Hydrogen Peroxide Therapy: Good for Cancer or a Hoax?
Early Signs And Symptoms Of Lung Cancer
Most people do not experience lung cancer symptoms during early stages but may notice signs if it spreads. Potential symptoms include unexplained weight loss, general fatigue, and difficulty breathing.
Some people experience subtle symptoms of early-stage lung cancer, but these symptoms more often stem from other health issues or factors such as smoking.
Lung cancer treatment is more effective during the early stages, so it is important for people to identify symptoms and seek a diagnosis as soon as possible.
This article explains some potential early symptoms of lung cancer, risk factors, and when to see a doctor.
According to the American Cancer Society (ACS), most types of lung cancer do not cause symptoms until they spread to other areas. However, some people may experience subtle symptoms during the earlier stages of the disease.
The symptoms below usually result from another underlying cause. However, people with these symptoms should visit their doctors as a precautionary measure.
Sudden weight lossUnexplained weight loss is a common lung cancer symptom.
A 2018 study of 3,180 adults with lung or gastrointestinal cancer found that 34.1% of the participants had already experienced weight loss by the time of diagnosis. The authors also associated weight loss before cancer treatment with lower survival rates.
Cancer can cause weight loss for many reasons, including:
Shortness of breathShortness of breath and wheezing are both common symptoms of lung cancer.
Some people may experience a slight cough in addition to shortness of breath. Others may have difficulty catching their breath but no cough.
CoughA cough that does not go away after three weeks can indicate lung cancer. Some people may assume this cough is due to smoking.
The level of coughing may not always align with cancer progression. The authors of a 2018 study did not associate smoking or lung cancer stage with the severity of coughing.
A cough that produces blood may result from lung cancer or another issue with the lungs. Anyone with this symptom should see a doctor.
General fatigueFatigue is one of the most common symptoms of lung cancer. Lung cancer fatigue may be due to:
Severe fatigue may make daily functioning harder.
Shoulder, chest, or back painMost people with lung cancer do not feel pain during the early stages because there are very few nerve endings in the lungs.
However, pain can occur when lung cancer invades the chest wall, ribs, vertebrae, or certain nerves. For example, Pancoast tumors, which form at the very top of the lungs, often invade nearby tissues, causing shoulder pain.
As a tumor develops, a person may begin to feel pain in their:
Coughing or laughing may worsen chest pain.
Hoarse voiceA person with lung cancer or another respiratory disease may develop a hoarse, raspy voice.
This can happen if a tumor presses on the laryngeal nerve within the chest. When something compresses the nerve, it can paralyze a vocal cord, causing the voice to change.
Finger clubbingA less typical symptom of lung cancer is finger clubbing. This causes the following changes to fingers and toes:
While lung cancer is a main cause of finger clubbing, the condition occurs in only 5% to 15% of people with lung cancer.
It is not entirely clear why finger clubbing occurs. It may be due to reduced blood oxygen levels causing tissue changes.
Horner syndromePancoast tumors in the upper lungs can also cause a condition called Horner syndrome. This occurs when the tumors affect nerves that lead to the eyes or face.
Symptoms of Horner syndrome will occur in one eye or on one side of the face and may include:
If lung cancer spreads, it may cause other eye problems, including blurriness, pain, and vision loss.
HypercalcemiaHypercalcemia occurs when there are high levels of calcium in the blood. It may be due to tumors releasing hormones that affect bone formation and calcium absorption.
Since hypercalcemia affects the entire body and can be due to other conditions, doctors may not recognize it as a lung cancer symptom initially.
Signs of hypercalcemia can include:
According to the Centers for Disease Control and Prevention (CDC), cigarette smoking is the biggest risk factor for lung cancer, accounting for 80% to 90% of lung cancer-related deaths.
