Lung Cancer

Facts About Lung Cancer

  • According to the American Cancer Society, this year nearly 175,000 Americans will learn they have lung cancer. This accounts for about 12 percent of cancer diagnoses.
  • Lung cancer is the second most common cancer found in both men and women.

Risk Factors for Lung Cancer

Smoking greatly increases your chances of developing lung cancer. Smoking leads to 85 percent to 90 percent of all lung cancers.

  • Other risk factors include exposure to second-hand smoke, radon, asbestos, air pollution and tuberculosis.

Quitting Smoking

The health benefits begin immediately after quitting smoking.

  • Quitting smoking makes treatment more effective for people with lung cancer. It also reduces the risks of infections, improves breathing and reduces the risks associated with surgery.
  • Talk to your doctor or visit www.smokefree.gov to learn how to quit.

Signs and Symptoms of Lung Cancer

Some indications of lung cancer include:

  • Persistent cough.
  • Coughing blood.
  • Shortness of breath.
  • Chest pain.
  • Pneumonia or bronchitis.
  • Swelling of the neck and face.
  • Unexplained weight loss, loss of appetite or fatigue.

Some patients may not notice any symptoms.

Diagnosing Lung Cancer

  • chest X-ray will often show a lung tumor.
  • CT scans and PET scans are often used to provide more detailed information.
  • To be certain if you have lung cancer, tissue from your lung will be removed to look for cancer cells. This is called a biopsy.
  • The biopsy may be done during a bronchoscopy. During this test, a flexible tube with a light is inserted into your nose or mouth to look at the airways of the lungs.
  • A biopsy may also be done with a thin needle inserted through the skin directly into the tumor.

Types of Lung Cancer

  • Non-small cell lung cancer is the most common type of lung cancer. The most common forms of non-small cell lung cancer are squamous cell carcinoma and adenocarcinoma.
  • Small cell lung cancer is less common than non-small cell lung cancer and looks different when examined under a microscope. In the past, small cell lung cancer was often called oat cell cancer.

Both types of lung cancer can spread to other parts of the body.

Treatment of Lung Cancer

Lung cancer treatment depends on several factors, including the type and size of the cancer, its location and your overall health. Surgery, radiation therapy and chemotherapy are the primary tools for treating lung cancer and may be used alone or in combination.

  • Non-small cell lung cancer may be treated with radiation therapy, surgery and chemotherapy.
  • Small cell lung cancer is usually treated with radiation therapy and chemotherapy.

A team of doctors will help you decide on the best treatment for you. This team may include a radiation oncologist, a medical oncologist and a surgeon.

Understanding Radiation Therapy

  • Radiation therapy, sometimes called radiotherapy, is the careful use of radiation to safely and effectively treat cancer.
  • Cancer doctors called radiation oncologists use radiation therapy to try to cure cancer, to control cancer growth or to relieve symptoms, such as pain.
  • Radiation therapy works within cancer cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them.
  • Healthy cells are also affected by radiation, but they are able to repair themselves in a way cancer cells cannot.

External Beam Radiation Therapy

External beam radiation therapy targets your lung cancer. Radiation is given in a series of daily treatments, Monday through Friday. Treatments are painless and last less than 30 minutes.

  • Conventional radiation therapy uses multiple radiation fields to target the cancer and keep radiation from healthy cells.
  • 3-dimensional conformal radiotherapy (3D-CRT) combines multiple radiation treatment fields to deliver precise doses of radiation to the lung tumor. Tailoring each of the radiation beams to focus on the tumor targets the cancer while protecting nearby healthy tissue.
  • Intensity modulated radiation therapy (IMRT) is a form of 3D-CRT that modifies the radiation by varying the intensity of each radiation beam. IMRT is still being studied for lung cancer.
  • Stereotactic body radiation therapy (SBRT) is a specialized form of 3D-CRT that delivers high doses of radiation over a period of five to eight days. It is currently being evaluated for the treatment of lung cancer. This type of treatment is available at only a few centers around the country.

