Lung Cancer

Frequently Asked Questions about Lung Cancer

This text has been adapted from the
Oncology Interactive Education Series.
Click here for a demo of this unique
and innovation series.

What is lung cancer?
Why does lung cancer occur and is it caused by smoking?
What are the symptoms of lung cancer?
Can lung cancer be cured?
Are there different types of lung cancer?
What treatment options are available to me?
What are the side effects of each type of treatment?
Will I be able to work during my treatments? Following my treatments?
How long will I be in hospital?
Do I have to give up smoking?
Which physician should I contact when I have a problem?
Are my children at risk?
Where should I go for additional information?
Why did I get lung cancer if I did not smoke?

1. What is lung cancer?
Lung cancer is the uncontrolled growth of cells located in the lung.

2. Why does lung cancer occur?
About 85% of lung cancers are related to smoking. Passive or second-hand smoke has also been shown to affect non-smokers, increasing their risk for lung cancer. Exposure to several other, less common, cancer-causing agents (carcinogens) can also increase your risk of developing lung cancer. Carcinogens, such as cigarette smoke, can affect the DNA in our cells (the blueprint for our cells). However, a number of changes must happen to a cell before it becomes cancerous. Once a cell becomes cancerous, it can multiply, develop into a tumour and spread to other parts of the body. A small number of people who develop lung cancer have no known risk factors.

3. What are the symptoms of lung cancer?
In the early stages of lung cancer, there are usually no symptoms. This is because there are no nerves in the lungs to trigger sensations of pain or irritation. A tumour can grow for many months or even years before symptoms develop. Sometimes, early-stage lung cancer may be detected on an x-ray during a routine check-up. However, in most cases, the cancer is not detected until is has become extensive enough to cause shortness of breath, coughing, pain or other symptoms. When lung cancer spreads to other parts of the body, such as bone, the liver or the brain, it can cause symptoms in these areas.

4. Can lung cancer be cured?
In some cases, lung cancer can be cured, particularly if the tumour is small and has not spread beyond the lung. If the cancer spreads to other parts of the body, there is little chance for cure. Because of the potential for spread, lung cancer is often life-threatening.

5. Are there different types of lung cancer?
The different types of lung cancer are distinguished based on the type of cell from which they develop. About 75-80% of lung cancers are of the non small cell type; about 20-25% of lung cancers are of the small cell type. The prognosis for small cell lung cancer is less favorable than for non small cell lung cancer because this type of cancer is aggressive and spreads very quickly.

6. What treatment options are available to me?
There are several treatment options available for lung cancer. The treatment that is recommended will depend on your unique situation.

7. What are the side effects of each type of treatment?
Each treatment has side effects. The severity and type of side effects depend on the type of treatment and your individual case.

Pain can result from lung cancer and its treatments. Your doctors and nurses will help you find the method of pain control that works best for you and ensure that your pain is managed effectively.

8. Will I be able to work during my treatments? Following my treatments?
Your ability to continue to work during your treatments will depend on a number of factors:

Which treatment you receive
If you have major surgery, you will want to take about 4 to 6 weeks off from work. This will give you time to recover. You may find that you are able to continue working while undergoing radiation therapy or chemotherapy treatments, although fatigue is a side effect of these treatments.
Your flexibility at work and where you work
If you work close to your treatment centre, and if your work schedule is flexible, you may be able to work between treatments. For example, if you are receiving radiation therapy, you will have to go to the hospital for daily visits. For some people, it is possible to work part of each day; for others, this is not an option and they must take several weeks off work.
Your health
Some people are able to remain active despite having lung cancer. In more severe cases, the cancer or its treatments may require you to alter your lifestyle.

In general, whether or not you can work during or after your treatments depends on your individual circumstances. You may have to wait and see how you feel. If you feel fit and are willing to work, you may wish to continue working. If you do not feel physically or emotionally well, you may wish to take a leave of absence. Remember that your doctor can provide a letter confirming your need for a leave of absence, or complete any required forms.

9. How long will I be in hospital?
The length of time you spend in the hospital depends on the treatment approach that is used.

If you receive external radiation therapy, you will be treated on an outpatient basis. You will not stay overnight in the hospital, but you will come to the hospital for treatment every weekday for several weeks. A small number of patients may receive internal radiation (brachytherapy). This treatment involves a short hospital stay.
If you receive chemotherapy, you will most likely be treated on an outpatient basis, although some forms of chemotherapy require that you stay overnight.
If you have surgery, you will usually have to stay in the hospital for three to five days.

10. Do I have to give up smoking?
Smoking is the most important risk factor for lung cancer. It is recommended that you give up smoking if you are diagnosed with lung cancer. Quitting will also improve your general health and make you better able to withstand the effects of the cancer and its treatments. It may also lower your risk of recurrence or of developing new smoking-related cancers.

11. Which physician should I contact when I have a problem?
Your health care team is a multi-disciplinary team that includes several different types of physicians (e.g., family physician, surgeon, radiation oncologist, medical oncologist). When you need to contact a physician, it can be confusing to decide which one to contact.

In general, you should contact the physician who is most actively involved in your care at the particular time. For example, contact your radiation oncologist if you are presently receiving radiation therapy, or contact your medical oncologist if you are presently receiving chemotherapy. The involvement of different members of your treatment team may vary during your treatment.

12. Are my children at risk?
With many types of cancer, certain families are at higher risk than others. This is sometimes due to genetic factors that make members of those families more susceptible to developing cancer. At this time, there is no evidence that lung cancer is hereditary.

This means that your children are not at a higher risk for developing lung cancer because you have the disease. However, just like any other person, your children will be at some risk for developing lung cancer. This risk level is determined by a number of factors.

13. Where should I go for additional information?
The best source of information on lung cancer is your treatment team. Each member of your treatment team has received specific training on the subject of lung cancer and can answer many of your questions.

You may wish to consult additional sources as well. Bookstores, the Internet, and the patient library at your local hospital are all good resources.

14. Why did I get lung cancer if I did not smoke?
Although the major risk factor for lung cancer is smoking, non-smokers are also at risk for the disease. Passive or second-hand smoke has also shown to affect non-smokers, increasing their risk for lung cancer. Other forms of inhaled substances can increase the risk of lung cancer. A very small percentage of lung cancers are not related to any known risk factors.

15. What should I ask my heath care team?
You should ask your health care team whatever questions are necessary to make sure that you are comfortable with what is happening to you during the course of your diagnosis, staging, treatment and follow-up.

Here are some examples of questions you may wish to ask your health care team:

Do I have small cell or non small cell lung cancer?
What stage is my cancer?
What are my treatment options?
Is there anyone else with whom I should speak?
Where can I find more information?
Where should I be treated?
Am I eligible for any ongoing clinical trials of new therapies?

This text has been adapted from the Oncology Interactive™ Education Series. Each title in this series contains between 15 and 20 hours of interactive, graphically rich and comprehensive content for patients, their families and health care professionals. You can use this series at any one of the Resource Centres at Princess Margaret Hospital, borrow a copy from the PMH Patient and Family Library, or purchase your own personal copy from http://www.OncologyInteractive.com.