James Isbell, MD with a patient.
MSK’s Guide To

Lung Cancer

Overview

No one should go through lung cancer alone. MSK’s team of lung cancer experts can help.

You may be reading this because you or someone you care about has learned they have lung cancer. Or maybe you’re curious about your risk of getting lung cancer. This is a good place to start. 

It’s important to get to know the signs of lung cancer. Lung cancer can be easier to treat when we catch it early. But at MSK, we have treatment options for lung cancer at every stage. 

This guide is a good place to learn about what causes lung cancer and lung cancer prevention. You also can learn about lung cancer symptoms.

This information can help you get ready to talk with your healthcare provider and understand your next steps.

Meet MSK’s lung cancer experts

What is lung cancer?

Lung cancer is one of the most common cancers. It’s caused by abnormal (not normal) cells that grow in the respiratory (breathing) system. This includes your lungs and other parts that help you breathe.

Anyone can get lung cancer, but we know there are some things that raise your chances. People who have smoked have the highest risk for getting lung cancer. Research shows that women who have smoked may be more likely to get lung cancer than men who have smoked.

Exposure to radon is the second leading cause of lung cancer after smoking. Radon is a radioactive gas that can be found in some homes and workplaces. People who smoke and are also exposed to radon have an even higher risk of lung cancer.

Research shows that lung cancer rates are going down in both men and women of all ages. But they’re falling more slowly among younger people assigned female at birth. That’s why more young women are being diagnosed with lung cancer than young men. 

Treatments for lung cancer can include surgery, radiation, chemotherapy, immunotherapy, or targeted therapy.

Thoracic medical oncologist Dr. Juliana Eng examines a lung cancer patient.
What are signs of lung cancer?

Many people do not notice any symptoms. Signs of lung cancer can include wheezing, shortness of breath, coughing, weight loss, and chest pain. There can be many reasons for these symptoms. 

Thoracic surgeon Dr. Prasad S. Adusumilli with a computer showing an image of a lung scan.
How is lung cancer diagnosed?

The first sign of lung cancer often is a spot on a chest X-ray or a CT scan. Your doctor may recommend a biopsy. This procedure shows if you have lung cancer, the type, and maybe how far it has spread. 

Anatomy of the lungs

What’s inside your lungs? Knowing your lungs’ anatomy can help you better understand where lung cancer starts. Anatomy (uh-NA-toh-mee) means the parts of a structure, such as a lung.

Your lungs are 2 organs in your chest. They’re part of your respiratory system. Other parts are your trachea (windpipe), bronchi, bronchioles, diaphragm, voice box, throat, nose, and mouth.  

  • Your trachea (TRAY-kee-uh) splits into tubes called bronchi (BRONG-ky). The bronchi are large airways that lead to the lungs. They split into small branches called bronchioles (BRONG-kee-olez).
  • Your alveoli (al-VEE-oh-ly) are tiny air sacs at the end of your bronchioles. 

Around your lungs are thin layers of tissue called the pleura (PLOOR-a). The pleura protects your lungs as they expand (get big) and contract (get small).

  • Your pleural  space is the space between the 2 layers of tissue around your lungs.
  • Your mediastinum (MEE-dee-uh-STY-num) is the area in the middle of your chest, between your lungs. 

Where does lung cancer start?

It starts in the cells of your respiratory system. Most often, lung cancer starts in your bronchi, bronchioles, or alveoli. The cancer cells then spread outside the lungs. 

Anatomy of the respiratory system with the mediastinum, lungs, adrenal glands, and pleura labeled.
MSK Dialog Window
Anatomy of the respiratory system with the mediastinum, lungs, adrenal glands, and pleura labeled.

The anatomy of the lungs

The anatomy of the lungs

The anatomy of the lungs
MSK Dialog Window
The anatomy of the lungs

Your lungs, bronchi, and trachea.

Your lungs, bronchi, and trachea.

Risk factors and prevention

What causes lung cancer?

A risk factor is anything that raises your chance of getting a disease, such as cancer. Major risk factors for lung cancer include your age and how many years you have smoked, if any.

Exposure to any kind of tobacco product is a risk factor. Nonsmokers who breathe in other people’s smoke (secondhand smoke) also are at higher risk for lung cancer.

Sometimes, there’s no clear reason why a person gets lung cancer. In fact, out of every 10 people with non-small cell lung cancer, about 2 of them never smoked. 

More people are getting lung cancer who who never smoked, were only very light smokers, or had no other risk factors. Almost 1 out of every 4 people we treat for lung cancer at MSK are nonsmokers or light smokers. Most of them are people assigned female at birth.

Researchers suggest 2 possible reasons why people who never smoked get lung cancer. It could be caused by exposure to things such as air pollution, asbestos, or radon. It also could be caused by a gene mutation (change). 

Who is at higher risk for lung cancer?

Knowing your risk for getting lung cancer can help you decide whether screening is right for you. 

Other than your age and years of smoking, here are other factors that may raise your risk for lung cancer: 

  • Breathing in the smoke of other people (secondhand smoke).
  • Exposure to radon. This is a radioactive gas found in some homes and buildings.
  • Breathing in other substances that cause cancer, such as asbestos, arsenic, and exhaust from vehicles or machines.
  • Having a family member related to you by blood who has lung cancer.

