Lung Cancer

Lung cancer is the second-most common type of cancer in the United States, and the most common cause of cancer death.

The two major types of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Approximately 85% of all lung cancers are non-small cell lung cancer, while about 10-15% are small cell lung cancer. A third type, lung carcinoid tumor, comprises less than 5% of lung cancer diagnoses. Non-small cell lung cancer can be subdivided into several types, including squamous cell carcinoma, adenocarcinoma, and large cell carcinoma.

A large majority of patients with lung cancer have a history of cigarette smoking. Not surprisingly, the risk of developing lung cancer increases with the amount of cigarette exposure (measured by the number of packs of cigarettes smoked as well as the number of years of smoking). In those individuals who stop smoking, the risk of developing lung cancer decreases proportionate to the number of years of abstinence, but never decreases to the level of someone who never smoked. Many non-smokers who develop lung cancer were exposed to high levels of second-hand smoke.

Other risk factors for developing lung cancer include:

• Asbestos exposure
• Heavy metal exposure (arsenic, cadmium, vinyl chloride, nickel, coal, beryllium, mustard gas)
• Radon exposure
• Diesel exhaust
• Radiation therapy for another cancer (breast, lymphoma)

There is much debate as to the need for lung cancer screening, which typically includes imaging such as a chest x-ray or spiral CT scan. Most authorities agree that screening is appropriate in high-risk populations such as heavy smokers and those with significant environmental exposure to known carcinogens.

Symptoms of lung cancer can include:

• Chronic cough
• Cough with yellow, white, or blood-tinged sputum
• Shortness of breath
• Chest pain
• Hoarse voice
• Weight loss (typically seen in advanced lung cancer)

If symptoms and/or imaging suggest lung cancer, a definitive diagnosis must be made with a biopsy. This biopsy typically occurs with the aid of CT- or ultrasound-guidance. Lymph nodes might also be biopsied if they appear suspicious.

It is important to distinguish between small cell lung cancer and non-small cell lung cancer, because they are treated differently. Sometimes, surgery can be performed to remove the tumor if it is in an accessible location. The extent of spread of the cancer to other sites must also be taken into consideration when planning treatment.

As with most cancers, conventional treatment options typically consist of surgery, chemotherapy, and radiation. In integrative oncology, we do not stop there. We also consider many other patient factors, including:

• Chronic medical problems, such as high blood pressure, diabetes, and digestive issues
• Previous medical history
• Diet and nutritional status
• Activity level and mobility
• Environmental exposures in the home and at work
• Sources of stress
• Treatment goals
• Support system, including family and friends

With all of these variables to consider, it becomes apparent that each cancer is unique. Dr. Stegall reviews your case very carefully, and after thorough discussion with you, a personalized treatment plan is generated which fits your specific situation. Once the roadmap is created, we have many tools at our disposal. These tools include advanced testing as well as innovative therapies that are on the cutting edge of science. Dr. Stegall feels strongly that the application of these treatments in a customized way for each patient is the future of cancer care.