Lung Cancer: Basic Information You Should Know

It’s cancer that starts in your lungs and can spread to other parts of your body. Although it’s the top cause of cancer deaths for U.S. men and women, it’s also one of the most preventable kinds, by not smoking and avoiding other people’s secondhand smoke.

The disease almost always starts in the spongy, pinkish gray walls of the lungs’ airways (called bronchi or bronchioles) or air sacs (called alveoli). There are more than 20 kinds. The two main types are non-small cell lung cancer and small-cell lung cancer. At first, you may not have any symptoms.

Non-Small Cell Lung Cancer

Adenocarcinoma is the most common kind of this. It makes up 40% of all lung cancer cases. It mainly happens in people who smoke (or who used to). And it’s also the No. 1 type of lung cancer among non-smokers.

More women get it than men. People with this type tend to be younger than those with other kinds.

Adenocarcinoma can spread to the lymph nodes, bones, or other organs such as the liver.

Squamous cell carcinoma usually starts in the lung’s largest branches, which doctors call the “central bronchi.”

This type accounts for 30% of lung cancers, and it’s more common in men and people who smoke. It may form a cavity within the tumor. It often involves the larger airways. It may make you cough up some blood.

Squamous cell carcinoma can also spread to the lymph nodes, bones, and other organs such as the liver.

Large-cell carcinomas are a group of cancers with large cells that tend to start along the lungs’ outer edges. They’re rarer than adenocarcinoma or squamous cell carcinoma, making up 10%-15% of lung cancers. This type of tumor can grow faster and often spreads to nearby lymph nodes and distant parts of the body.

Small Cell Lung Cancer

This is the most aggressive form of the disease. It usually starts in the lungs’ large, central bronchi. Almost all people who get it are smokers. It spreads quickly, often before symptoms appear. Many times, it spreads to the liver, bone, and brain.

The outlook for someone with lung cancer depends on a lot of things, including what type they have, their overall health, and how advanced the disease is when doctors find it.


Smoking is the biggest reason. It’s responsible for about 85% of all cases.

Quitting cuts the risk. Former smokers are still slightly more likely to get it than nonsmokers.

There are also other reasons. Some genetic glitches may put some people at higher risk.

Secondhand tobacco smoke is also a cause. People who live with someone who smokes are 20% to 30% more likely to get lung cancer than those who live in a smoke-free home.

Some other chemicals are risky, too. People who work with asbestos or are exposed to uranium dust or the radioactive gas radon are more

likely to get lung cancer, especially if they smoke.

Lung tissue that was scarred by a disease or infection, such as scleroderma or tuberculosis, becomes at risk for tumors in that tissue. Doctors call this a scar carcinoma.

Some researchers think that diet may also influence your risk. But that’s not clear yet.


Lung Cancer usually has no symptoms in its early stages. When signs of the disease start to appear, they can include:

Chronic, hacking, raspy coughing, sometimes with mucus that has blood in itChanges in a cough that you’ve had for a long timeRespiratory infections that keep coming back, including bronchitis or pneumoniaShortness of breath that gets worseWheezingLasting chest painHoarseness 

Swelling of the neck and facePain and weakness in the shoulder,  arm, or handFatigue, weakness, loss of weight, and appetite, fever that comes and goes, severe headaches and body painTrouble swallowing

What are the types of lung cancer?

Lung cancers are broadly classified into two types: small cell lung cancers (SCLC) and non-small cell lung cancers (NSCLC). This classification is based upon the microscopic appearance of the tumor cells. These two types of cancers grow, spread, and are treated in different ways, so making a distinction between these two types is important.

SCLC comprises about 10%-15% of lung cancers. This type of lung cancer is the most aggressive and rapidly growing of all the types. SCLC is strongly related to cigarette smoking. SCLCs metastasize rapidly to many sites within the body and are most often discovered after they have spread extensively.

