Chest Services

The University of Tennessee Medical Center Chest Service provides a unique specialty service for patients with suspected or known lung disease, including chest malignances.

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Asthma Services

UT Medical Center’s Heart Lung Vascular Institute features an Asthma Clinic dedicated to assisting patients with more effective disease management.

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Respiratory Care

Respiratory Care Services at UT Medical Center provide services to those who require treatment or diagnosis for conditions affecting the cardiopulmonary system.

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Lung Cancer

Lung cancer is cancer that starts in the lungs. Lung cancer is the deadliest type of cancer for both men and women. Each year, more people die of lung cancer than breast, colon, and prostate cancers combined. Lung cancer is responsible for an estimated 160,000 deaths in the United States annually.

The lungs are located in the chest. They help you breathe. When you breathe, air goes through your nose, down your windpipe (trachea), and into the lungs, where it spreads through tubes called bronchi. Most lung cancer begins in the cells that line these tubes.

What are the types of lung cancer?

There are two main types of lung cancer:

  • Non-small cell lung cancer (NSCLC) is the most common type of lung cancer.
  • Small cell lung cancer makes up about 20% of all lung cancer cases. Small cell lung cancer grows more quickly and is more likely to spread to other organs in the body.

If the lung cancer is made up of both types, it is called mixed small cell/large cell cancer .

If the cancer started somewhere else in the body and spread to the lungs it is called metastatic cancer to the lung.

What causes lung cancer?

Multiple exposure to carcinogens (cancer causing agents) results in damage to DNA in the cells of the body. 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.

The more cigarettes you smoke per day and the earlier you started smoking, the greater your risk of lung cancer. There is no evidence that smoking low-tar cigarettes lowers the risk. However, lung cancer has occurred in people who have never smoked. Secondhand smoke (breathing the smoke of others) increases your risk of lung cancer. According to the American Cancer Society, an estimated 3,000 nonsmoking adults will die each year from lung cancer related to breathing secondhand smoke.

The following may also increase one's risk of lung cancer:

  • High levels of air pollution
  • High levels of arsenic in drinking water
  • Lung diseases, including chronic obstructive pulmonary disease (COPD).
  • Radon gas
  • Asbestos
  • Family history of lung cancer
  • Radiation therapy to the lungs
  • Exposure to cancer-causing chemicals such as uranium, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, chloromethyl ethers, gasoline, and diesel exhaust.

Who's most at risk?

Smokers, particularly heavy smokers (a pack a day), are at the highest risk for developing lung cancer.

Other risk factors include:

  • Family history
  • People who suffer from chronic obstructive pulmonary disease (COPD)
  • Environmental and occupational exposure to certain substances, including arsenic, asbestos, ether, chromium, nickel, and radon
  • Exposure to excessive radiation (wartime or industrial exposure, or radiotherapy to the chest)
  • Poor diet (however, diets high in fruits and vegetables may decrease your risk)

Symptoms of lung cancer

Early lung cancer may not cause any symptoms. Many times, lung cancer is found when an x-ray is done for another reason.

Symptoms depend on the specific type of cancer you have, but may include:

  • Cough that doesn't go away
  • Coughing up blood
  • Shortness of breath
  • Wheezing
  • Chest pain
  • Loss of appetite
  • Losing weight without trying
  • Fatigue

Additional symptoms that may also occur with lung cancer, often in the late stages:

  • Weakness
  • Swallowing difficulty
  • Nail problems
  • Joint pain
  • Hoarseness or changing voice
  • Shoulder pain
  • Swelling of the face or arms
  • Facial paralysis
  • Eyelid drooping
  • Bone pain or tenderness

These symptoms can also be due to other, less serious conditions, so it is important to talk to your health care provider. The health care provider will perform a physical exam and ask questions about your medical history. You will be asked if you smoke, and if so, how long you have smoked.

Signs/Tests for lung cancer

Your primary care physician will listen to your chest with a stethoscope. He or she can sometimes hear fluid around the lungs, which could (but not always) suggest cancer. If you need help finding a healthcare provider, let us help you make an appointment.

Tests that may be performed include:

  • Low-dose CT lung cancer screening
  • Chest  x-ray
  • Sputum cytology test to look for cancer cells
  • Blood work
  • CT scan of the chest
  • Chest MRI
  • Lung  PET scan

To confirm lung cancer, the health care provider needs to remove a piece of tissue from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this:

  • Bronchoscopy combined with  biopsy
  • Pleural biopsy
  • CT-scan-directed needle biopsy
  • Mediastinoscopy with biopsy
  • Open lung biopsy
  • Endoscopic esophageal ultrasound (EUS) with biopsy

Lung cancer treatments

The best way to prevent and reduce lung cancer affects is to stop smoking tabacco products. Those who are already diagnosed with COPD or lung cancer, will see immediate health benefits after smoking their last cigarette. A treatment plan depends on the cell type, stage of disease, possibility for removing the tumor, and the patient's ability to survive surgery.

Various therapies can treat lung cancer.

  • Chemotherapy can control cancer growth and relieve symptoms.
  • Photodynamic therapy involves the use of a chemical that is injected into the bloodstream and absorbed by cells all over the body, and which remains in cancer cells for a longer time. 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.
  • Surgery is the only treatment that offers hope of a cure of 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.
  • Radiation therapy is used before surgery to shrink a tumor, or after surgery to destroy remaining cancer cells. Radiation therapy may also be used instead of surgery, or it may be used to relieve symptoms such as shortness of breath.
  • Complimentary and alternative therapies: A comprehensive treatment plan for lung cancer may include a range of complementary and alternative therapies. Ask your team of health care providers about the best ways to incorporate these therapies into your overall treatment plan.

Periodic follow up is useful in helping 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.