Analysis of healthy people to detect lung cancer: People with a higher risk of having lung cancer may consider having cancer screenings with low-dose CT scans. The lung cancer screening test is usually offered to people age 55 and older who smoked a lot for several years and otherwise are healthy.
Talk to your doctor about your risk of lung cancer. Together you can decide if the lung cancer screening test is in your best interest.
Analysis to diagnose lung cancer
If there is a reason that you think you may have lung cancer, the doctor may order several tests to look for cancer cells and rule out other diseases.
These are some of the tests:
Diagnostic tests by images. An x-ray of the lungs may reveal an abnormal nodule or mass. A CT scan may reveal small lesions in the lungs that may not be detected on the x-ray.
Sputum cytology. If you have a cough with sputum production, sputum observation under a microscope can sometimes reveal the presence of cancerous lung cells.
A tissue sample (biopsy). A procedure called “biopsy” can be done for which a sample of abnormal cells is removed.
The doctor can perform a biopsy in different ways, for example: bronchoscopy, in which the doctor examines the abnormal areas of the lungs with a tube that has a light and that goes down the throat to reach the lungs; mediastinoscopy, in which an incision is made at the base of the neck and surgical instruments are introduced behind the sternum to take tissue samples from the lymph nodes; and needle biopsy, in which the doctor uses radiographic or CT imaging to guide a needle through the chest wall into the lung tissue and collect suspicious cells.
A biopsy sample may also be taken from the lymph nodes or other areas where cancer has spread, such as the liver.
A thorough analysis of cancer cells in a laboratory will reveal what type of lung cancer you have. The results of sophisticated tests can tell the doctor about the specific characteristics of your cells, which can help determine your prognosis and guide your treatment.
Analysis to determine the extent of cancer
Once lung cancer has been diagnosed, the doctor will continue working to determine the grade (stage) of cancer. The cancer stage is useful for you and the doctor to decide which treatment is the most appropriate.
Staging tests can include diagnostic imaging procedures that allow the doctor to look for evidence that cancer has spread outside the lungs. These analyzes include computed tomography scans, magnetic resonance imaging, positron emission tomography, and bone scans. Not all studies are suitable for anyone, so talk to your doctor about what procedures are right for you.
The stages of lung cancer are indicated with Roman numerals ranging from 0 to IV. The lower stages indicate that the cancer is limited to the lung. In stage IV, cancer is considered advanced and has spread to other parts of the body.
You and your doctor choose a cancer treatment plan based on a number of factors, such as your general health, the type, and stage of cancer, and your preferences.
Mayo Clinic lung cancer specialists offer holistic and comprehensive care for people with lung cancer. Each year, more than 4,900 people with lung cancer receive care at Mayo Clinic. This experience means that doctors have the knowledge and resources to give you exactly the care you need.
At Mayo Clinic, you will receive care from a team of specialists from different areas working together to determine your treatment options for lung cancer. This team approach means that your care is coordinated to meet your needs so that you receive the most appropriate treatment for you. In the treatment plans, your values and preferences are taken into account.
The health care team can include the following professionals:
Other specialists, as needed, as doctors who specialize in palliative care
The fact of having a multidisciplinary team of experts means that all the doctors who work with you work in harmony. This is particularly beneficial when coordinating complex treatment protocols comprising several therapies.
In some cases, you may choose not to do any treatment. For example, you may feel that the side effects of the treatment will outweigh the potential benefits. In that case, the doctor may suggest care intended to provide comfort, to treat only the symptoms that cause cancer, such as pain and shortness of breath.
More than 900 people undergo minimally invasive lung surgery at Mayo Clinic each year. Studies show that hospitals with high surgical volumes have better results, including reduction of postoperative pain, hospital stays, and complications.
During surgery, the surgeon tries to eliminate lung cancer and a margin of healthy tissue. These are the procedures to eliminate lung cancer:
Wedge resection to remove a small part of the lung where the tumor is plus a margin of healthy tissue
Segmental resection to remove a larger part of the lung, but not a whole lobe
Lobectomy to remove the entire lobe of a lung
Pneumonectomy to eliminate a whole lung
If you undergo surgery, the surgeon can also remove lymph nodes from the chest, in order to analyze them for signs of cancer.
Surgery may be an option if cancer is limited to the lungs. If you have a larger type of lung cancer, the doctor may recommend chemotherapy or radiation therapy before surgery to reduce the size of cancer. If there is a risk of cancer cells remaining after surgery or cancer may recur, the doctor may recommend chemotherapy or radiation therapy after surgery.
Advanced surgical techniques, such as minimally invasive surgery and videothoracoscopic surgery, can reduce the amount of time you have to stay in the hospital after lung cancer surgery and can help you resume your normal activities faster. Research shows that people who undergo minimally invasive lung cancer surgery, in hospitals that perform many of these operations every year, tend to have less pain and complications. Mayo Clinic surgeons perform more than 900 video thoracoscopic surgeries per year.
Radiation therapy uses high-energy energy beams, from sources such as X-rays or protons, to destroy cancer cells. During radiation therapy, you lie on a stretcher while a machine moves around you and directs the radiation to specific points on the body.
