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Lung Cancer — An Overview

Medically reviewed by Ashfaq Hafiz, M.D.
Written by Emily Wagner, M.S.
Updated on September 30, 2024

According to the National Cancer Institute, 5.7 percent of people in the United States will be diagnosed with lung cancer at some point in their lifetime. Lung cancer is the second most common cancer overall in the U.S., after breast cancer in women and prostate cancer in men, according to the American Cancer Society. Lung cancer mainly affects people aged 65 and older. The CDC estimates that in 2024, there will be about 234,580 new cases of lung cancer, with the disease remaining the leading cause of cancer death in the U.S.​

What Is Lung Cancer?

Lung cancer is a type of cancer that develops in different parts of the lung as a result of abnormal cell growth. When these cells invade surrounding tissues or break off and spread to other locations, the process is called metastasis, marking the progression of the disease.

What Causes Lung Cancer?

Lung cancer, like all cancers, is caused by genetic mutations (changes) that lead to uncontrolled cell growth and division. Most cancers are caused by acquired mutations that develop over a person’s lifetime. The average age of people diagnosed with lung cancer is 70. You’re at a higher risk if you have a family history of lung cancer, but most cases are caused by environmental factors.

According to the American Lung Association, more men are diagnosed with lung cancer each year, but more women currently live with the disease. Black men and women are more likely to develop and die from lung cancer compared to any other racial or ethnic group in the United States.

Smoking tobacco is the leading cause of lung cancer deaths, particularly in small cell lung cancer (SCLC). Exposure to secondhand smoke can also increase your risk.

Other environmental factors that raise the risk of lung cancer include:

  • Air pollution
  • Secondhand smoke (breathed in when other people nearby are smoking)
  • Radiation therapy to the chest
  • Exposure to asbestos and other carcinogenic chemicals
  • Radon exposure
  • Certain dietary supplements, such as beta-carotene, have been linked to an increased risk in people who smoke

Read more about risk factors and causes of lung cancer.

How Is Lung Cancer Diagnosed?

Although lung cancer screening isn’t recommended for everyone, low-dose CT scans are recommended for people at high risk of the disease. Most of the time, symptoms of lung cancer aren’t obvious until the disease has progressed to an advanced stage. Once lung cancer is suspected, doctors order a number of tests to confirm the diagnosis and pinpoint the type of lung cancer. They’ll also develop a comprehensive treatment plan.

Tests for lung cancer may include:

  • Physical exam
  • Imaging tests, such as chest X-rays and CT scans, positron emission tomography scans, and bone scans
  • Lung-specific testing, such as sputum cytology, bronchoscopy, and biopsies
  • Genetic testing to identify specific mutations
  • Laboratory tests on blood samples, including complete blood count and blood chemistry

Read more about tests to diagnose lung cancer.

What Are the Different Types of Lung Cancer?

The two main types of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer. NSCLC accounts for 80 percent to 85 percent of cases and SCLC for 10 percent to 15 percent. Rare subtypes of lung cancer can also be found in less than 5 percent of all cases.

The three main types of NSCLC are:

  • Adenocarcinoma — 40 percent of lung cancer cases
  • Squamous cell carcinoma — 30 percent of lung cancer cases
  • Large cell carcinoma — 2 percent of lung cancer cases

Rare subtypes of NSCLC include sarcomatoid carcinoma (0.1 percent to 0.4 percent of lung cancer cases) and adenosquamous carcinoma (0.4 percent to 4 percent of lung cancer cases).

The two main types of SCLC are:

  • Small cell carcinoma
  • Combined small cell carcinoma

There are also many other rare subsets of lung cancer that aren’t classified in these groups.

Staging Lung Cancer

Each case of NSCLC is assigned to one of four stages, while SCLC cases are said to be in either the limited stage or the extensive stage. Cancer staging depends on a number of factors, including tumor size, whether the cancer has spread to nearby lymph nodes, and how far it has spread (known as metastasis).

Read more about the staging of lung cancer.

What Are the Symptoms of Lung Cancer?

Symptoms of lung cancer can vary from person to person, but the most common are:

  • Chest pain
  • Persistent coughing
  • Shortness of breath
  • Hoarseness
  • Recurring lung infections, such as pneumonia or bronchitis
  • Change in sputum production and color
  • Fatigue
  • Unintentional weight loss and loss of appetite

All types of lung cancer often lead to similar symptoms, but some symptoms may be more common depending on your type of lung cancer. Tumors in the upper part of the lung, which are usually NSCLC, may press on nerves that connect to the face. This may cause eyelid drooping or lack of sweat on one side of the face.

SCLC is more likely to cause paraneoplastic syndromes. These are groups of symptoms that develop when cancer cells make molecules that spread throughout the body and affect distant body parts, even where the cancer hasn’t spread. For example, some paraneoplastic syndromes affect the nervous system, leading to symptoms like muscle weakness and trouble speaking or swallowing.

Read more about the symptoms of lung cancer.

How Is Lung Cancer Treated?

