettes per day for a year. In other words, smoking a pack a day for 20 years equals 20 pack-years. Smoking two packs a day for 10 years also equals 20 pack-years.  

The USPSTF says that screening can stop once a person has not smoked for 15 years or has a health problem that limits their life expectancy or their ability to have lung surgery.  

If your health care provider thinks you may have lung cancer, you will need certain exams and tests to be sure. Diagnosing lung cancer starts with your health care provider asking you questions. You'll be asked about your health history, your symptoms, possible risk factors, and family history of disease. A physical exam will be done. You might need to:  

• Have a sputum cytology test. Each morning for three to five days in a row, you'll collect the mucus (sputum) that you cough up from your lungs. It's then sent to a lab and looked at under a microscope to see if there are cancer cells in it.  
• Have blood drawn. A needle might be used to take a small amount of blood from your hand or arm. Blood tests can show how well certain organs are working and give an idea of your overall health.  
• Get a chest X-ray. This is done to look for changes in your lungs, such as tumors or fluid buildup.  
• Schedule other imaging tests. These are done to get a better picture of your lungs. A CT scan gives detailed X-ray pictures of the inside of your body and is most often used.  

Any of these tests might suggest that you have lung cancer. If imaging tests show something that doesn't look normal, such as a mass or fluid, you'll need to have a biopsy. This is when a health care provider takes out a tiny sample of the mass or some of the fluid for testing at a lab. A biopsy is almost always needed to diagnose lung cancer.