For people with locally advanced lung cancer, radiation can be used before or after surgery. It is often combined with chemotherapy treatments. If surgery is not an option, the combination of chemotherapy and radiation therapy may be your primary treatment.
For advanced types of lung cancer and for those that have spread to other parts of the body, radiation therapy can help relieve symptoms, such as pain.
When compared to standard radiotherapy techniques, novel precisely targeted treatments can be more effective and cause fewer side effects. Mayo Clinic offers state-of-the-art radiotherapy planning and administration technologies, such as intensity-modulated radiation therapy, volumetric arch therapy, image-guided radiotherapy, and proton therapy.
Chemotherapy uses drugs to kill cancer cells. You may be given one or more chemotherapy drugs through a vein in your arm (intravenously) or by mouth. Usually, a combination of medications is given in a series of treatments, over a period of weeks to months, with breaks in between, so you can recover.
Chemotherapy is usually used after surgery to kill all the cancer cells that may have been left. It can be used alone or in combination with radiotherapy. Chemotherapy can also be used before surgery to decrease the size of malignant tumors and facilitate their removal.
For people with advanced lung cancer, chemotherapy can be used to relieve pain and other symptoms.
Stereotactic body radiation therapy, also called “radiosurgery,” is a treatment with intense radiation that targets many radiation beams from different angles to cancer. Stereotactic body radiation therapy is usually completed in one or a few treatment sessions.
Radiosurgery may be an option for people with small lung cancers who can not have surgery. It can also be used to treat lung cancer that has spread to other parts of the body, such as the brain.
Targeted therapy with medications
Targeted drug treatments focus on specific abnormalities present within the cancer cells. By blocking these abnormalities, treatments with targeted drugs can kill cancer cells.
Several targeted therapy drugs are used to treat lung cancer, although most are reserved for people with advanced or recurrent cancer.
Some targeted therapies only work in people who have cancer cells with certain genetic mutations. It is possible for cancer cells to be tested in a laboratory to see if these drugs can help.
In immunotherapy, your own immune system is used to fight cancer. It is possible that the body’s immune system that fights diseases does not attack cancer because cancer cells produce proteins that can not be detected by cells of the immune system. What immunotherapy does is interfere with that process.
In general, immunotherapy treatments are reserved for people with advanced lung cancer.
The Mayo Clinic researchers made an important discovery that led to immunotherapy treatments called immune checkpoint inhibitors that have revolutionized the medical care of people with metastatic lung cancer.
People with lung cancer often have signs and symptoms of cancer, in addition to the side effects of treatment. Complementary care, also known as “palliative care,” is a specialized field of medicine that involves working with a doctor to minimize signs and symptoms.
The doctor may recommend that you check with a palliative care team soon after diagnosis to make sure you are comfortable during and after cancer treatment.
In one study, people with advanced non-small cell lung cancer who began receiving complementary care shortly after diagnosis lived longer than people who continued with treatments, such as chemotherapy and radiation. Those who received complementary care reported an improvement in mood and quality of life. On average, they survived almost three months longer than those who received standard care.
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Explore the Mayo Clinic studies evaluating new treatments, interventions and analyzes as a means to prevent, detect, treat or control this disease.
Lifestyle and home remedies
Dealing with the difficulty of breathing
Many people with lung cancer have shortness of breath at some point in the course of the disease. There are treatments, such as the administration of oxygen, and medications to make you feel more comfortable, but not always reach.
To deal with the lack of air, you could use the following tips:
Try to relax Having shortness of breath can cause fear. But fear and anxiety make breathing more difficult. When you begin to feel short of breath, try to control the fear by doing something that helps you relax. Listen to music, imagine your favorite place to vacation, meditate or pray.
Get in a comfortable position. Leaning forward can help you when you have shortness of breath.
Concentrate on your breathing. When you feel short of breath, concentrate on your breathing. Instead of trying to fill your lungs with air, concentrate on moving the muscles that control the diaphragm. Try to breathe with pursed lips making your breaths keep up with your activity.
Save energy for what is important. If you have shortness of breath, you could get tired easily. Discard daily activities that are not essential so you can use that energy in things you have to do.
Tell your doctor if your symptoms of shortness of breath or other symptoms worsen, as there are many other treatments available to relieve shortness of breath.
Alternative and complementary treatments against lung cancer can not cure cancer. But, usually, these treatments can be combined with medical care to help alleviate the signs and symptoms.
The American College of Chest Physicians recommends that people with lung cancer consider the following therapies:
Acupuncture. During an acupuncture session, a trained acupuncturist inserts small needles at specific points on the body. Acupuncture can relieve the pain and side effects of cancer treatment, such as nausea and vomiting, but there is no evidence that it has any effect on cancer.
Hypnosis. Hypnosis is usually done by a therapist who guides you with relaxation exercises and asks you to concentrate on pleasant and positive thoughts. Hypnosis can reduce anxiety, nausea, and pain in people with cancer.
Massages During a massage session, the massage therapist uses his hands to apply pressure on the skin and muscles. Massage can help relieve anxiety and pain in people with cancer. Some massage therapists are specially trained to work with people who have cancer.