When describing risk, organizations and experts may use the term "pack-year." A pack-year is the number of cigarettes a person smokes per day each year. For example, a person with a 30-pack-year smoking history may have:
Other risk factors for lung cancer include:
The U.S. Preventive Services Task Force recommends yearly lung cancer screenings for people ages 50 to 80 years who:
Screening cannot detect every instance of lung cancer, but it may lower a person's risk of dying from the disease.
According to the CDC, people who smoke have a 15 to 30 times higher chance of dying from lung cancer than people who do not smoke.
They also highlight that, from 2013 to 2014, 1 in 4 people who did not smoke, including children, were exposed to secondhand smoke. This increases their risk of developing the disease.
Quitting smoking can reduce the risk of lung cancer regardless of age.
The symptoms above usually result from issues other than lung cancer. However, since they can indicate cancer, anyone who experiences the following issues should visit a doctor:
Often, there are no symptoms during the early stages of lung cancer.
Below are answers to some common questions about the early stages of lung cancer.
What is usually the first symptom of lung cancer?Lung cancer usually does not show signs at first. Symptoms are most likely to appear after the cancer has spread.
Initial symptoms may include a persistent cough, chest pain, and unexplained weight loss. Lung cancer screenings may detect the disease even without symptoms.
Can someone test themselves for lung cancer?Medical tests are necessary to find and confirm lung cancer.
Doctors may use low dose CT scans or other imaging tests to look for abnormalities in the lungs. They will confirm the diagnosis by looking at lung cells under a microscope.
Where does lung cancer usually start?Lung cancer often starts in the alveoli (small air sacs in the lungs) or the cells inside the bronchi, the tubes that branch off from the windpipe to enter the lungs.
Other cancers may spread to the lungs from other areas of the body, but those are not lung cancer.
When do lung cancer symptoms appear?Lung cancer symptoms typically appear after the cancer spreads. Symptoms may worsen as the disease progresses, and new symptoms, such as lymph node swelling and bone pain, may develop if the cancer moves to other parts of the body.
Lung cancer does not usually cause symptoms until it spreads. This can cause a delay in diagnosis and treatment.
However, some people experience subtle symptoms during the initial stages. Recognizing these is important because treatment is typically more effective at this stage.
Anyone with potential symptoms of lung cancer should see a doctor. In many cases, another health condition is the cause, but it is best to seek medical advice as a precaution.
Read this article in Spanish.
What To Know About Lung Adenocarcinoma
A lung adenocarcinoma is a type of non-small cell lung cancer (NSCLC) that begins in the glandular cells of the lungs. Depending on the stage, this can be a serious illness. However, treatment can improve a person's outcome.
According to the American Cancer Society (ACS), lung cancer is the second most common type of cancer in both males and females.
Among lung cancer types, lung adenocarcinoma is most frequently observed. Most cancers that begin in the breast, pancreas, and prostate also are adenocarcinomas.
Read on to learn more about lung adenocarcinoma, its symptoms, treatment, and outlook.
There are two predominant types of lung cancer:
The ACS reports that NSCLC is much more common, making up 80% to 85% of all lung cancers.
Lung adenocarcinoma is a type of NSCLC, with the two others being squamous cell lung carcinoma and large cell carcinoma. About 40% of all lung cancers are NSCLC, according to the National Cancer Institute (NCI).
It begins in the glandular cells, which create and release fluids such as mucus and line the walls of your alveoli, the tiny air sacs in your lungs. When they turn cancerous, they begin to grow abnormally. They're often found on the outer parts of the lungs.
Adenocarcinoma of the lung can be further divided into different subtypes based on factors like:
Early on, a person with NSCLC may not experience symptoms. Once symptoms appear, they usually include a cough that does not go away. NSCLC can also cause chest pain when taking a deep breath, coughing, or laughing.
Other symptoms include:
The outlook for people with lung cancer is better when the cancer is found and treated early. If you develop any of the symptoms above, make an appointment with a doctor. They can perform tests to help find what's causing your symptoms.