Many types of therapies are used to treat lung cancer. For both NSCLC and SCLC, treatment options may include surgery, chemotherapy, radiation therapy, and immunotherapy. Targeted therapies directed toward specific gene mutations (variations) may also be used to treat some cases of NSCLC.

Your doctor will recommend treatment options based on several factors, including your type of lung cancer. Your age and overall health may also be important considerations. Multiple treatments may be combined in a treatment plan or used alone as a single agent, known as monotherapy. Some people may choose to participate in clinical trials to try new therapies that are being studied for safety and effectiveness in people.

SCLC is extremely aggressive, and treatment should begin immediately upon diagnosis. NSCLC is often treated based on subtype. Adenocarcinoma is often diagnosed early, before it spreads, so less aggressive treatment may be needed. On the other hand, large cell carcinoma is often harder to treat.

The overall goals of lung cancer treatment may differ from person to person. In the early stages, doctors usually try to cure the cancer by doing surgery to remove the tumor. Sometimes, they also use chemotherapy or radiation to help get rid of it completely. In more serious cases, the goal is to make the cancer go away for a while (remission), stop it from coming back, or keep it under control by slowing its growth and reducing symptoms. If the cancer has spread a lot or is really aggressive, treatments like immunotherapy, special targeted medicines, or palliative care (focused on making a person feel better) can help a person live longer and improve their quality of life.​

Read more about new lung cancer treatments.

How Do Other Health Conditions Affect Lung Cancer?

Comorbidity refers to having two or more diseases at the same time. Comorbid conditions may be related to lung cancer in many ways. Conditions such as chronic obstructive pulmonary disease (COPD), cardiovascular disease, diabetes, and kidney disease are often linked with lung cancer, particularly because they share some risk factors, such as smoking.

If you have other health conditions as well as lung cancer, these comorbidities can lower your tolerance for lung cancer treatment and limit your options. For these reasons, having comorbidities may influence your lung cancer prognosis (outlook).

In addition, other health conditions may develop after lung cancer treatment. Your doctor can help you better understand your risk factors for developing these conditions and may recommend steps to lower your risk.

What Is the Prognosis for Lung Cancer? Can It Be Cured?

Research shows that new ways of treating lung cancer, in addition to education about risk factors, have increased survival rates steadily. Whether a cure is possible depends on many factors related to your specific lung cancer case, available treatment options, and your age and overall health.

Overall, the five-year survival rate after a lung cancer diagnosis is 26.6 percent. However, this rate rises to 63.7 percent in cases where the cancer is localized to one lung.

Talk With Others Who Understand

On MyLungCancerTeam, the social network for people with lung cancer and their loved ones, more than 13,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Have you or a loved one been diagnosed with lung cancer? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. Cancer Stat Facts: Lung and Bronchus Cancer — National Cancer Institute Surveillance, Epidemiology, and End Results Program
  2. Lung Cancer Statistics — Centers for Disease Control and Prevention
  3. Key Statistics for Lung Cancer — American Cancer Society
  4. Familial Risk for Lung Cancer — Oncology Letters
  5. Lung Cancer Trends Brief — American Lung Association
  6. Lung Cancer Risk Factors — American Cancer Society
  7. Small Cell Lung Cancer Treatment (PDQ) — Patient Version — National Cancer Institute
  8. Can Lung Cancer Be Found Early? — American Cancer Society
  9. Tests for Lung Cancer — American Cancer Society
  10. Lung Adenocarcinoma — Lungevity
  11. Squamous Cell Lung Cancer — Lungevity
  12. Large Cell Lung Cancer — Lungevity
  13. Pulmonary Sarcomatoid Carcinoma: University of Cincinnati Experience — Oncotarget
  14. Adenosquamous Carcinoma of the Lung — American Journal of Clinical Pathology
  15. Small Cell Lung Cancer — Cleveland Clinic
  16. Combined Small Cell Lung Carcinoma — OncoTargets and Therapy
  17. Non-Small Cell Lung Cancer Stages — American Cancer Society
  18. Small Cell Lung Cancer Stages — American Cancer Society
  19. Cancer Staging — American Cancer Society
  20. Signs and Symptoms of Lung Cancer — American Cancer Society
  21. Lung Cancer Surgery — American Lung Association
  22. How Is Chemotherapy Used To Treat Cancer? — American Cancer Society
  23. Radiation Therapy — Mayo Clinic
  24. Immunotherapy To Treat Cancer — National Cancer Institute
  25. Targeted Therapy To Treat Cancer — National Cancer Institute
  26. What Is Lung Cancer? American Cancer Society
  27. Comorbidity and Survival in Lung Cancer Patients — Cancer Epidemiology, Biomarkers & Prevention
  28. What Are the Long-Term Effects of Lung Cancer Treatment? — Moffitt Cancer Center
  29. New Treatments Spur Sharp Reduction in Lung Cancer Mortality Rate — National Institutes of Health
  30. Lung Cancer Key Findings — American Lung Association

Ashfaq Hafiz, M.D. completed his medical school and residency training in radiation oncology at SKIMS Deemed University in India. Learn more about him here.
Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.

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