by Mona Jhaveri - October 13, 2021

Lung cancer can be challenging to detect because symptoms often do not appear until the disease has progressed to a later stage.

Lung cancer screening is performed on individuals with a high risk of getting the disease, such as smokers and former smokers. These screenings are usually done using low-dose CT scans (LDCTs).

In terms of prognosis, lung cancer has one of the lowest survival rates among all cancers. However, people diagnosed early have higher chances of surviving for five years or more from their diagnosis date.

This blog post will discuss how lung cancer is diagnosed, the different stages of the disease, and its survival rates.

Lung Cancer Screening

Screening for lung cancer is typically performed on individuals who are at high-risk of getting the disease. Lung cancer screening involves LDCT scans to help diagnose the disease before symptoms appear and when cancer treatment options are more effective.

Formerly, chest X-rays were considered a lung cancer screening method. Still, LDCTs provide better images of the lungs and are more accurate in detecting changes that might indicate lung cancer. Unlike the X-ray method, LDCTs can help save lives.

Screening for lung cancer is vital in high-risk patients even if they don’t exhibit any symptoms. Lung cancer is considered a silent killer because it takes time before symptoms arise, and when they do, the disease has already progressed.

As of now, there are no guidelines that recommend LDCT screenings for all people regardless of smoking history or other risk factors. Lung cancer screening might not benefit low-risk individuals who have little chance of developing lung cancer.

Lung Cancer Symptoms

While some lung cancers are detected during regular screening, most are only discovered once the symptoms begin to bother the patient. Lung cancer can cause a few common symptoms, including:

  • Coughing that doesn’t go away or gets worse over time
  • Chest pain, especially when coughing or breathing deeply
  • Shortness of breath, wheezing, or trouble catching your breath during physical activities
  • Hoarseness
  • Loss of appetite and unexplained weight loss
  • Fatigue
  • Bronchitis, pneumonia, or similar infections that stay for prolonged periods or repeatedly return

However, not all lung cancers cause symptoms. Lung cancer is the leading cause of cancer death among non-smokers, and there are cases where it can be asymptomatic or without any noticeable signs. Therefore, regular medical checkups to evaluate lung health are strongly advised for both smokers and nonsmokers, and people with or without symptoms. 

Detection Methods

If a patient or healthcare provider suspects lung cancer, their doctors may advise on a range of tests to confirm the diagnosis. Lung cancer is typically diagnosed using a combination of imaging methods such as CT scans and X-rays, biopsies, sputum cytology, and bronchoscopy.

  • Imaging tests

Imaging tests include CT scans and X-rays, which are used to examine the lungs for possible tumors. Lung cancer can be detected early on CT scans because they provide detailed images that help spot subtle changes in lung tissue.

A specialized type of imaging test called positron emission tomography (PET) is more expensive than other methods but provides more accurate results when combined with CT scanning.

  • Sputum cytology

Sputum cytology is a method used to detect lung cancer. It involves taking mucus samples from patients and analyzing them under a microscope for suspicious changes. This method effectively discovers squamous cell carcinoma but may not be the best for other lung cancer types.

  • Biopsy

For most lung cancer patients, a biopsy is the standard method of diagnosing cancer. Tissue samples are taken from different parts of the lungs by inserting thin needles through the chest wall or via endoscopy (bronchoscopy), where flexible tubes with cameras attached to them are inserted into the lungs.

Lung tissue biopsy is more accurate than cytology sample testing because abnormalities can be spotted more easily. Several needle biopsy types include fine-needle aspiration biopsy (FNAB), core needle biopsy, and transthoracic lung biopsy.

Lung Cancer Prognosis

Survival rates of lung cancer depend on several factors, such as:

  • Subtype of lung cancer.
  • The stage at which cancer is diagnosed. Lung cancer that has not spread to other parts of the body and is detected early on generally offers a better prognosis.
  • Age, sex, and general health status of the patient.

The 5-year survival rate represents how likely a patient is to survive at least five years after diagnosis.

To better understand the survival data, we should first define three categories of cancer, based on how far it has spread:

  • Localized – Lung cancer that has not spread to any other parts of the body.
  • Regional – Lung cancer that has spread into nearby lymph nodes, tissues, or organs.
  • Distant – Lung cancer that has reached remote places in the body.

NSCLC Survival Rates

The five-year survival rate of non-small cell lung cancers in the United States was 25% for all stages combined, according to statistics from 2010-2016.

Here is the data breakdown for each of the three groups of NSCLC:

  • Localized – 63%
  • Regional – 35%
  • Distant – 7%

SCLC Survival Rates

For small cell lung cancers, the five-year survival rate for all stages combined was significantly lower than for NSCLC, at 7%.

This is the 5-year survival rate for each SCLC cancer stage:

  • Localized – 27%
  • Regional – 16%
  • Distant – 3%

These numbers are discouraging but still an improvement from the past. Lung cancer is now among the top ten most diagnosed cancer types in both men and women. The overall five-year relative survival rates for all lung cancers have improved substantially since 1990 due to advancements in early detection options.

Survivorship

It is estimated that, currently, there are over 384,000 survivors of lung cancer in the United States. Lung cancer survivorship is often seen as a single-event experience; however, many survivors live with the disease for years.

Lung cancer survivors often experience a variety of physical and psychological issues after treatment. These include but are not limited to fatigue, loss of appetite, trouble breathing, heart palpitations, and coughing up blood. Lung cancer survivors are also at risk for developing secondary cancers due to treatment effects or lifestyle factors.

However, survivors diagnosed in earlier stages tend to have lower rates of long-term side effects than those diagnosed when their disease was more advanced.

Lung cancer survivorship may also cause financial stress due to the high costs of diagnosis, surgery, chemotherapy and other therapies such as radiation or immunotherapy. This is especially true for underserved populations, such as minorities, and low-income individuals.

Lastly, a certain type of social stigma comes with a lung cancer diagnosis. Plenty of people still believe that it is a self-inflicted condition that patients can avoid if they choose to quit smoking.

Different types of lung cancer can develop in people without any history of smoking. Genetic mutations can predispose individuals to lung cancer, regardless if they smoked or quit smoking many years ago.

These common misconceptions about the disease only serve as barriers that prevent patients from seeking treatment early, which ultimately leads to more severe cases and a lower chance of survival. Lung cancer can affect anyone, regardless of age, race, or socioeconomic status.

Conclusion

Early detection of lung cancer is key to increasing a patient’s chances of survival. Lung cancer screening is performed on individuals with a high risk of getting the disease, such as smokers and former smokers. The screening typically involves low-dose CT scans.

However, most cases of lung cancer are detected once patients start to experience symptoms. Overall, the five-year survival rates for all stages of lung cancer are low.

Survivors diagnosed in earlier stages tend to have lower rates of long-term side effects than those diagnosed when their disease was more advanced.

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