NSCLC tends to form in the cells along the outer part of the lungs. In the precancerous stage, cells undergo genetic changes that cause the abnormal cells to grow faster.
Further genetic alterations may lead to changes that help the cancer cells grow and form a mass or tumor. Cells that make up a lung cancer tumor can break off and spread to other parts of the body.
The growth of lung adenocarcinoma happens in the following stages:
Depending on the stage of diagnosis, lung adenocarcinoma can be a serious illness. The more the cancer has spread, the more ongoing treatment you will need.
That said, a variety of factors can affect your outlook with adenocarcinoma of the lung. These include:
Having a family history of lung cancer raises your chance of developing it yourself. Certain genetic mutations can also predispose you to it.
Other risk factors include:
To diagnose lung adenocarcinoma of the lung, your doctor will first request your medical history. They'll ask about the symptoms you're having if you currently or have previously smoked and if you have a family history of lung cancer.
They'll then perform a physical examination. At this time, they'll get your vital signs and will listen to your lungs as you breathe.
The tests that may be ordered to help diagnose adenocarcinoma of the lung are:
A lung biopsy is the only way to definitively diagnose adenocarcinoma of the lung. If the tests above raise suspicions of lung cancer, your doctor will request that a biopsy be collected from the affected area and examined under a microscope to look for signs of cancer.
This tissue can also be tested for proteins or genetic changes associated with adenocarcinoma of the lung. If present, they can affect outlook and may also be targets for treatments like targeted therapy and immunotherapy.
An effective treatment for non-small cell adenocarcinoma depends on the cancer's stage. It may include:
Surgery to remove all or only part of the lung is often required if the cancer has not spread. Other treatments are more likely to be needed if the cancer has spread.
Is lung adenocarcinoma cancer curable?While it's not impossible to cure lung adenocarcinoma, this is often difficult because the condition is commonly diagnosed at an advanced stage.
Overall, the 5-year survival rate for NSCLC depends on whether the cancer has spread:
That said, research suggests that people with lung adenocarcinoma may have a slightly higher 5-year survival rate compared to those with other types of lung cancer (32.3% vs 25.4%).
People with two subtypes of adenocarcinoma of the lung, adenocarcinoma in situ and minimally invasive adenocarcinoma have a better outcome, especially when the cancer is treated early with surgery. If surgery completely removes the cancer, the 5-year survival rate approaches 100%.
That said, survival rates are calculated based on data from many people with NSCLC and do not account for individual factors or recent advances in diagnosis and treatment. Overall, it's best to discuss your individual outlook with your care team.
A lung adenocarcinoma is a form of NSCLC originating in the glandular cells of the lungs. Depending on its stage, this can be potentially life threatening. There are treatment options available that may lead to better outcomes.
Doctors and researchers also continue to develop newer, more effective treatments for adenocarcinoma of the lung. These can include new targeted therapy or immunotherapy drugs or new ways to use existing treatments.
Before being used on a larger scale, these new treatments need to be tested in clinical trials. If you're interested in taking part in a clinical trial, talk with your care team. They can help you to find one that you would be a good candidate for.
You can also consider looking at clinical trials supported by the NCI. The LUNGevity Foundation also provides a clinical trial matching service via the phone or an online search tool.
Read this article in Spanish.
Lung Cancer Drug's 'Off-the-Charts' Results Give Patients Hope
June 6, 2024 – Adam DeMara brushed off new symptoms last fall – feeling of pain in his lower right side, becoming breathless walking up a hill at his golf course – as nothing to worry about, maybe a hernia. But the symptoms persisted.
"I was taking ibuprofen to ease the pain, and then consulted with a friend who's a doctor at Henry Ford Health," said DeMara, 39, of Clinton Township, MI, who works at the health system as a clinic service representative.
