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View Clinical TrialsLung cancer is a type of cancer that forms in the tissues of the lungs, most often in the cells that line air passages. It occurs when these cells start to grow and multiply uncontrollably, usually as a result of exposure to toxins such as tobacco smoke, radiation and asbestos.
Lung cancer is a type of cancer that forms in the tissues of the lungs, most often in the cells that line air passages. It occurs when these cells start to grow and multiply uncontrollably, usually as a result of exposure to toxins such as tobacco smoke, radiation and asbestos.
Symptoms
Lung cancer symptoms vary from person to person. Some people with lung cancer don't have any symptoms. Often, symptoms are easily confused with common respiratory illnesses such as bronchitis or pneumonia, delaying an accurate diagnosis.
The most common symptoms of lung cancer include:
- Cough that does not go away and gets worse over time
- Chest pain that is constant and often made worse by deep breathing, coughing or laughing
- Arm or shoulder pain
- Coughing up blood or rust-colored phlegm
- Shortness of breath
- Wheezing
- Hoarseness
- Infections like pneumonia or bronchitis that do not go away or come back often
- Swelling of the neck and face
- Loss of appetite and/or weight loss
- Feeling weak or tired
- Widening of the fingertips and nailbed also known as “clubbing"
If lung cancer spreads to other parts of the body, it may cause:
- Bone pain
- Arm or leg weakness or numbness
- Headache, dizziness or seizure
- Balance problems or an unsteady gait
- Jaundice (yellow coloring) of skin and eyes
- Swollen lymph nodes in the neck or shoulder
These symptoms do not always mean you have lung cancer. However, it is important to discuss any lung cancer symptoms with your doctor, since they may also signal other health problems.
In rare cases, lung cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our genetic testing page to learn more.
Molecular diagnosis
Lung cancer traditionally is categorized by the type of cell where it begins. Today, doctors can also diagnose the disease on a molecular level.
This approach usually looks for mutations in the DNA of cancer cells and/or proteins produced by the cells. There are hundreds of different molecular diagnoses, including mutations to the EGFR, ALK, KRAS and ROS1 genes.
These molecular subtypes can impact how quickly the disease grows and spreads. They also can predict how the disease will respond to specific treatments, including different types of chemotherapy, targeted therapy and immunotherapy. By diagnosing a patient’s disease on a molecular level, doctors can design treatment plans with the best chance of fighting each patient’s specific cancer.
Cellular diagnosis
The traditional diagnosis based on the type of cell where the cancer started can still help doctors understand the patient’s condition and make a treatment plan. The two main categories are:
Non-small cell lung cancer (NSCLC)
About 85% of lung cancer cases are considered NSCLC. It arises from the lungs’ epithelial cells, a type of cell that lines the surface of organs. There are several types of non-small cell lung cancer based on the type of epithelial cell where the disease begins, including adenocarcinoma, squamous cell carcinoma and large cell carcinoma.
Small cell lung cancer (SCLC)
About 15% of lung cancers are SCLC and almost always are caused by smoking tobacco. It often starts in the more central portions of the chest. It usually grows and spreads quickly to other parts of the body, including the lymph nodes. Because it is so aggressive, surgery is used less often for small cell lung cancer than non-small cell lung cancer.
Lung anatomy
When you breathe in, oxygen comes through your mouth and nose and then travels through the trachea, or windpipe. The trachea divides into two tubes called bronchi, which take the oxygen to the left and right lungs. Inside the lungs are smaller branches called bronchioles and alveoli, tiny air sacks where oxygen is transferred to the blood stream.
Each lung is divided into sections called lobes. The right lung has three lobes and the left lung has two lobes. The left lung is smaller than the right lung because the heart is also located in the left side of the chest. Each lobe can be further divided into bronchopulmonary segments.
The pleura is a thin membrane that covers the outside of each lung and lines the inside wall of the chest. The space between the lungs and the chest wall usually contains a very small amount of fluid that allows the lungs to move smoothly during breathing.
Cancer grows in lungs, may spread
When lung cancer is small and at an early stage, it usually does not cause symptoms. However, once the disease grows, it may damage surrounding tissue, interfering with the lungs’ normal function and causing symptoms such as hemoptysis (coughing up blood), shortness of breath or pain.
