Signs and Symptoms

• A persistent cough that gets worse over time
• Constant chest pain
• Coughing up blood
• Shortness of breath, wheezing, or hoarseness
• Repeated pneumonia or bronchitis
• Swelling of the neck and face
• Loss of appetite or weight loss
• Fatigue

What Causes It?

Exposure to carcinogens (cancer causing agents) damages DNA in the cells of the body. The major cause of lung cancer is cigarette smoking. Other contributing factors include environmental tobacco smoke, occupational exposure to carcinogens, and diet.

Who Is Most At Risk?

Tobacco smoke is the biggest carcinogen, responsible for 85% of all lung cancers in the United States. Risk increases with the amount of tobacco used, and the amount of time it has been used. Non smokers exposed to tobacco smoke are also at risk of developing lung cancer. Other forms of tobacco use, such as cigar smoking and pipe smoking, are also associated with lung cancer. Other risk factors include:

• Family history.
• Environmental and occupational exposure to certain substances, including arsenic, asbestos, ether, chromium, silica, cadmium, nickel, and radon.
• Exposure to excessive radiation (wartime or industrial exposure, or radiotherapy to the chest).
• Lung diseases, including chronic obstructive pulmonary disease (COPD).
• Poor diet (however, diets high in fruits and vegetables may reduce risk).

What to Expect at Your Doctor's Office

If you have symptoms associated with lung cancer, see your health care provider. Your health care provider will evaluate your medical history, smoking history, exposure to environmental and occupational substances, and family history of cancer. You will also have a physical exam, and your provider may analyze your breath to determine if you have lung cancer.

You may be sent for a chest x-ray and other tests. These include a sputum cytology, the microscopic examination of cells obtained from a deep cough sample of mucus in the lungs. In some cases, your doctor may order a computed tomography (CT) scan. Research suggests these scans may reduce deaths from lung cancer by 20%. A biopsy -- the removal of a small sample of tissue for examination under a microscope by a pathologist -- can confirm whether you have cancer.

If you have cancer, your provider will want to learn the stage (or extent) of the disease to find out whether the cancer has spread, particularly to the brain or bones, using tests such as CT scan, magnetic resonance imaging (MRI), radionuclide scan, positron emission tomography (PET), and bone scan.

Treatment Options

Prevention

The best means of prevention is to never start smoking or chewing tobacco, or to stop using tobacco products. A healthy diet is also an important part of prevention. In fact, studies show adquate vitamin D levels are associated with a reduced risk of lung cancer.

Treatment Plan

A treatment plan depends on the cell type, stage of disease, possibility for removing the tumor, and the patient's ability to survive surgery.

Drug Therapies

Various therapies can treat lung cancer.

• Chemotherapy. Can control cancer growth and relieve symptoms.
• Photodynamic therapy. Involves injecting a chemical into the bloodstream, which is absorbed by cells all over the body, including cancer cells. A laser light activates the chemical, which then kills the cancer cells. Photodynamic therapy may be used to control bleeding, relieve breathing problems, or to treat very small tumors.
• Immunotherapy. Unleashes the immune system to more effectively fight cancer.

Surgical and Other Procedures

Surgery is one of the few treatments capable of curing non-small cell lung cancer. Removal of a small part of the lung is a segmental or wedge resection, removal of an entire lobe of the lung is a lobectomy, and removal of an entire lung is a pneumonectomy. Doctors may prescribe radiation therapy before surgery to shrink a tumor, or after surgery to destroy remaining cancer cells. They may also use radiation therapy instead of surgery, or to relieve symptoms, such as shortness of breath.

Complementary and Alternative Therapies

A comprehensive treatment plan for lung cancer may include a range of complementary and alternative therapies (CAM). Studies show several CAM therapies may be helpful in improving the overall care of patients with lung cancer. Ask your team of doctors about the best ways to incorporate these therapies into your overall treatment plan. Some CAM therapies may be contraindicated in lung cancer, and some may interact negatively with medications or therapies used in conventional cancer care. Work with a qualified professional when deciding if and what CAM therpaies to use. Always tell your doctor about the herbs and supplements you are taking.