Meditation. Meditation is a moment of silent reflection in which you focus on one thing, such as an idea, an image or a sound. Meditation can reduce stress and improve the quality of life of people with cancer.
Yoga. Yoga combines gentle stretching movements with deep breathing and meditation. Yoga can help people with cancer sleep better.
Coping strategies and support
The diagnosis of cancer can be overwhelming. Over time, you will find ways to cope with the suffering and uncertainty of cancer. Until then, the following tips may help you:
Get enough information about lung cancer to make decisions about your medical care. Ask the doctor about your lung cancer, including about treatment options and, if you wish, about the prognosis. The more you know about lung cancer, the more confidence you will have to make decisions about treatment.
Stay close to your family and friends. Strengthening the bond with people with whom you have a close relationship will help you cope with lung cancer. Family and friends can provide the practical support you need, such as helping you take care of your home if you are in the hospital. They can be emotional support when you feel overwhelmed by cancer.
Find someone to talk to. Find a person who knows how to listen and who is willing to listen to you talk about your hopes and fears. It can be a family member or friend. The interest and understanding of a therapist, a medical social worker, a church member, or a support group for people with cancer may also be helpful.
Ask the doctor to give you information about the support groups in your area. Or, you can go to local and national cancer organizations, such as the National Cancer Institute or the American Cancer Society.
Preparation for the consultation
Start with a consultation with your family doctor if you have signs and symptoms that worry you. If your doctor suspects you have lung cancer, you may be referred to a specialist. The specialists who treat people suffering from lung cancer are the following:
Doctors who specialize in treating cancer (oncologists)
Doctors who diagnose and treat diseases of the lungs (pulmonologists)
Doctors who use radiation to treat cancer (radiation oncologists)
Doctors who treat the signs and symptoms of cancer, and who treat cancer (specialists in palliative care)
What can you do
As the consultations may be brief and there is often much to talk about, it is advisable to be well prepared. To be prepared, try to do the following:
Take into account any restrictions prior to the consultation. When you schedule the consultation, be sure to ask if there is something you should do in advance, such as restricting your diet.
Record any symptoms you have, even those that seem unrelated to the reason you scheduled the query. Record when the symptoms began.
Record your most important personal information, including what causes you the most stress or any recent change in your life.
Make a list of all medications, vitamins, and supplements you are taking.
Collect your medical file. If you have a chest x-ray or if another doctor did an examination, try to get the file and take it to the consultation.
Consider asking a family member or a trusted friend to be with you. At times, it can be difficult to remember all the information that is provided during a consultation. The person who accompanies you can remember some detail that you have overlooked or forgotten.
Write down the questions you want to ask the doctor.
Questions to ask if you were diagnosed with lung cancer
Your time with the doctor is limited; therefore, preparing a list of questions can help you make the most of your time together. Sort the questions from the most important to the least important, in case time, runs out. Some basic questions regarding lung cancer are the following:
What type of cancer do I have?
Could you see the chest x-ray or the CT scan that shows cancer?
What causes my symptoms?
What is the stage of cancer?
Will I need to do more tests?
Should I have an analysis of lung cancer cells to detect genetic mutations that can determine my treatment options?
Did cancer spread to other parts of the body?
What are my treatment options?
Will any of these treatment options cure cancer I have?
What are the possible side effects of each treatment?
Is there any treatment that you think is right for me?
Does it benefit me if I stop smoking now?
What advice would you give to your friend or family member if he were in my situation?
What happens if I do not want to follow any treatment?
Are there ways to relieve the signs and symptoms I have?
Can I enroll in a clinical trial?
Should I consult a specialist? How much will it cost? Will my insurance cover it?
Is there a brochure or other material that can take me? What websites do you recommend?
In addition to the questions you have prepared to ask the doctor, do not hesitate to ask others during the consultation.
What to expect from the doctor
The doctor is likely to ask you a series of questions. Being ready to answer them may give you more time to address the points you want to address. The doctor may ask you the following:
When did you start having the symptoms?
Have the symptoms been continuous or occasional?
How intense are the symptoms?
Do you breathe with a snort?
Do you have a cough that feels like you’re clearing your throat?
Have you ever been diagnosed with emphysema or chronic obstructive pulmonary disease?
Do you take medication for difficulty breathing?
Is there something that, apparently, is improving the symptoms?
Is there something that, apparently, is making the symptoms worse?
Knowledge and categories
Mayo Clinic lung cancer specialists are widely respected for their experience and expertise in using the latest treatment options to provide personalized care for people with lung cancer.
Mayo Clinic Cancer Center meets the rigorous standards of a comprehensive cancer center designated by the National Cancer Institute, which recognizes its scientific excellence and a multidisciplinary approach focused on the prevention, diagnosis, and treatment of cancer.
Mayo Clinic doctors and researchers participate in research cooperatives, such as the Alliance for Clinical Trials in Oncology, which offers people with cancer access to the latest clinical trials.
Mayo Clinic Cancer Center (Mayo Clinic Cancer Center) is accredited by the Cancer Commission of the American College of Surgeons, which recognizes high-quality cancer treatment programs that provide comprehensive and multidisciplinary care.