Lung cancer frequently spreads, or metastasizes through the lymphatic system. Lymph is a clear fluid that is drained from our tissues and contains immune cells that help fight infection. It travels through your body in lymphatic vessels. Lymph nodes are small, bean-shaped organs that link lymph vessels. They often trap cancer cells that have spread to the lymphatic system.
Cancer cells can spread to other parts of your body through the bloodstream, as well. When lung cancer spreads to other organs such as the liver or bone, it is known as stage IV lung cancer or metastatic lung cancer. Cancer that has spread to another organ is still referred to as lung cancer. Whether or not a lung cancer has spread to lymph nodes or to other organs significantly influences how the tumor is treated.
Lung metastases
Sometimes, a tumor starts in another part of the body and then spreads, or metastasizes, to the lungs. These tumors are called lung metastases, and they are not the same as lung cancer. In these cases, they are the type of cancer where they came from. For example, a colon cancer with lung metastases is called metastatic colon cancer.
Statistics
Lung cancer is the most common cause of cancer-related deaths and second most common cancer in both men and women in the United States. According to the National Cancer Institute, more than 230,000 people in the U.S. are diagnosed with the disease each year. While most cases are linked to tobacco smoking, a growing number of diagnoses are among non-smokers, especially among women. Most lung cancers are diagnosed after the disease has spread. As a result, the five-year survival rate for lung cancers is 22%, though cases that are caught before the disease has spread have a much higher survival rate.
Risk factors
A risk factor is anything that increases the chance that a person will develop a particular disease. The main risk factors for lung cancer are:
- A history of or current tobacco use
- Exposure to second-hand smoke
- Exposure to asbestos, arsenic, chromium or other chemicals
- Living in an area with air pollution
- A family history of lung cancer
- Infection with the human immunodeficiency virus (HIV)
- Radiation exposure, including radiation therapy to the breast or chest, and radon exposure. This is a minor risk factor and the benefits of radiation therapy as a cancer treatment far outweigh the risks.
In some cases, lung cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our family history site to learn more about genetic counseling and testing.

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Diagnosis & Treatment
Diagnosis
Early stage lung cancer often does not have symptoms. In addition, when symptoms appear they can easily be mistaken for common respiratory illnesses like bronchitis or pneumonia. Because of this, many cases are diagnosed at an advanced stage.
Patients at high risk for lung cancer, especially those with a history of smoking, should undergo regular screenings in order to catch the disease at its early stages, when there is a better chance of cure.
If you have symptoms that signal lung cancer, your doctor will ask you questions about your medical, smoking and family history and whether you have been around certain chemicals or substances.
You will then undergo an imaging exam, typically a chest X-ray. Images cannot diagnose lung cancer, but they can show areas of concern. If the image shows such an area, the doctor may order other scans, including a CT scan or PET scan, for additional details regarding the area of concern.
If the findings on the imaging scans indicate cancer, the doctor will request that tissue or fluid be removed from the lung for examination. The act of obtaining a tissue or fluid sample is called a biopsy. There are several ways doctors can perform biopsies of lung tumors:
- Needle biopsy: A CT-guided biopsy where a needle is inserted through the skin under local anesthesia to acquire a tumor sample. One type of needle biopsy is fine needle aspiration (FNA), which uses a very small needle and suction to remove a small amount of tissue.
- Thoracentesis: Fluid from around the lungs is drawn out with a needle and tested for cancer cells.
- Bronchoscopy: A thin, flexible tube with a tiny camera is inserted through the nose or mouth and down into the lungs to obtain a small tissue sample (biopsy). This is usually performed under mild sedation. Bronchoscopies are rarely done alone. Bronchoscopy is usually performed with an endobronchial ultrasound.
- Endobronchial ultrasound (EBUS): A bronchoscope with an attached ultrasound device is used to check for lung cancer inside nearby chest lymph nodes. EBUS is often performed at the same time as a bronchoscopy and requires general anesthesia.
- Video-assisted thoracoscopic surgery (VATS): This minimally invasive surgical procedure uses a small camera to help retrieve tumor samples that are otherwise difficult to access. VATS requires a general anesthetic and is performed in the operating room by a thoracic surgeon.
