Lung Cancer

Lung cancer starts when cells in the lungs start to grow out of control resulting in a mass of abnormal cells. Lung cancer can spread to lymph nodes and other organs.

What is lung cancer?

Lung cancer, like other cancers, forms when cells in the body begin to grow out of control. The numerous cells form tumors that invade and destroy healthy tissue. There are two main types of lung cancer: small cell and non-small cell, which is the slower growing of the two.

Signs and symptoms of lung cancer include:

  • A persistent cough
  • Shortness of breath
  • Chest pain
  • Hoarse voice
  • Weight loss
  • Loss of appetite
  • Fatigue

If you’re noticing any of these symptoms of lung cancer, talk with a doctor. Early detection of lung cancer is key. When caught early, your care team can use treatments that are less aggressive and less invasive. You’ll experience improved survival rates, reduced risk of recurrence, and better quality of life. Your AHN care team  is here to help.

Lung and Pleural Cancer Center of Excellence

The AHN Lung and Pleural Center of Excellence is where innovation and compassion merge. Our team of doctors, nurses, and specialists use pioneering radiation therapy options and immunotherapy. At AHN, you have a team that works together across specialties to ensure your unique needs are being met.

AHN's Commitment to Excellence in Lung Cancer Care

AHN is committed to providing the highest quality of care to patients with lung cancer. Our team of experts has extensive experience in diagnosing and treating this rare cancer. We offer a variety of treatment options, including:

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Targeted therapy
  • Immunotherapy 

We also offer a variety of support services to help patients and their families cope with the challenges of lung cancer. These services include:

  • Social work: Social workers can help patients and their families with financial assistance, transportation, and other practical needs.
  • Nutrition counseling: Nutrition counselors can help patients maintain a healthy diet during treatment.
  • Palliative care: Palliative care teams can help patients manage pain and other symptoms of lung cancer.

AHN is dedicated to providing the best possible care to patients with lung cancer. We’re  committed to helping our patients live longer, healthier lives.

Lung cancer symptoms and signs

Early-stage lung cancer signs and symptoms can be hard to spot. The most common symptoms include a prolonged cough that doesn’t go away, coughing up blood or rust-colored spit, chest pain, hoarseness, loss of appetite, and changes to fingers. It’s important to talk with your doctor if you notice any of these symptoms.

Changes in fingers and nails

A surprising place lung cancer can show symptoms is in the fingers and nails. Known as finger clubbing or lung cancer nails, these conditions can be associated with the disease.

Finger clubbing is where the tips of fingers become enlarged and rounded. It can be caused by not only lung cancer, but heart and liver disease.

Lung cancer nails, or nail clubbing, happen when the nails curve up — picture an upside-down spoon — or appear wider or swollen. The nails might also feel soft and sponge-like, be warm to the touch, or look red.

Finger clubbing and lung cancer nails could detect early-stage lung cancer, so if you notice any of these, contact your doctor to talk through your concerns.

Lung cancer risk factors

Since lung cancer doesn’t have many symptoms early on in the disease, it’s important to know the top lung cancer risk factors.

  1. Smoking: Smoking cigarettes — at any point of your life — increases your risk of lung cancer. Smoking is the leading risk factor for lung cancer. Being exposed to secondhand smoke also increases your risk for lung cancer. 
  2. Radon gas: Radon is a radioactive, naturally occurring gas that is emitted from the breakdown of uranium in soil. It is the second-leading cause of lung cancer. It can enter in through cracks in homes or buildings, and when there’s exposure in high concentration, it can cause lung cancer.
  3. Asbestos: Asbestos is a mineral that was once used in many building materials. Breathing in asbestos fibers can cause lung cancer and pleural mesothelioma.
  4. Exposure to pollution and chemicals: Air pollution, especially from diesel exhaust, can increase your risk of lung cancer. 

Are you at risk for developing lung cancer?

Lung cancer is the third most common cancer in the United States and the leading cause of cancer death. Find out if you’re at risk. 

Lung cancer screening and diagnosis

Screening for lung cancer, especially if you have higher risk factors, is critical to early diagnosis. There are safe, effective, and innovative treatments at AHN that can help you and your care team get the full picture of your health.

A low-dose compute tomography or LDCT is used to screen for lung cancer in people who are at high risk, such as those who smoke, have smoked or have a history of lung cancer. There is no prep work for an LDCT, and it is safe, painless — taking only 15 minutes to complete.

