Lung Nodules

Lung Nodules are usually small abnormalities seen on a chest x-ray or CAT scan, which are most often less than a centimeter in size.  It may be scar tissue, infection, inflammation, or a tumor/cancer.  About 60% of lung nodules are benign or non-cancerous.

Non-cancerous Lung Nodules

Non-cancerous lung nodules are most often caused by inflammation or infection. Infections could be bacterial, fungal, or parasitic. Acute or chronic infection is often treated with medication.

Another common cause is sarcoidosis, an inflammatory disease which may or may not require treatment. It can form in almost any body organ, but most commonly begins in the lungs or lymph nodes.

A third common cause is associated with rheumatoid arthritis and may require further evaluation. Rheumatoid nodules can be as small as a pea or grow as large as a walnut and usually cause no symptoms. They are not a risk for lung cancer, but may occasionally rupture.

Cancerous Lung Nodules

Malignant lung nodules include lung cancers, lymphomas, and cancers that have metastasized or spread from elsewhere in the body. If the lung nodule is on the larger size, a biopsy will reveal whether it is cancerous or benign.

A malignant lung nodule can be caused by a genetic predisposition, tobacco exposure, or exposure to toxic materials.

A cancerous lung nodule often should be removed with surgery, and if no other cancer is found, it may require no other treatment. When caught early, malignant lung nodules are often successfully treated.

Lung Cancer

Lung cancer is an abnormal growth of tissue which destroys normal tissue and produces substances that can make the entire body weak and sick. It is the second most common cancer among both men and women in the US.

Lung cancer begins in the lungs with abnormal cells which cluster to form a tumor. These cancer cells grow without any control or order, destroying the healthy lung tissue around them.

The reason lung cancer causes so much concern is that it often spreads to lymph nodes or other organs in the body, such as the brain. If the cancer cells grow too quickly, they can prevent organs in the body from working properly. Cancer that begins in other parts of the body may spread to the lungs, but this is not the same as lung cancer.

The two main types of lung cancer are small cell lung cancer and non-small cell cancer. Small cell is more aggressive, spreads faster, and has fewer treatment options. Non-small cell cancer is more treatable and may be caught at an earlier stage.

Doctors diagnose lung cancer using physical exams, and various imaging and lab tests. Treatment will vary as there are many available options based on the type of lung cancer, the stage it’s in, and how far it has advanced.

Lung Cancer Risk Factors

  • Smoking
  • Secondhand Smoke
  • Radon
  • Exposure to Workplace Substances
  • Prior Radiation Therapy to the Chest
  • Family History of Lung Cancer
  • Diet and Arsenic in Drinking Water

Symptoms of Lung Cancer

A number of lung cancer patients exhibit no symptoms. Most develop some symptoms and the disease advances. Most of the earliest symptoms are often overlooked or explained away. The symptoms of lung cancer can include any one or more of the following:

  • Cough that doesn’t go away or becomes worse over time
  • Coughing up blood of a rusty-colored sputum
  • Shortness of breath
  • Persistent pain in the chest area
  • Wheezing
  • Hoarseness
  • Recurrent respiratory infections such as pneumonia or bronchitis
  • Unexplained weight loss and loss of appetite
  • Fatigue or weakness
  • Nervous system changes such as headaches, weakness or numbness, dizziness, problems with balance
  • Yellowing of the skin and eyes – jaundice
  • Pain or weakness in the arm, shoulder, or hand
  • Swelling of the neck and face
  • Lumps near the surface of the body due to cancer spreading to the skin or to lymph nodes
  • General decline in healthg the liver, the brain, and bone.

Non-Small Cell Lung Cancer

There are three main types of non-small cell lung cancer which accounts for over 80% of lung cancers.

Adenocarcinoma – The most common type of non-small cell carcinomas accounting for about 40% of cases. Though adenocarcinomas are most often associated with smoking, it is becoming more common in non-smokers, especially women. One form of adenocarcinoma called BAC or bronchioloalveolar carcinoma seems to be increasing worldwide in non-smokers, women and the Asian population. BAC occurs in the small air sacs of the lungs.

Squamous Cell Carcinoma – Squamous cell carcinomas used to be more common than adenocarcinomas, but now account for approximately 25% of non-small cell lung cancer cases. Sometimes referred to as epidermoid carcinomas, these cancers occur most often in the central area of the chest in the bronchi. Squamous cell carcinoma usually starts in the bronchial tubes in the central part of the lungs.

Large Cell Carcinoma – Large cell carcinomas are the least common of lung cancers and are sometimes called undifferentiated carcinomas. They are found most often in the outer regions of the lungs and can grow very quickly and spread rapidly.

Stages of Non-Small Cell Lung Cancer

Stage I

Cancer is isolated in the lungs and has not spread to any lymph nodes.

Stage II

Cancer is in the lung and has spread to the lymph nodes nearby.

Stage III

Cancer is in the lung and lymph nodes in the middle of the chest.

Stage IIIA

Cancer has spread to lymph nodes on the same side of the chest where the cancer began.

Stage IIIB

Cancer has spread to the lymph nodes on the opposite side of the chest where the cancer started or above the collar bone.

Stage IV

Most advanced stage of the disease — the cancer has spread to both lungs and the surrounding fluid, as well as to another part of the body.

Small Cell Lung Cancer

Small cell lung cancers account for less than 20% of lung cancers and often grow quickly and spread very quickly. These cancers usually begin in the large airways or bronchi of the lungs and spread early.

Patients diagnosed with small cell cancer have typically had their symptoms for a short period of time before they see a doctor. Symptoms are caused by the growth of the tumor, its spread to nearby or distant areas of the body, or paraneoplastic syndrome which occurs when the body’s immune system responds to a tumor or because of substances that are secreted by the tumor cells. This can affect nearly any system in the body.

Slightly more common in men than in women, small cell lung cancer is the most aggressive form of lung cancer and is most often due to cigarette smoking. It is seen very rarely in non-smokers.

There are two stages of small cell lung cancer:

Limited Stage

The tumor is confined to a single radiation field. This includes the lung, the lymph nodes, and within and between the lungs.

Extensive Stage

The cancer has spread from the lungs to other body organs, including the liver, the brain, and bone.