Lung Cancer

Lung cancer is the leading cause of cancer deaths in U.S. men and women.

The lungs are part of the respiratory system. Their function is to supply oxygen to the blood while removing carbon dioxide.

Lung cancer may spread to the lymph nodes or other tissues in the chest (including the other lung). In many cases, lung cancer may also spread to other organs of the body, such as the bones, brain, or liver.

Lung cancer can often be associated with known risk factors for the disease. Many risk factors can be changed, but not all can be avoided.

TOBACCO: Studies show that smoking tobacco products in any form is the major cause of lung cancer. People who stop smoking and never start again lower their risk of developing lung cancer or of having lung cancer recur (come back). Many products, such as nicotine gum, nicotine sprays, nicotine inhalers, nicotine patches, or nicotine lozenges, as well as antidepressant drugs, may be helpful to people trying to quit smoking. Never smoking lowers the risk of dying from lung cancer.

Second-hand tobacco smoke also causes lung cancer. This is smoke that comes from a burning cigarette or other tobacco product, or smoke that is exhaled by smokers. People who inhale second-hand smoke are exposed to the same cancer-causing agents as smokers, although in weaker amounts. Inhaling second-hand smoke is called involuntary or passive smoking.

ENVIRONMENTAL CAUSES: There are other causes of lung cancer in the environment, but their effect on lung cancer rates is small compared to the effect of cigarette smoking.

Cancer-causing agents that may be found indoors, especially in the workplace, include asbestos, radon, arsenic, chromium, nickel, tar, and soot. These substances can cause lung cancer in people who have never smoked, and combine with cigarette smoke to further increase lung cancer risk in smokers. Many countries are working to control these cancer-causing agents in the workplace.

Air pollution may also increase the risk of lung cancer. Studies show that lung cancer rates are higher in cities with higher levels of air pollution.

BETA CAROTENE: Studies show that heavy smokers who avoid taking beta carotene supplements may avoid further increasing their risk of lung cancer compared with smokers who do take beta carotene.

DIET AND PHYSICAL ACTIVITY: Studies show that a diet rich in fruit, and possibly vegetables, may help lower the risk of lung cancer, while heavy alcohol drinking may increase the risk of lung cancer. In addition, studies show that people who are physically active may have a lower risk of lung cancer than those who are not, even after taking cigarette smoking into account.

CHEMOPREVENTION: Chemoprevention is the use of specific natural or man-made drugs to reverse, suppress, or prevent cancer growth. Chemoprevention is an area of active clinical research. It has not yet become standard therapy.

Exam Overview

Your medical history can help your health professional find out what is causing your symptoms. Your health professional will ask you questions about:

• Your symptoms, such as shortness of breath, cough, bloody mucus or blood from the lungs (sputum), and wheezing.
• How long you have had your symptoms.
• Whether your symptoms are becoming worse.
• Any change in your appetite or a recent weight loss.
• Your use of tobacco.
• Your contact with certain chemicals, such as asbestos, radioactive dust, or radon.
• Your work-related contact with fumes and dust (for example, you might be exposed to dust on the job if you work in the mining industry).
• Any respiratory problems you had when you were a child.
• Your family history of respiratory problems and/or cancer.
• Other medical conditions you may have.

During the physical exam, your health professional will examine your body to help find the cause of your symptoms. Your health professional may:

• Take your temperature and weight to check for a fever or weight loss.
• Examine your ears, eyes, nose, and throat for signs of infection.
• Listen to your heart and lungs with a stethoscope. He or she will listen for abnormal air movement through your lungs that may indicate pneumonia or other respiratory problems.
• Examine your chest for areas of pain in your ribs or muscles.
• Press or tap on your belly (abdominal palpation) to check for pain, fluid buildup, or an enlarged liver.
• Examine your neck, armpits, groin, and other areas of your body to check for enlarged lymph nodes.

Laboratory tests may also be part of your physical exam for lung cancer.  Laboratory tests may include a complete blood count (CBC), a routine chemistry screen, and a chest X-ray.

Cancer Research

Piedmont Hospital participates in clinical trials for a variety of cancers. We are a member of the Atlanta Regional Community Clinical Oncology Program (ARCCOP), a National Cancer Institute (NCI) project, which allows community hospitals access to clinical trials. We also participate in pharmaceutical sponsored clinical trials. This enables patients to participate in cutting edge research studies without having to travel far distances to a research institution or the NCI.

For more information, please contact the Oncology Research department at:

Bonita Feinstein
Piedmont Hospital
Oncology Research
1968 Peachtree Rd. NW
Atlanta, GA 30309
404.605.2887

For a listing of current Atlanta Regional CCOP clinical trials open at Piedmont, you may access www.atlantaccop.org.
For other information related to cancer clinical trials, you may access the following web-sites:
Georgia’s Cancer Clinical Trials - www.georgiacancertrials.org
National Institutes of Health (NIH) Clinical Trials – www.clinicaltrials.gov
National Cancer Society (NCI) – www.cancer.gov

Clinical Trials

Studies of promising new treatments are known as clinical trials. A clinical trial is done only when there is some reason to believe that the new treatment may be of value to the patient. Clinical trials are needed in order to find new and better ways to treat cancer. Treatments used in clinical trials are often found to have real benefits. The main questions the researchers want to answer are:

• Is this treatment helpful?
• Does it work better than the one we're now using?
• What side effects does it cause?
• Do the benefits outweigh the side effects?
• Which patients are most likely to find this treatment helpful?

Clinical trials are carried out in steps called phases. Each phase is designed to answer certain questions.

Phase I clinical trials look at the best way to give a new treatment and how much of it can be given safely. The main purpose of a phase I study is to test the safety of the new drug.

Phase II clinical trials are designed to see if the drug works. Patients are given the highest dose that doesnt cause serious side effects and then watched closely to see if there is an effect on the cancer.

Phase III clinical trials compare the new treatment with standard treatment. Large numbers of patients are divided into 2 groups. The control group receives standard treatment and the other group receives the new treatment. Everyone is closely watched to see which treatment is more effective. The study is stopped if the side effects are too severe or if one group has much better results than the other.

If you are in a clinical trial, you will have a team of experts watching your progress very carefully. However, there are some risks. No one knows in advance if the treatment will work or exactly what side effects will occur. That is what the study is designed to discover. Keep in mind, though, that even standard treatments have side effects.