LDCT results

An LDCT (sometimes called a low-dose CT) is a lung cancer screening that will provide your care team in-depth, detailed images of any potential issues or problem areas.

Lung cancer diagnosis

You may be wondering how is lung cancer diagnosed? Since it is especially hard to detect in early stages, these are some ways you and your doctor can monitor your health.

  1. Have regular checkups from your doctor and talk with them about any changes in your health. This is especially important if you are or have been a smoker or have a family history or biomarkers of lung cancer. Your doctor can help monitor the signs and symptoms of any potential issues.
  2. Get screened if you are at higher risk for lung cancer. Your doctor can help you figure out your lung cancer screening options.
  3. Know the signs and symptoms of lung cancer such as persistent cough, shortness of breath, chest pain, and unexplained weight loss. If you experience any of these, get in touch with your doctor right away.

Imaging

Medical imaging can help you and your doctor monitor your lung health and, if you are diagnosed with lung cancer, imaging will provide a clearer picture of the stage and severity. 

Chest X-ray: An X-ray can help diagnose lung cancer by providing images of the inside of your lungs. These images can show any abnormalities, such as tumors or nodules, that could be signs of cancer. X-rays can also help your doctor determine the stage of lung cancer, which is important for planning treatment.

Diagnostic Computed Tomography (CT) Scan: CT Scans are used to give a detailed cross-section of images that help to detect lung cancer at an earlier stage, determine the size and location of a tumor, and identify any lymph nodes that may be affected.

PET CT: A PET CT is a special type of X-ray that uses a radioactive tracer (a safe, harmless dye) to help doctors see lung health. The tracer goes through your body and collects in areas where there is a lot of activity, like in a tumor. The doctor uses a PET CT with other tests to look for evidence of lung cancer.

Diagnostic procedures

A diagnostic procedure is a test that’s used to learn more about an imaging result. Diagnostic procedures can include:

Bronchoscopy

A bronchoscopy is performed by your doctor, frequently done under anesthesia. This procedure uses a small scope (camera) that goes in your mouth and gently moves  down into the lungs to get a full view of the area. There are a few different bronchoscopies your AHN specialist may use to determine your specific care needs:

  • Endobronchial Ultrasound: This bronchoscopy uses the scope plus an ultrasound so your doctor can see the inside of your lungs and also your lymph nodes. It provides a closer, more detailed view of any suspicious masses.
  • Robotic Lung BiospyTM: AHN is the first in Western Pennsylvania to use the new IonTM  Endoluminal System that allows your doctor to take tissue samples from previously difficult places in the lungs. This means we can detect and treat lung cancer earlier than ever before.
  • Thoracentesis: Thoracentesis is a procedure in which a needle is inserted into the pleural space, the area between the lungs and the chest wall, to remove fluid, which can help improve any difficulties you may have with breathing. This fluid can then be tested to look for signs of infection, cancer, or other medical conditions.

Mediastinoscopy and Mediastinotomy

Mediastinoscopy and mediastinotomy are both surgical procedures that allow doctors to view the mediastinum, the area between the lungs.

  • Mediastinoscopy is a minimally invasive procedure that uses a small camera to view the mediastinum. This allows your doctor to see the lymph nodes, blood vessels, and other parts of the mediastinum to look for the presence of cancer.
  • Mediastinotomy is a more invasive procedure that involves making a larger incision in the chest. This allows the doctor to directly visualize the mediastinum and to take biopsies of any suspicious tissue.

Thoracoscopy

This minimally invasive procedure is used by your doctor to see if cancer has spread to the area between the lungs and chest wall or the lining of those spaces. Using a thoroscope, your doctor will examine the area. In early-stage lung cancer, thoracoscopy — specifically video-assisted thoracic surgery (VATS) — can be used as part of the treatment plan to remove a part of the lung that’s affected by cancer.

Lab Testing

With any type of medical issue, lab testing is a major part of helping your care team determine what the best options are for your specific treatment plan and therapy. AHN uses advanced testing options in lung cancer diagnoses with board-certified pathologists so you and your doctors get the most accurate results.

  • Cytology: Cytology is the study of cells. Your doctor will perform tests to collect the right material and then work with our board-certified pathologists to analyze and determine if cancer cells are present. This whole-team approach helps establish your care plan in a holistic manner.
  • Molecular Testing: In some cases, especially for non-small cell lung cancer (NSCLC), doctors may test for specific gene changes in the cancer cells. If detected, targeted drugs might be prescribed by your oncologist to help treat the cancer.   