- Thorascopy/pleuroscopy: A thin, flexible tube with a tiny camera is inserted through a small incision in the back (for a thorascopy) or between the ribs (for a pleuroscopy). Doctors use this device to look for and retrieve suspected cancer tissue.
To complete assessment of how advanced the cancer is, which is called staging, the patient will undergo a PET-CT scan and an MRI or CT scan to check for signs of cancer spread to other organs, including the brain. This will guide the treatment decisions for each patient’s lung cancer.
In some cases, lung cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our family history site to learn more about genetic counseling and testing.
Treatment
At MD Anderson, some of the nation’s top lung specialists focus their extraordinary expertise on you. We customize your treatment to deliver the most advanced, effective and least invasive treatments available for lung cancer. And because your peace of mind is important to us, we specialize in techniques and therapies than can help preserve lung function and quality of life
We’re constantly researching safer and more effective treatments for lung cancer with fewer side effects. We are proud to be one of the few cancer centers in the nation to house a prestigious federally funded lung cancer SPORE (Specialized Program of Research Excellence) program. This leads to a large number of active clinical trials at MD Anderson and ensures that our patients have access to some of the most cutting-edge therapy anywhere in the world.
If you are diagnosed with lung cancer, your doctor will discuss the best options to treat it. This depends on several factors, including the stage and type of lung cancer; other lung problems, such as emphysema or chronic bronchitis; other prior or current medical conditions; and possible side effects of treatment.
Your treatment for lung cancer will be customized to your particular needs. It may include one or more of the following therapies to treat the cancer and help relieve symptoms.
Surgery
Surgery may be a good option for those with early-stage non-small cell lung cancer. In some cases, patients may receive chemotherapy or radiation before surgery to shrink the tumor. This is called neoadjuvant therapy.
The most common types of surgery for lung cancer, in order of the amount of lung tissue removed, are:
- Wedge resection: Removal of the tumor and a pie- or wedge-shaped piece of the lung around the tumor. This procedure is typically used to perform a biopsy of a lung nodule.
- Segmentectomy or segmental resection: Removal of a segment, or part, of the lobe where the cancer is located. Both the segmentectomy and wedge resection are typically performed on patients who have limited lung capacity and can’t tolerate the removal of a larger section of the lung. They are also a good option for patients with small early-stage tumors generally measuring less than two centimeters. Both preserve lung capacity and the patient’s quality of life.
- Lobectomy: Removal of the lung lobe where the cancer is located. This is considered the “standard of care” for most lung cancer patients who undergo surgery.
- Sleeve lobectomy: A more complex form of lobectomy that is typically used for centrally located tumors. It involves removing the lobe where the tumor is located and part of the connecting bronchus. The cut bronchus is then connected with the remaining lobes. Though not always possible, sleeve lobectomies are preferable to pneumonectomy (complete removal of the lung) in order to preserve more functioning lung tissue.
- Pneumonectomy: Removal of an entire lung. This surgery is occasionally required due to the location of the tumor. In people with lungs that are otherwise healthy and function normally, pneumonectomy is well tolerated.
During most of these procedures, the surgeon will also remove lymph nodes from the chest. Since cancer often spreads through these nodes, doctors will examine them under a microscope to find out if the lung cancer has moved outside the lungs. This will help doctors decide if you need further treatment after surgery, such as chemotherapy, radiation therapy or targeted therapy. Treatment following surgery is called adjuvant therapy.
Surgical approaches
For some lung cancer surgeries, there are different ways to perform the same procedure. Your surgeon will work with you to choose the best option. These methods include:
- Open surgery: The traditional surgical method. Surgeons perform the procedure through a four- to eight-inch incision between the ribs.
- Minimally invasive surgery: These procedures require several smaller incisions, typically between ¼ and ½ inch, and usually have a shorter recovery time and less pain for the patient. There are two primary methods of minimally invasive surgery for lung cancer patients.
- Video-assisted thoracic surgery (VATS) or thoracoscopy: This technique uses a small camera and instruments that are inserted into the chest allowing the surgeon to perform the surgery through small incisions. It is typically performed on patients with small, early stage lung cancers.
- Robotic-assisted Surgery: This newer method of minimally invasive surgery uses robotic arms remotely controlled by the surgeon. Better images of the surgical site and greater instrument dexterity allow the surgeon to perform more complex surgery than is possible with VATS.
