6.8 Lung Cancer
Overview
Cancer is a disease where cells grow out of control. Lung cancer is a type of cancer that begins in the cells of the lungs. Lung cancer can also be cancer that has spread from other parts of the body called metastasis.
Lung cancer is commonly classified into two main categories called Non-Small Cell Lung Cancer (NSCLC) or Small Cell Lung Cancer (SCLS). Each type grows differently and is treated differently. NSCLC is the most common type of lung cancer, accounting for approximately 85% of all lung cancer cases. NSCLC includes subtypes such as adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. SCLC is a more aggressive type of cancer, often associated with a high growth rate and earlier metastasis.[1],[2]
Smoking is the greatest risk for lung cancer, but nonsmokers can also have lung cancer. Other risk factors include family history; exposure to secondhand smoke; infection with human immunodeficiency virus (HIV); and exposure to radon gas, radiation, air pollution, and other workplace exposures like asbestos, arsenic, and chromium.[3],[4]
The most common symptoms of lung cancer when it is initially diagnosed include worsening cough, dyspnea, pleuritic chest pain (i.e., worse on deep breathing or coughing), hemoptysis (blood-tinged sputum), malaise, weight loss, and hoarseness.[5]
Staging is the process of determining how much cancer is within the body and if it has metastasized. Staging includes the location and size of the tumor, whether the cancer has spread to the lymph nodes, and whether the cancer has spread to the rest of the body. Stage has a critical role in the medical treatment plan. See Figure 6.25[6] for an illustration of the general stages of lung cancer.
Assessment
Early detection and diagnosis are crucial for identifying and managing lung cancer effectively. Clinical manifestations of lung cancer vary depending on the stage and type of lung cancer, as well as the individual’s overall health. See Table 6.8 for a summary of clinical manifestations of lung cancer by body system. Not all individuals with lung cancer will experience all these symptoms. Some symptoms are associated with advanced stages or specific types of lung cancer.
Table 6.8. Clinical Manifestations of Lung Cancer Across Body Systems[7],[8]
| Body System | Clinical Manifestations Across Body Systems |
|---|---|
| Respiratory | Persistent cough, often with hemoptysis, dyspnea, hoarseness or voice changes, recurrent respiratory infections, pleuritic chest pain, and pleural effusion |
| General | Unexplained weight loss, fatigue, weakness, fever, night sweats, and loss of appetite |
| Cardiovascular | Superior vena cava syndrome, a blockage of blood flow into the superior vena cava, often caused by cancer, leading to swelling in the face, neck, or upper chest |
| Nervous | Neurological symptoms, such as severe headache or seizures if cancer has metastasized to the brain |
| Musculoskeletal | Bone pain and fractures if cancer has m