NSCLC is the most common lung cancer, accounting for about 85% of all cases. NSCLC has three main types designated by the type of cells found in the tumor. They are:

Adenocarcinomas are the most common type of NSCLC in the U.S. and comprise up to 40% of lung cancer cases. While adenocarcinomas are associated with smoking like other lung cancers, this type is also seen in non-smokers — especially women — who develop lung cancer. Most adenocarcinomas arise in the outer, or peripheral, areas of the lungs. They also have a tendency to spread to the lymph nodes and beyond. Adenocarcinoma in situ (previously called bronchioloalveolar carcinoma) is a subtype of adenocarcinoma that frequently develops at multiple sites in the lungs and spreads along the preexisting alveolar walls. It may also look like pneumonia on a chest X-ray. It is increasing in frequency and is more common in women. People with this type of lung cancer tend to have a better prognosis than those with other types of lung cancer.Squamous cell carcinomas were formerly more common than adenocarcinomas; today, they account for about 25% to 30% of all lung cancer cases. Also known as epidermoid carcinomas, squamous cell cancers arise most frequently in the central chest area in the bronchi. This type of lung cancer most often stays within the lung, spreads to lymph nodes, and grows quite large, forming a cavity.Large cell carcinomas, sometimes referred to as undifferentiated carcinomas, are the least common type of NSCLC, accounting for 10%-15% of all lung cancers. This type of cancer has a high tendency to spread to the lymph nodes and distant sites.

Other types of cancers arise in the lung; these types are much less common than NSCLC and SCLC and together comprise only 5%-10% of lung cancers:

Bronchial carcinoids account for up to 5% of lung cancers. These tumors are generally small (3-4 cm or less) when diagnosed and occur most commonly in persons under age 40. Unrelated to cigarette smoking, carcinoid tumors can metastasize, and a small proportion of these tumors secrete hormone-like substances. Carcinoids generally grow and spread more slowly than bronchogenic cancers, and many are detected early enough to be surgically removed.Cancers of supporting lung tissue such as smooth muscle, blood vessels, or cells involved in the immune response are rare in the lung.

As discussed previously, metastatic cancers from other primary tumors in the body are often found in the lung. Tumors from anywhere in the body may spread to the lungs either through the bloodstream, through the lymphatic system, or directly from nearby organs. Metastatic tumors are most often multiple, scattered throughout the lung and concentrated in the outer areas rather than central areas of the organ.

How Is Lung Cancer Diagnosed?

Your doctor may suspect lung cancer if a routine physical exam reveals:

Swollen lymph nodes above the collarboneWeak breathingAbnormal sounds in the lungsDullness when the chest is tappedUnequal pupilsDroopy eyelidsWeakness in one armExpanded veins in the arms, chest, or neckSwelling of the face

Some lung cancers produce abnormally high blood levels of certain hormones or substances such as calcium. If a person shows such evidence and no other cause is apparent, a doctor should consider lung cancer.

Lung cancer, which originates in the lungs, can also spread to other parts of the body, such as distant bones, the liver,  adrenal glands, or the brain. It may be first discovered in a distant location, but is still called lung cancer if there is evidence it started there.

How Do I Know If I Have Lung Cancer?

If a routine physical exam reveals swollen lymph nodes above the collarbone, a mass in the abdomen, weak breathing, abnormal sounds in the lungs, dullness when the chest is tapped, abnormalities of the pupils, weakness or swollen veins in one of the arms, or even changes in the fingernails,  a doctor may suspect a lung tumor.  Some lung cancers produce abnormally high blood levels of certain hormones or substances that can lead to an abnormally high calcium level in the bloodstream. If a person shows such evidence and no other cause is apparent, a doctor should consider lung cancer. 

Once a malignant tumor begins to cause symptoms, it is usually visible on an X-ray. Occasionally a tumor that has not yet begun to cause symptoms is seen on a chest X-ray taken for another purpose. A CT scan of the chest may be ordered for a more detailed look.

(  There are over 200 types of cancer. Some types are easier to cure or put into remission than others. In general, here is the criteria uses in the United States to determine if a patient diagnosed with cancer is at the point of being hospice-appropriate:


The patient has 1, 2, and 3:

1. Clinical findings of malignancy with widespread, aggressive, or progressive disease as evidenced by increasing symptoms, worsening lab values and/or evidence of metastatic disease.

2. Impaired performance status with a Palliative Performance Score (PPS) <70% p=””>

3. Refuses further curative therapy or continues to decline despite definitive therapy. Decline is evidenced by:

Hypercalcemia >12.Cachexia or weight loss of 5% in the preceding three monthsRecurrent disease after surgery/radiation/chemotherapyRefusal to pursue additional curative or prolonging cancer treatmentSigns and symptoms of advanced disease (e.g., nausea, anemia, malignant ascites or pleural effusion, etc.)

The following information will be required: 1. Tissue diagnosis or malignancy OR 2. Reason(s) why a tissue diagnosis is not available

In the absence of one or more of the above findings, rapid decline or co-morbidities may also support eligibility for hospice care.


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