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Hands holding each other.

life with lung cancer

You’re not alone in fighting this disease.

In 2016, an estimated 224,000 others are expected to start on this journey.

An arrow pointing downward.

Your Lung Cancer Journey

Lung cancer is the most common cancer in the world. In the US, lung cancer is the second most common cancer (not including skin cancer) in both men and women yet the leading cause of cancer death in both men and women. In the United States alone, it's expected to account for about 13% of all new cancer diagnoses in 2016. Lung cancer affects the cells or tissues of the lungs and can spread to other parts of the body. This section contains information to help you understand how lung cancer is diagnosed and treated—and what you might expect along the way.

Diagnosis: What’s going on?

Lung cancer starts in the tissues of the lung, usually in the cells lining the air passages. Some cancers can be caused by exposure to tobacco smoke, radon, radiation, and other known cancer-causing agents. Genetics also may play a role.

Two doctors studying an x-ray.

About your lungs

Your lungs are located in your chest, one on the left and one on the right. They allow you to breathe in (inhale) the oxygen your body needs and breathe out (exhale) the carbon dioxide it doesn’t. Your lungs are made up of:

  • Lobes: Main sections of each lung. The right lung has three lobes; the left lung has two
  • Bronchi: Tubes that carry air from the windpipe (trachea) to both lungs
  • Bronchioles: Very small tubes that carry air inside the lungs
  • Alveoli: Air sacs at the ends of the bronchioles. Alveoli have thin walls so that oxygen from the air can be exchanged for carbon dioxide in the blood
  • Pleura: Outside covering of your lungs. There is a small amount of fluid between the lungs and the pleura that help the lungs move smoothly as you breathe

Symptoms of lung cancer

There are two main types of lung cancer, small cell (SCLC) and non-small cell (NSCLC). With lung cancer, symptoms may not appear until the cancer is advanced. Always discuss any of the following signs or symptoms with your healthcare team:

  • Chest discomfort or pain
  • A cough that doesn’t go away or gets worse over time
  • Trouble breathing
  • Wheezing
  • Blood in sputum (mucus coughed up from the lungs)
  • Hoarseness
  • Loss of appetite
  • Weight loss for no known reason
  • Feeling very tired
  • Trouble swallowing
  • Swelling in the face and/or veins in the neck

How lung cancer is diagnosed

Different tests and procedures are used to detect, diagnose, and evaluate lung cancer and may include:

Physical exam and medical history

A general examination is performed to check for unusual lumps and signs of disease and to record overall health, including smoking history.

Laboratory tests

Blood, tissue, or urine samples may be taken.

Imaging

For a better look inside the body, doctors often use imaging, such as x-rays, computed tomography (CT) scans, or positron emission tomography (PET) scans.

Sputum cytology

Mucus (sputum) coughed up from the lungs is examined under a microscope to see if it contains cancer cells.

Biopsy

A small amount of lung tissue or fluid is removed through a thin needle and examined in a laboratory.

Bronchoscopy

A thin, tube-like instrument with a light, lens, and sometimes a surgical tool is inserted through the mouth or nose into the windpipe and lungs. This allows the doctor to see the lung tissue more closely and remove a sample to be examined under a microscope.

Thoracoscopy

A thin, tube-like instrument is inserted through a small cut made in the chest so the doctor can look for abnormal areas and remove a sample of tissue to be examined under a microscope to look for cancer cells.

Thoracentesis

Fluid is removed from the space around the lungs and examined under a microscope.

Immunohistochemistry

A lab test is performed on a lung tissue sample where a pathologist (a doctor who specializes in studying tissue and performing lab tests) stains the tissue with dyes to help determine differences amongst various types of cancer.

How lung cancer is staged

The system used most often to stage NSCLC is the American Joint Committee on Cancer (AJCC) TNM system, which is based on:

  • The size of the main (primary) tumor (T) and whether it has grown into nearby areas
  • Whether the cancer has spread to nearby (regional) lymph nodes (N). Lymph nodes are small bean-shaped collections of immune system cells to which cancers often spread before going to other parts of the body
  • Whether the cancer has spread (metastasized; M) to other organs of the body. The most common sites are the brain, bones, adrenal glands, liver, kidneys, and the other lung

Numbers or letters appear after T, N, and M to provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once the T, N, and M categories have been determined, this information is combined in a process called stage grouping, and an overall stage is assigned.