Statistically speaking, the more experienced the surgeon, the better the outcomes for lung cancer patients. MD Anderson’s Thoracic Center is home to many of the field’s most highly trained, experienced and respected thoracic surgeons. They operate only on cancers involving the chest and use the most advanced surgical techniques to treat a wide variety of lung cancers, including highly complex cases.
All patients with lung cancer who undergo surgery at the Thoracic Center enroll in a program of enhanced recovery, which aims to minimize pain, surgical stress and downtime. This leads to faster recovery, fewer side effects and better quality of life following surgery.
Radiation Therapy
Radiation therapy uses focused, high-energy photon beams to destroy lung cancer cells. It is performed by a radiation oncologist, a specialist who is specially trained to treat cancer with ionizing radiation. At most hospitals, radiation oncologists are expected to treat several different types of cancer. MD Anderson’s Thoracic Center has radiation oncologists dedicated exclusively to caring for patients with lung cancer. This gives them incredibly deep experience in designing treatment plans.
Working with these radiation oncologists is a team of radiation therapy specialists, including dosimetrists and medical physicists. Together, this team of experts develops models for several different treatment types and determines which is best for each patient. This way, MD Anderson can deliver the maximum amount of radiation with the least damage to healthy cells. The radiation therapy treatments used for lung cancer patients include:
- 3D-conformal radiation therapy: Several radiation beams are given in the exact shape of the tumor. This is primarily used as a palliative treatment and not to cure the disease.
- Brachytherapy: Tiny radioactive seeds are placed in the body close to the tumor. Brachytherapy is primarily used to treat metastatic growths in the airway. Since most of these growths can be treated with external beam radiation, brachytherapy is rarely used on lung cancer patients.
- Intensity-modulate radiotherapy (IMRT): Treatment is tailored to the specific shape of the tumor. This type of radiation is commonly used to treat cancers that have invaded nearby lymph nodes.
- Volumetric-modulate Arc therapy (VMAT): This is a special type of IMRT. In it, the part of the machine that shoots out the beam of radiation rotates around the patient in an arc. This can irradiate the tumor more precisely and shorten procedure times.
- Stereotactic body radiation therapy (SBRT): High doses of radiation delivered with several beams at various intensities and angles to precisely target the tumor. Learn more about SBRT.
Proton therapy
A type of radiation therapy, proton therapy delivers a high dose of radiation directly to the tumor, sparing nearby healthy tissue and organs. MD Anderson operates one of the world’s largest and most advanced proton therapy centers. Read more about proton therapy and how it is used to treat lung cancer.
Systemic Therapy
Systemic therapy is an umbrella term for treatments that use substances that travel through the bloodstream to reach affected cells all over the body. There have been significant advances in systemic therapy treatments for lung cancer over the last decades. The medical oncologists at MD Anderson’s Thoracic Center are world-renowned in the care of lung cancer patients and have participated in the clinical trials that have led to the development of important new treatments, including targeted and immune therapies.
Targeted therapy
Cancer cells use specific molecules (often in the form of proteins) to survive, multiply and spread. Targeted therapies stop or slow the growth of cancer by interfering with, or targeting, these molecules. Currently there are targeted therapies for many subtypes of adenocarcinoma. Read more about targeted therapies.
Immunotherapy
Immunotherapies recruit the body’s own immune system in the fight against cancer. The current standard of care for non-small cell lung cancer includes the use of checkpoint inhibitor immunotherapies, which take the natural “brakes” off the immune system, allowing it to attack cancer cells. This treatment can lead to durable responses and has revolutionized care for lung cancer patients. Read more about immunotherapy.
Chemotherapy
Chemotherapy uses drugs to directly kill cancer cells by stopping their growth. This form of treatment is commonly combined with immunotherapy. In combination, both drugs become more effective. Learn more about chemotherapy.
Angiogenesis inhibitors
Angiogenesis is the process of creating new blood vessels. Vascular endothelial growth factor (VEGF) is one of the main molecules that control the process. Some cancerous tumors are very efficient at using these molecules to create new blood vessels, which increases blood supply to the tumor and allows it to grow more rapidly.