After several tests, DeMara got the bombshell diagnosis: He had a rare lung cancer that typically affects nonsmokers, and at a much younger age than other lung cancers. It was stage IV non-small-cell lung cancer, involving mutations in the anaplastic lymphoma kinase (ALK) gene, or ALK-positive NSCLC.
While 85% of all lung cancers are non-small-cell (NSCLC), just 3% to 5% of the these cancers are the ALK-positive kind. The prognosis has been especially grim, as it's common for the cancer to spread to the brain and survival is typically measured in months. Globally, about 72,000 people a year get ALK-positive NSCLC.
In DeMara's case, the cancer was already found in both lungs, his liver, bones, and brain.
His doctors prescribed a targeted oral medication, lorlatinib (Lorbrena). The day before Thanksgiving, DeMara was literally couch bound, but started the drug. "Within 3 or 4 days, I was starting to see dramatic results," he said. "I was still a little bit sick, but I was better, more mobile."
In the months since then, tests suggest his tumors are either stable or decreasing. At his last medical appointment, he said, "there was a feeling of 'off-the-charts' optimism."
His doctor, he said, seems to think he is going to be living for a long time.
5-Year Results Favor Lorlatinib
That optimism is warranted, suggest the results of a new 5-year follow-up study published in a cancer journal and presented at the recent American Society of Clinical Oncology annual meeting in Chicago. In the phase III CROWN clinical trial, researchers randomly assigned 296 people with advanced and previously untreated ALK-positive lung cancer to receive either lorlatinib or crizotinib (Xalkori), another targeted therapy for this type of cancer. Pfizer makes both medications. DeMara was not part of the study.
Lorlatinib improved progression-free survival and protected the brain better than crizotinib, repeating results of an earlier analysis of the trial.
For the 5-year follow-up, researchers looked at a measure called median progression-free survival (PFS) – how long a patient lives without the disease worsening over the 5 years. While 60% of the lorlatinib patients remained alive at 5 years without disease progression, just 8% of the crizotinib patients did.
The researchers said the progression-free survival for patients on lorlatinib was the longest ever reported with a single-agent molecular targeted treatment in advanced NSCLC and for all solid tumors that had spread, known as metastases.
Lorlatinib also provided strong brain protection, said Todd M. Bauer, MD, a principal investigator for the trial and a medical oncologist at Tennessee Oncology's Greco-Hainsworth Centers for Research in Nashville. In the study, about 25% had seen the disease spread to the brain at the start of the study.
"In the group without brain metastases at the start, 4 of 114 [on lorlatinib] developed it over the next 5 years," Bauer said, indicating a 96% prevention of spread to the brain. "It's very strong data to suggest a good protective benefit for our patients' brains," he said. The median time to brain progression with crizotinib was 16.4 months.
The drug works by blocking the ALK protein, slowing the growth and spread of tumors. The FDA approved lorlatinib as second- or third-line treatment in 2018 and as first-line one in 2021.
Side Effects, Coverage
According to Pfizer, side effects can include numbness, fatigue, weight gain, and joint pain, among others. In the 5-year study, 5% of the lorlatinib patients and 6% of the crizotinib patients stopped treatment due to side effects, and no new safety issues were found.
"It makes the appetite ravenous," DeMara said. He gained about 20 pounds quickly, but his 6-foot, 1-inch frame had gotten too thin, he said. Now, he's been able to maintain at an ideal 220 pounds if he's careful to exercise.
Costs without insurance may be more than $7,000 a month. "As with most of our modern anti-cancer drugs, it is very expensive," Bauer said, "but fortunately, insurance does cover for most patients." Patient assistance programs are also available, he said.
From Terminal Diagnosis to Chronic Disease?
Bauer, who consults for Pfizer, Bayer, and Eli Lilly and Company, has diagnosed two patients with this rare cancer in the past few months. He said he can now tell them: "We have the ability to treat your metastatic cancer with a pill you take every day that is typically well tolerated and can convert this disease into a chronic illness along the lines of heart disease or diabetes."
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