Internal Radiation

  • Internal radiation or brachytherapy is the placement of radioactive material into or near your tumor.
  • Before treatment, a bronchoscopy will be done to place one or two thin plastic tubes into your nose and into the airways of the lung.
  • The tube or tubes are then connected to a brachytherapy machine. The tube serves as a channel to deliver a dose of radiation by briefly placing a tiny radioactive source near the lung tumor.
  • After treatment, the tubes are removed. They may be placed again if you need more treatment.

Possible Side Effects

  • Side effects are different for everyone. Some patients feel fine during treatment while others may feel uncomfortable.
  • Possible problems may include skin irritation, difficulty or pain when swallowing, and fatigue.
  • Lung radiation may cause shortness of breath. This may be temporary or permanent depending on your cancer and its treatment.
  • With radiation therapy to the chest, you should not lose the hair on your head or have an upset stomach. Chest radiation will not affect your ability to have children.
  • Talk to your doctor about any discomfort you feel. He or she can provide treatments to help.
  • Everyone responds differently to the stress of cancer and treatment. Doctors, nurses, social workers and support groups are available to help.

 

Lymphoma

Facts About Lymphoma

The lymphatic system is a network of tiny vessels extending throughout the body. They are often next to the veins and arteries but are even smaller than them. Scattered along these vessels are lymph nodes. The lymphatic vessels carry a clear fluid called lymph from the extremities and organs back to the blood circulation. The job of the lymphatic system is to fight infection and disease. Cancer of the lymphatic system is called lymphoma. The two main types are Hodgkin's and non-Hodgkin's lymphomas.

Hodgkin's Lymphoma

  • Hodgkin's lymphoma (or Hodgkin's disease) most often begins in the larger, more central lymph nodes of the body including those along the largest blood vessels of the neck, central chest, abdomen along the spine, and armpit and groin areas where the vessels return from the arms and legs.
  • It is named for the British doctor Thomas Hodgkin, who first described the disease in 1832.
  • According to the American Cancer Society, more than 8,000 people will be diagnosed with Hodgkin's in the United States each year.
  • Hodgkin's is very treatable and often curable. More than 75 percent of patients with Hodgkin's live longer than 10 years after diagnosis.
  • Hodgkin's is usually treated with radiation therapy and/or chemotherapy.

Non-Hodgkin's Lymphoma (NHL)

  • NHL is a cancerous growth of cells that make up the lymph nodes.
  • NHL is eight times more common than Hodgkin's lymphoma. The American Cancer Society expects that 63,000 people will be diagnosed with the disease annually.
  • Since the 1970s, the number of people with NHL has increased significantly. Researchers are studying to see whether a gene makes people more likely to develop NHL.
  • There are about 30 types of NHL, and the best treatment depends on the exact type. All types of NHL are treatable, and many are curable.
  • NHL is usually treated with chemotherapy, radiation therapy, biologic therapy and/or a stem cell transplant. Depending on your cancer and overall health, you might receive only one of these treatments or several in combination.

Staging of Lymphoma

The stage of lymphoma is a term used to describe the extent of the disease.

  • Stage I: Single lymph node or non-lymph node region is affected.
  • Stage II: Two or more lymph nodes or non-lymph node regions are affected on the same side of the diaphragm (the muscle under the lungs).
  • Stage III: Lymph nodes or non-lymph node regions above and below the diaphragm are affected.
  • Stage IV: The cancer has spread outside the lymph nodes to organs such as the liver, bones or lungs. Stage IV can also refer to a tumor in another organ and/or tumors in the distant lymph nodes.

Talk to your physician to find out exactly which stage you have. Determining the stage and exact type of lymphoma (by microscopic examination of tissue from a biopsy) are essential steps toward planning the best treatment to cure your disease.

