Important Facts About Lung Cancer
by Beth G. Hodges, MD

Anyone who thinks about picking up a pipe or cigarette should know the facts about lung cancer.

Fact number one is that 90% of all lung cancers are directly or indirectly related to smoking. The longer a person has smoked (quantified by the medical community as "pack years") the greater the risk. Thirty or more "pack years" significantly increases that risk.

Someone who smokes one pack per day for thirty years has a "thirty pack year history." Someone who smoked two packs per day for fifteen years has the same. The risk does not come from the nicotine. It is from the nitrosamines and polycyclic aromatic hydrocarbons and about four thousand other toxic substances in the tobacco smoke.

Conversely to the building of risk, cessation of smoking can with time diminish that risk and pull the odds back to baseline. Fifteen years after smoking cessation, the risk of developing lung cancer is down to almost that of a nonsmoker.

Still, lung cancer is the leading cause of cancer death in men and women both in the U.S. and the world, with only a 14% 5 year survival rate, meaning that within 5 years of the diagnosis, 86% of lung cancer victims have died.

Popular wisdom sometimes says that smoking a pipe or a cigar is "not as bad" as smoking a cigarette. While it is true that the risk is not AS great, there is still a significantly increased risk above that of a nonsmoker. Read more about smoking and lung cancer here.

There are other causes of lung cancer, such as asbestos, radon gas, family history, air pollution, occupational exposures (I.e. arsenic or chromium), even a previous history of lung cancer. Someone who has been cured of a previous lung cancer has an increased risk of developing a second "primary" lung cancer (talk about unfair!)

Lung cancer kills more men and women in the United States and in the world than any other type of cancer. It is also a very difficult cancer to cure, with only a 14% survival rate overall at 5 years. That means that five years after diagnosis, 86% of lung cancer victims will have died. Read more about lung cancer survival rates here.

Part of the problem of curing lung cancer is that 75% of the cancers are not found until symptoms develop, by which time most of these cancers have progressed and spread.

There are two main types of lung cancer accounting between themselves for nearly 95% of all lung cancers. These two types (small cell lung cancer and non small cell lung cancer) can be further broken down into subtypes.

Typing the cancers and staging the cancers (determining the extent of the disease) guides treatment options and is of critical importance. Mistyping or a misdiagnosis of cancer type could lead to necessary treatment being withheld if the odds indicated likelihood of benefit from chemo or radiation were poor. Read more about lung cancer stages here.

Recently, there have been changes in the staging of non small cell lung cancer that will change treatment plans for a large percentage of those diagnosed with the disease. That change is the first major alteration to the staging system in twenty years.

The facts about lung cancer may seem bleak, and to many they are, but medicine has come a long way in being able to control disease and prolong or improve quality of life for those afflicted with this terrible disease.

Published - September, 2009