Researchers developed drugs called angiogenesis inhibitors, or anti-angiogenic therapy, to disrupt the growth process. These drugs search out and bind themselves to VEGF molecules or receptor proteins, prohibiting them from activating angiogenesis.
Learn more about lung cancer:
In some cases, lung cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our family history site to learn more about genetic counseling and testing.
Frequently asked questions
What is small cell lung cancer?
Lung cancer is traditionally categorized by the type of cell where it begins. Small cell lung cancers (SCLCs) make up about 15% of lung cancers and almost always are caused by smoking tobacco. The cancer often starts in the more central portions of the chest — in the bronchi, the two large tubes that carry air from the windpipe to the lungs. It usually grows and spreads quickly to other parts of the body, including the lymph nodes. Because this cancer is so aggressive, surgery is used less often for SCLC than for non-small cell lung cancers.
What are the stages of lung cancer?
Lung cancer stages are determined through various tests and procedures, including MRIs, CT scans, PET scans, and lymph node biopsies. The doctor will combine the results of these procedures to stage the cancer, using the TNM (tumor, node, metastasis) classification system.
Can you get lung cancer from smoking?
Yes, you can get lung cancer from smoking. MD Anderson recommends lung cancer screening if you’re age 50–80, are a current smoker (or a former smoker who quit within the past 15 years), and have a 20 pack-year smoking history (for example, one pack a day for 20 years or two packs a day for 10 years).
Is lung cancer hereditary?
Lung cancer is hereditary in some cases, and a family history of lung cancer is considered a risk factor. Some rare genetic conditions, such as Li-Fraumeni syndrome (LFS), are associated with an increased risk of developing lung cancer.
Is lung cancer curable?
Lung cancer is sometimes curable; it depends on the specific cancer a person has and how early the cancer was caught. Some lung cancers are very aggressive, while others are very responsive to targeted therapy and are curable if caught early.
How are CT scans used to diagnose lung cancer?
CT scans are used in certain instances, in combination with other tests, to help diagnose lung cancer. In the process of diagnosis, patients will typically undergo an imaging exam, usually a chest X-ray. Images alone are not enough to make a lung cancer diagnosis, but they can show areas of concern. If an image shows such an area, the doctor may order other scans, including a CT scan or a PET scan, to get additional details. If the findings of the image scans indicate cancer, the doctor will request the removal of tissue or fluid from the lung for examination. Obtaining a tissue or fluid sample is called a biopsy.
When is immunotherapy used to treat lung cancer?
Immunotherapy may be used in combination with chemotherapy as a treatment for lung cancer. However, its usefulness depends on the type of cancer being treated.
Why choose MD Anderson for your lung cancer treatment?
Choosing the right hospital may be the most important decision you can make as a lung cancer patient. At MD Anderson you’ll get treatment from one of the nation’s top-ranked cancer centers. Our expertise starts with the ability to accurately diagnose and stage even extremely rare cancers, then carries on through groundbreaking treatment and into survivorship.
As a patient at MD Anderson, you’ll see the benefits of care from a top-ranked cancer center. These include:
- Treatment from specialists who focus exclusively on lung cancer and other thoracic cancers, including radiation oncologists, medical oncologists, surgeons and pathologists.
- Molecular diagnosis of cancer cells, allowing doctors to identify which treatments have the best chance of success against your exact cancer.
- Expert surgical care designed to offer complete resection of your tumor and any involved lymph nodes.
- An enhanced surgical recovery program along with robotic and minimally invasive procedures that offer faster recovery times and less pain from surgery.
- Groundbreaking clinical trials that may not be available anywhere else. These include trials of new targeted therapies, immunotherapies and drug combinations.
MD Anderson patients also have access to all the services and support offered by one of the nation’s top-ranked comprehensive cancer centers. From counseling and support groups to integrative medicine and physical therapy, MD Anderson has all the support and wellness services needed to treat the whole person – not just the disease.
This support and care is available beyond MD Anderson’s campus in the Texas Medical Center. Through our Houston-area locations, patients throughout the region can get top-ranked care and personalized attention close to home.
They're focused on you as a person, and they're focused on fighting the disease. But they also show so much kindness and compassion.
Alexa DiVenere
Survivor
Treatment at MD Anderson
MD Anderson lung cancer patients can get treatment at the following locations.

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