Treatment Options for Lymphoma

Treatment options depend on the type of lymphoma, its stage and your overall health. Treatment may include chemotherapy or radiation therapy, either alone or in combination. It may help to talk to several specialists before deciding on the best course of treatment for you, your disease and your lifestyle.

  • A radiation oncologist is a doctor who specializes in destroying diseased cells with high-energy X-rays or other types of radiation.
  • A medical oncologist is a doctor who is an expert at prescribing special drugs (chemotherapy) to treat disease. Some medical oncologists are also hematologists, meaning they have experience treating drug disorders.

Understanding Radiation Therapy

Radiation therapy, also called radiotherapy, is the careful use of radiation to kill diseased cells safely and effectively while avoiding nearby healthy tissue.

  • Radiation oncologists use radiation therapy to cure disease, to control disease growth or to relieve symptoms, such as pain.
  • Radiation therapy works within diseased cells by damaging their ability to grow. When these cells are destroyed by the radiation, the body naturally eliminates them.
  • Healthy tissues can also be affected by radiation, but they are usually able to repair themselves in a way that cancer cells cannot.

External Beam Radiation Therapy

External beam radiation therapy is a series of outpatient treatments used to deliver radiation to the diseased cells accurately. Radiation therapy has been proven to be very successful at treating and curing lymphoma.

  • Radiation oncologists deliver external beam radiation therapy to the lymphoma from a machine called a linear accelerator.
  • Each treatment is painless and is similar to getting an X-ray. Treatments last less than 30 minutes each day and take place every day but Saturday and Sunday, for several weeks.
  • Involved field radiation is when your doctor delivers radiation only to the parts of your body known to have the disease. It is often combined with chemotherapy. Radiation above the diaphragm to the neck, chest and/or underarms is called mantle field radiation. Treatment below the diaphragm to the abdomen, spleen and/or pelvis is called inverted-Y field radiation.
  • Your radiation oncologist may deliver radiation to all the lymph nodes in the body to destroy cells that may have spread to other lymph nodes. This is called total nodal irradiation.
  • Your radiation oncologist may also deliver radiation to the entire body. This is called total body irradiation. It is often done before chemotherapy and a stem cell or bone marrow transplant to eliminate any diseased cells.

Radiation therapy may be used alone or in combination with chemotherapy or biologic therapy. You will work with your radiation oncologist to agree on a treatment plan that is best for you.

Biologic Therapy

Also called immunotherapy, biologic therapy works with your immune system to fight disease. Biologic therapy is like chemotherapy. The difference is that chemotherapy attacks the diseased cells directly, and biologic therapy helps your immune system fight the disease.

  • Monoclonal antibodies work by targeting certain molecules in the body and attaching themselves to those molecules.This causes some cells to die and makes others more likely to be destroyed by radiation and chemotherapy.
  • Radiolabeled antibodies are monoclonal antibodies with radioactive particles attached. These antibodies are designed to attach themselves directly to the diseased cells and damage them with small amounts of radiation without injuring nearby healthy tissue.

Possible Side Effects

The side effects you might experience will depend on the part of the body being treated, the dose of radiation given and whether you also receive chemotherapy. Before treatment begins, ask you doctor about possible side effects and how best to manage them.

  • You may experience mild skin irritation like a sunburn, sore throat or upset stomach, loose bowel movements and/or fatigue. Most side effects will go away when treatment ends.
  • Radiation to your head or mouth may cause mouth dryness that can lead to tooth decay. Fluoride treatments may help, so your radiation oncologist will ask you to see a dentist before treatment begins.
  • You might loose you hair in areas treated. Your hair will grow back, but it might not have the same texture or thickness.
  • Tell your doctor or nurse if you experience any discomfort. They may be able to prescribe medication or change your diet to help.

These side effects are temporary and should go away after treatment ends. Your doctor will discuss any possible long-term side effects with you before treatment begins.