Other factors play a role in your risk for lung cancer. They include your race, gender, sex, and lifestyle. 

For example, Black men are more likely to get lung cancer than white men. Black women are less likely to get lung cancer than white women.

If you have any of these risk factors, talk with your healthcare provider. They may recommend you get a lung cancer screening. Learn if screening is right for you. 

Podcast

Lung Cancer: Why One of The Most Common Cancers is Also The Most Stigmatized

Anyone can get lung cancer, whether or not you smoked. Listen to thoracic surgeon Dr. Bernard Park explain why some smokers blame themselves. They think they do not deserve a simple lung screening or medical care.  

How can I lower my risk for lung cancer?

If you smoke, and if you stop now, you can lower your risk for lung cancer. That also will lower the risk for your family and other people around you. 

Even if you learned you have lung cancer or are in treatment, it’s not too late to quit. Research shows that quitting smoking can make chemotherapy work better.

You can also lower your risk by taking care of your health in these ways:

  • Avoid indoor and outdoor pollutants, such as smoke, cleaning products, and mold.
  • Wash your hands often to prevent respiratory infections. These are infections in areas involved in breathing, such as your sinuses, throat, airways, or lungs.
  • Get a physical exam each year. Visiting a healthcare provider every year can help you stay healthy.
  • Exercise to help keep your lungs strong. Getting at least 30 minutes of activity a day 5 days a week is best for your health. Exercise includes walking, jogging, running, cleaning your home, gardening or outdoor chores, and taking the stairs.
  • Test your house for radon. You can buy test kits at home improvement stores, hardware stores, or online for about $20 to $30. There’s a process for fixing radon levels that are too high. 
You wouldn’t ask someone with cancer or another disease like diabetes or a heart condition to treat themselves. So why should someone with a tobacco addiction be expected to quit without help from the latest and best treatments?
Psychologist Chris Kotsen
Associate Director of MSK’s Tobacco Treatment Program
The MSK Difference

Our Tobacco Treatment Program has experts who can help you quit smoking. It’s open to people who never had cancer or a disease linked to tobacco. It also welcomes anyone who has cancer, and cancer survivors. Our program offers treatment options to help you quit, such as counseling and medicine. 

Screening for lung cancer

What is lung cancer screening?

Lung cancer screenings are routine tests that can find lung tumors and nodules before symptoms start. Regular screenings can find cancer earlier, when it’s easier to treat.

MSK follows the latest recommendation for lung cancer screening from the United States Preventive Services Task Force. The type of screening and your screening schedule are based on your personal risk for lung cancer. 

What are the screening tests for lung cancer?

Screening for lung cancer is done with a scanner that uses X-rays and a computer to combine images for a clear view of your lungs. This is called a low-dose CT scan.

During this scan, you’ll lie down on a table. It will move you in and out of a CT machine that takes many pictures. A computer will put these images together to make a very clear 3D picture of your lungs.

Your CT scan will take less than 30 minutes. Most CT scans take less than 10 minutes.

When should you be screened for lung cancer?

MSK recommends you get screened every year if you are between ages 50 and 80 and:

  • Smoke now or used to smoke.
  • Have smoked an average of 1 pack a day for at least 20 years. Or, you smoked a similar amount, such as 2 packs a day for 10 years.

Lung cancer screening is quick, easy, and can save your life. When lung cancer is found early, treatment is often just surgery or radiation therapy alone. This can cure lung cancer for up to 9 out of every 10 people.

Is a lung screening right for you?

MSK designed an easy tool to help people who smoked learn their risk for getting lung cancer. Our tool will help you plan your next steps.

What are the signs and symptoms of lung cancer?

Many people do not notice any symptoms of lung cancer. The first sign often is found during tests for some other health condition. An abnormal spot is found on a chest X-ray or a CT scan.

Symptoms of lung cancer can include:
  • Coughing that gets worse or does not go away
  • Shortness of breath
  • Chest pain
  • Coughing up blood
  • Losing weight without trying
  • Feeling very tired all the time

Lung cancer symptoms mostly are the same in men and women. People of all genders, including men, women, nonbinary, and transgender people, have the same common symptoms. Lung cancer symptoms are the same, no matter your age, ethnicity, or smoking history.

Many other health conditions can cause symptoms like these. Some people are given a wrong diagnosis of asthma, bronchitis, or walking pneumonia instead of lung cancer. Talk with your doctor to help you find out what is causing your symptoms.

THE MSK DIFFERENCE

We’re bringing promising new therapies to our patients. We’re learning more about the biology of lung cancer. And we’re exploring new ways to treat lung cancer. This important work is done by the Fiona and Stanley Druckenmiller Center for Lung Cancer Research at MSK.

Innovations at MSK

Our experts are always finding new ways to treat lung cancer and manage side effects. Explore the latest lung cancer news from MSK.
 

Ingrid Adams speaks with nurse practitioner Virginia Ferreira.
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