These nutritional tips may help reduce symptoms:

• Try to eliminate suspected food allergens. Your doctor may want to test you for food allergies.
• Eat foods high in B-vitamins and iron, such as whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.
• Eat antioxidant-rich foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell pepper). Low concentrations of vitamins A, C, and E have been associated with development of lung cancer.
• Avoid refined foods, such as white breads, pastas, and sugar.
• You should use quality protein sources, such as organic meat and eggs, whey and vegetable protein shakes as part of a balanced program aimed at gaining muscle mass and preventing wasting, which can sometimes be a side effect of cancer therapies.
• Use healthy cooking oils, such as coconut oil. Avoid cooking oils at high temperatures, as carcinogens may form.
• Reduce or eliminate trans-fatty acids, found in such commercially-baked goods as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid caffeine and other stimulants, alcohol, and tobacco.
• Exercise lightly, if possible. Speak to your doctor to determine the best regimen for you.
• Eat foods containing curcumin. Studies show this spice, common in Indian cuisine, suppresses lung tumor growth.

You may address nutritional deficiencies with the following supplements:

• Probiotic supplement (containing Lactobacillus acidophilus). 5 to 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. Some probiotic supplements may need refrigeration. Check the label. Probiotics may not be appropriate for people who are severely immunocompromised. Speak with your physician.
• Omega-3 fatty acids. Such as fish oil, 1 to 2 capsules or 1 tbsp. (15 mL) of oil, 1 to 2 times daily, to help reduce inflammation and enhance immunity. Fish oils may increase bleeding in sensitive individuals, such as those taking blood-thinning medications (including aspirin).
• Melatonin. 2 to 6 mg at bedtime, for immune support and sleep. Higher doses may be beneficial in lung cancer, so check with your doctor. Melatonin can interfere with many medications, including sedatives, antidepressants, birth control, and others.

Herbs may be an important part of an integrated cancer care strategy, but they should only be prescribed by a knowledgeable practitioner who is collaborating with all of your physicians.

• Mistletoe (iscador). Studies suggest taking iscador in conjunction with chemotherapy, can reduce side effects of chemotherapy. You should only take mistletoe under the supervision of a knowledgeable prescriber, in consultation with all of your treating physicians. Speak to your doctor.

Few studies have examined the effectiveness of specific homeopathic therapies, however professional homeopaths may consider the following remedies for the treatment of gastritis symptoms (such as nausea and vomiting) based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type, includes your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for you as an individual.

An experienced homeopath may prescribe a regimen to support general health during lung cancer. Acute remedies may be useful to relieve symptoms associated with complications. You should only take homeopathic remedies under the direction of an experienced homeopath, and in consultation with all of your treating physicians.

Homeopathy may help reduce symptoms and strengthen overall constitution, reduce the effects of stress during cancer, and also help reduce the side effects of chemotherapy.

• Radium bromatum. Is specific for radiation poisoning, especially followed by arthritic complaints. Acute dose is 3 to 5 pellets of 12X - 30C every 1 to 4 hours until symptoms are relieved.

While acupuncture is not used as a treatment for cancer itself, evidence suggests it can be a valuable therapy for cancer-related symptoms (particularly nausea and vomiting, which often accompany chemotherapy treatment). Studies indicate that acupuncture may help reduce pain and shortness of breath. Acupressure (pressing on rather than needling acupuncture points) has also proved useful in controlling breathlessness. Patients can treat themselves using this technique.

Some acupuncturists prefer to work with a patient only after the completion of conventional medical cancer therapy. Others will provide acupuncture or herbal therapy during active chemotherapy or radiation. Acupuncturists treat cancer patients based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In many cases of cancer-related symptoms, acupuncturists detect a qi deficiency in the spleen or kidney meridians.

Prognosis/Possible Complications

The outlook varies by cell type and stage of the disease. In general, the prognosis is better for squamous cell cancers than for adenocarcinomas. Early detection improves chances of survival.

Following Up

Periodic follow up is useful to help to detect recurrence of the lung cancer or other smoking-related cancers. Frequent follow up and rehabilitation for loss of lung function from cancer, surgery, or other treatment may be necessary.

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