Types and stages of lung cancer

There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Your treatment plan will be tailored to your specific type and personal needs.

You may be wondering what does lung cancer look like?

Non-small cell lung cancer (NSCLC)

Non-small cell (NSCLC) consists of three types:

  • Adenocarcinoma is the most common type of lung cancer. It starts in the glands of the lungs.
  • Squamous cell carcinoma is the second most common type of lung cancer and starts in the cells that line the lungs.
  • Large cell carcinoma is a less common type of lung cancer that starts in the large cells of the lungs.

They are all grouped together as non-small cell lung cancer because the treatments are often similar.

The second type of lung cancer, called small cell lung cancer (SCLC), is not as common and grows quicker than non-small cell lung cancer.

Small cell lung cancer

Small cell lung cancer (SCLC) is the least common lung cancer, but is also the most aggressive. It forms in the small cells of the lungs and is more common in people ages 50 – 70 who also smoked.

A lung cancer diagnosis will be classified into a stage.

There are four lung cancer stages:

  • Stage I: The tumor is the least severe and measures less than 3cm and has not spread to lymph nodes or other parts of the body.
  • Stage II: The tumor is between 3 and 7 centimeters, is contained in the lung and/or may have spread to nearby lymph nodes on the same side as the tumor.
  • Stage III: The tumor is greater than 3 centimeters in size, but has likely spread lymph nodes in other lung or invaded the space surrounding the lungs, but has not spread to other parts of the body.
  • Stage IV: This advanced stage is also known as metastatic cancer, which means the cancer has spread to other parts of the body like your bones, brain, or liver.

A lung cancer diagnosis can be life-altering and scary, so your AHN team of doctors, specialists, oncologists, nurses — the whole team, are here to walk with you through this journey and figure out the best care plan. 

Lung cancer treatment

When you come to AHN Cancer Institute, you benefit from the latest diagnostic and treatment advances in lung cancer. Our comprehensive lung cancer team uses the most sophisticated treatment techniques and technologies to treat your lung cancer. Your treatment will be specific to your type and stage of lung cancer — personalized for you and your specific diagnosis. We see you at the center of everything.

The treatment options include:

Surgery

Surgery is often the standard of care for those with lung cancer. A skilled AHN surgeon will talk with you about the best treatment course and what surgery might entail. Our team will use the latest, most innovative surgery techniques that use minimally invasive methods.

Radiation therapy

Using radiation therapy can help shrink lung cancer tumors and relieve lung cancer symptoms. Your doctor will help put together a care plan that is best for your specific needs. Radiation therapy at AHN uses pioneering radiation therapies like MR-Linac that target cancer.

MR-Linac is a breakthrough technology that simultaneously generates magnetic resonance images (MRI) and delivers radiation beams to the tumor tissue. Your doctor can view tumor tissue in real time and can adapt the radiation dose during the treatment.

The MR-Linac gives your doctor the ability to reshape the radiation dose based on daily changes in the shape, size, and position of the tumor and surrounding healthy tissue and organs — potentially resulting in better outcomes and fewer side effects.

The AHN Cancer Institute is one of the few facilities in the country to have the MR-Linac technology treatment option.

Medical oncology

AHN offers the latest in medical oncology treatments. Your care team will analyze and assess the best treatment courses for your specific needs.

Chemotherapy: This delivers strong medicine to kill your cancer cells. Our team monitors you closely to determine the correct dose for maximum effectiveness and to reduce side effects.

Immunotherapy:  These drugs help your own immune system fight the cancer cells.

Targeted therapy: These drugs target and help block the spread of cancer. They typically cause less severe side effects than chemotherapy.

Contact us

Overview of the diagnostic and treatments available at AHN Cancer Institute.

To schedule with medical oncology, radiation oncology, call (412) 578-HOPE (412) 578-4673.

To schedule with thoracic surgery, call (412) 359-6137.

Second opinions

When it comes to cancer, we have an all-hands-on-deck approach. You have a team of lung cancer specialists ready to review your medical records and offer you a second opinion.  They will talk with you about your goals to determine a course of treatment that’s right for you. To get started, complete our second opinion request form. A nurse navigator will contact you to discuss next steps and to help you schedule an appointment.