Lung cancer is the leading cause of cancer death, accounting for more than a quarter of all deaths from cancer, according to The American Cancer Society. One reason for this high mortality rate is that lung cancer symptoms usually don’t manifest until the disease has reached an advanced state.
Yet, caught early enough, lung cancer is potentially curable—more than 430,000 people alive today have faced a lung cancer diagnosis, the ACS notes. Those survival rates may increase now that screening for lung cancer is recommended for certain people at higher risk.
So, before you experience any lung cancer symptoms, talk to your doctor about screening that may help identify the disease at an earlier, more curable stage. Most important, if you smoke, discuss strategies to help you quit and reduce your risk of lung cancer in the first place. (See our post “How to Quit Smoking: 6 Steps to Success.”)
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Lung Cancer Symptoms
By the time most people develop signs of lung cancer, the disease has spread beyond the point of a cure. But in some instances, symptoms may develop early on, and seeking a medical evaluation to diagnose the disease quickly may improve the odds of successful treatment.
See your doctor as soon as possible if you develop one or more of these common lung cancer symptoms:
- New persistent coughing, or changes in a chronic cough
- Shortness of breath
- Coughing up blood (or phlegm tinged with blood)
- Chest pain, especially pain that worsens when you breathe deeply, cough, or laugh
- Unintended weight loss
- Loss of appetite
- Persistent or recurrent bouts of bronchitis, pneumonia, or other lung infections.
Lung cancer may cause lumps near the skin if it spreads to the skin or lymph nodes. It also may cause bone pain if it metastasizes to the bone, neurological symptoms (e.g. dizziness, headache, or arm or leg weakness/numbness) if it advances to the brain or spinal cord, or jaundice if it spreads to the liver.
Know Your Risk and Get Screened
Undoubtedly, smoking is the leading risk factor for lung cancer—the ACS estimates that 80 percent or more of lung cancer deaths are attributable to smoking. The longer you smoke and the more packs of cigarettes you smoke each day, the greater your risk, regardless of the type of cigarettes you smoke. Smoking a pipe or cigars also increases lung cancer risk, as does breathing in secondhand smoke. If you smoke, talk to your doctor about nicotine replacement products, medications, counseling, and other methods that can help you kick the habit and remain tobacco free.
The landmark National Lung Screening Trial found that annual screening with low-dose computed tomography (CT) scans reduced the risk of death from lung cancer by 20 percent among people ages 55–74 with a smoking history of at least 30 pack-years (e.g. one pack a day for 30 years or two packs a day for at least 15 years) who still smoke or have quit within the past 15 years. Several leading cancer and pulmonary organizations, including the ACS, now recommend low-dose CT screening for this patient population. Lung cancer screening is not recommended for people with a serious medical condition that could limit their life expectancy or affect cancer treatment.
Despite the benefits identified in the NLST, lung cancer screening is not without potential drawbacks and limitations. For instance, lung CT scans often detect small nodules or other abnormalities that are not cancerous. Unfortunately, experts cannot tell for sure which nodules will become life threatening and which are benign.
In some instances, false-positive findings may prompt unnecessary biopsies or surgeries, each with associated risks. Screening also may lead to further CT scans, which expose patients to radiation over time and potentially increase the risk of secondary cancers. Additionally, screening does not identify all lung cancers, nor will it find all cancers at an early stage. So, even if you are screened, you may still die from lung cancer.
Discuss the pros and cons of screening with your physician. Choose a medical center equipped with the right type of CT scanner, with experts in the management of lung nodules, appropriate radiologists to read the images, and well qualified lung surgeons in place if the screening results are abnormal. Also, check to make sure that your insurance provider covers the cost of lung cancer screening.
If you opt for screening, you should be screened annually until age 74, as long as you remain healthy. If any abnormalities are found, you may require more frequent follow-up testing. To diagnose lung cancer, your physician may order further imaging studies, a sputum cytology test to check for lung cancer cells under a microscope, and/or a lung biopsy.
Originally published in 2016, this post is regularly updated.