Once the T, N, and M categories have been assigned, this information is combined to assign an overall stage of 0, I, II, III, or IV (4). This process is called stage grouping. Some stages are subdivided into A and B. The stages identify cancers that have a similar outlook (prognosis) and thus are treated in a similar way. Patients with lower stage numbers tend to have a better outlook.

Distress: This can’t be happening.

A lung cancer diagnosis can be difficult to hear, but for some people, it may be even harder. Over 50 years ago, smoking was directly linked to lung cancer. Unfortunately, lung cancer has since become labeled as a “smoker’s disease” and carries with it a very real stigma that may affect people who are fighting it. In addition to the blow of their diagnosis, some people who smoked may experience feelings of fear, guilt, self-blame, and shame that may impact them psychosocially.

According to the American Lung Association, there are several reasons why lung cancer has become stigmatized. Unlike other cancers, there is not as strong community support, there is a lack of public knowledge about various causes, and there is a perception of personal responsibility. However, as new advances in treatment and research increase, the number of people who get lung cancer, or pass away because of it, is slowly decreasing. And as more people become aware that smoking isn’t the only cause of lung cancer and recognize how even people who have quit smoking or have never smoked also may develop lung cancer, the more urgent the need to fight it will become.

Coming to terms with a lung cancer diagnosis or any social challenges it may bring isn’t easy. Your healthcare team may know of resources in your area that can help. Organizations like these are also great places to learn more and find support.

Association of Cancer Online Resources

acor.org

Cancer Support Community

cancersupportcommunity.org

All third-party names, brands, and other trademarks are the property of their respective trademark owners. Those trademark owners are not affiliated with Lilly and they do not sponsor or endorse this material.

Plan: What's next?

A doctor speaks with a couple.

A lung cancer journey means many aspects of life will have to be carefully planned for the person who’s going through it, and those who care for that person, starting with treatment. Each treatment option presents different/special considerations for the patient. Daily schedules will likely change. Priorities may shift. Just know that each person living with lung cancer is different and has different ideas about treatment. Some may want the most aggressive option possible. Others may want to minimize the amount of side effects they might experience. Still others may want a balance of both. As you consider and decide on your treatment options, it’s important to:

  • Educate yourself
  • Work closely with your care team
  • Involve loved ones

Treat: It’s time to act.

While many people who have lung cancer—and those who share their journey—may be more than ready to start fighting the cancer, each treatment option comes with special considerations that could impact day-to-day life. Although treatment options and side effects will vary, here are some common approaches to treating lung cancer. Discuss treatment options with your doctor, including risks and potential benefits.

A man leaning on a fence.

New normal: Life’s different.

A nurse comforts a woman.

Adjusting to life with lung cancer and all its challenges is a journey that brings ongoing cycles of changing emotions and practical needs for everyone involved. Here are some suggestions that might help throughout your cancer treatment journey:

Know your options early

Lung cancer treatment can consist of multiple phases. If your cancer stays stable or improves with your initial treatment, your doctor may talk to you about staying on medication to help maintain your body’s response for as long as possible. This is called maintenance therapy. Your doctor may keep you on the same medication you had before (continuation maintenance) or use a new medication (switch maintenance). If your cancer comes back after treatment (recurrence), you also may have the option of starting treatment with a different medication. Talk with your doctor to understand treatment and to help you develop a plan of action you and your loved ones are comfortable with from the start.

Talk to your healthcare team about diet and physical activity

Many cancer medicines may change your sense of taste or cause nausea. Eating smaller meals every 2 to 3 hours, getting at least 5 servings of fruits and vegetables, and choosing lean meats and whole grain foods can help you get the nutrition you need. If your doctor approves, physical activity also may help improve your mood and reduce tiredness. Your healthcare team can help you find the right diet and exercise plan for your needs and abilities.

Share your story and get involved

People with lung cancer may face similar journeys and experiences, so how they got the disease shouldn’t matter. When experiences are shared, we raise awareness of lung cancer and empower others to do the same. This helps create a community grounded on the fact that anyone can get lung cancer, on the need for improved quality of life for those living with lung cancer, and on new research and treatment advances. If you choose to share your story or join a support community, here are a few ways to do it: