What is lung cancer?
What are the risk factors for lung cancer?
How can the risk of lung cancer be reduced?
What are the symptoms of lung cancer?
How can lung cancer be detected?
Why does lung cancer recur?
How is relapsed lung cancer treated?
What is the goal of treatment—cure or control of my symptoms?
How may Hycamtin help me?
What is lung cancer?
Lung cancer is cancer that usually starts in the lining of the bronchi. Lung cancers are generally divided into two types:
- Small cell lung cancer, sometimes called oat cell cancer because the cancer cells may look like oats when viewed under a microscope, grows rapidly and quickly spreads to other organs
- Non-small cell lung cancer is more common than SCLC
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What are the risk factors for lung cancer?
It is important to remember that risk factors increase the odds of getting a disease but do not guarantee it will occur. Several risk factors make a person more likely to develop lung cancer [7]:
- Smoking is the leading cause of lung cancer, with more than 87% of lung cancer thought to be a result of smoking
- Second-hand smoke—breathing in the smoke of others
- Smoking marijuana cigarettes
- A personal history of recurring inflammation, such as tuberculosis and some types of pneumonia
- A family history of lung cancer
- Asbestos exposure
- Air pollution
- Radon. A radioactive gas that cannot be seen, tasted, or smelled. It is produced by the natural breakdown of uranium
- Unprocessed talcum powder. Talcum powder is made from talc, a mineral that in its natural form may contain asbestos. Today, law requires that all home-use talcum products (baby, body, and facial powders) be asbestos-free
- Cancer-causing agents in the workplace, including the following:
- Radioactive ores such as uranium
- Inhaled chemicals or minerals such as arsenic, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, and chloromethyl ethers
- Fuels such as gasoline
- Diesel exhaust
- Diets low in fruits and vegetables may increase your risk if you are exposed to tobacco smoke
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How can the risk of lung cancer be reduced?
- Smoking tobacco is by far the leading cause of lung cancer. The best way to prevent lung cancer is to not smoke, quit smoking if you’ve started, and avoid people who do [7]
- Find out about cancer-causing chemicals that you may be exposed to at work and take appropriate protective measures
- If you live in an area where natural uranium deposits in the soil release radon gas, consider testing radon levels in your home
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What are the symptoms of lung cancer?
Lung cancer usually does not cause symptoms when it first develops, but they often become present after the tumor begins growing. A cough is the most common symptom of lung cancer. Other symptoms include [7]
- A cough that does not go away
- Chest pain, often aggravated by deep breathing, coughing, and laughing
- Hoarseness
- Weight loss and loss of appetite
- Recurring lung infections, such as pneumonia or bronchitis, bloody or rust-colored sputum
- Shortness of breath
- Wheezing
- A tumor that presses on large blood vessels near the lung, which can cause swelling of the neck and face
- A tumor that presses on certain nerves near the lung, which can cause pain and weakness in the shoulder, arm, or hand
None of these symptoms is a sure sign of lung cancer. Only a health care provider can tell whether a symptom is caused by cancer or by another problem. If you have any of these problems, consult your health care provider right away.
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How can lung cancer be detected?
In addition to a complete medical history to check for risk factors and symptoms, and a physical examination, procedures used to diagnose lung cancer may include [7]
- Chest X-ray
This is typically the first test that your doctor will use to look for any mass or spot on the lungs. If something suspicious is seen, additional tests may be ordered.
- Computerized tomography scan (CT or CAT scan)
CT scans produce cross-sections of the body by taking many pictures as it rotates around it. While it takes slightly longer, CT scans are more detailed than general X-rays.
- Sputum cytology
A study of phlegm (spit) cells is viewed under a microscope to see if cancer cells are present. This is typically the best way to get early morning samples from a patient 3 days in a row.
- Needle biopsy
A needle is used to remove a sample of the mass. The sample is then evaluated under a microscope.
- Bronchoscopy
The examination of the bronchi (the main airways of the lungs) using a flexible tube (bronchoscope). A patient is sedated for this exam.
- Mediastinoscopy
A small cut is made in the neck so that a tissue sample can be taken from the lymph nodes (mediastinal nodes) along the windpipe and the major bronchial tube areas.
- Mediastinotomy
This procedure also removes samples from the lymph nodes. In this procedure, the surgeon opens the chest cavity by making a small incision beside the sternum. This allows the surgeon to reach lymph nodes that can’t be reached by mediastinoscopy.
- X-rays (brain, liver, bone, and adrenal glands)
Used to determine if the cancer has spread from where it started into other areas of the body.
Other tests and procedures may be used as well.
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Why does lung cancer recur?
Recurrence (or relapse) means a reappearance of the signs and symptoms of cancer. Small cell lung cancer is initially very responsive to chemotherapy, given alone or with radiation therapy; however, most cases of SCLC become resistant to treatment, and most patients with small cell lung cancer sensitive disease eventually experience a recurrence of their disease.
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How is relapsed lung cancer treated?
Many of the same issues that affected treatment during your initial (or first-line) cancer therapy will be considered again when planning treatment for relapsed disease. Small cell lung cancer grows very quickly and can spread (or metastasize) to other parts of the body, including the bones, brain, liver, and lymph nodes.
Treatment of recurrent disease is intended to slow or stop the growth of cancer in the lung as well as other parts of the body where the disease has spread. Second-line treatment of small cell lung cancer may include chemotherapy drugs that were not used in the initial treatment plan. Radiation therapy may also be used to help shrink or destroy tumors in the lung or elsewhere in the body and to help control symptoms.
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What is the goal of treatment?
Though some oncologists feel that chemotherapy does not provide sufficient survival benefits for relapsed small cell lung cancer patients, some patients do benefit from treatment and achieve prolonged survival, symptom relief, and improved quality of life. A small percentage of patients have durable remissions. Be sure to discuss the goal of your treatment with your health care team.
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How may Hycamtin help me?
In one comparative study, Hycamtin given alone was found to be similar in effectiveness to a triple-drug chemotherapy regimen (known as CAV*), with the potential for improvement in many disease-related symptoms, including shortness of breath, fatigue, hoarseness, loss of appetite, cough, interference with sleep, chest pain, and interference with daily activities.
For information about the side effects of Hycamtin, see side effects. It’s important to remember that all patients respond differently to therapy. Individual results may vary, so make sure you discuss with your doctor whether Hycamtin is right for you.
*CAV=cyclophosphamide, Adriamycin® (doxorubicin), vincristine. Adriamycin is a registered trademark of the Pharmacia & Upjohn Company.
Remember, no one source can answer all your questions or replace the information provided by your doctors and nurses. This Web site is not intended to replace ongoing communication between you and your health care team.
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Important Safety Information
Use of Hycamtin
Hycamtin is used for the treatment of small cell lung cancer that returns at least 2 months after completion of your first treatment.
Reasons Not to Use Hycamtin
Do not use if you have had an allergic reaction to Hycamtin, if you are pregnant, if you are breast-feeding, or if you have low blood counts.
Side Effects
Hycamtin can interfere with your body’s ability to make white and red blood cells. Your doctor may prescribe a supportive therapy to help your body make more blood cells.
Side effects often associated with Hycamtin included nausea (64%), vomiting (45%), diarrhea (32%), hair loss (49%), fatigue (29%), and shortness of breath (22%). Most of these side effects were mild to moderate.
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