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Lung cancer is a massive health problem. It’s the leading cause of cancer death in the and . Oftentimes, the best way to start solving a problem â€� from the tiniest to the most serious â€� is to first understand it.

Benjamin J. Seides, MD, a pulmonologist and lung cancer specialist at »ªÌå»á, sheds light on lung cancer by sharing answers to the top questions he gets from his patients.  

1. What are the risk factors for lung cancer?

• Cigarette smoking is the greatest risk factor for lung cancer and accounts for roughly of all lung cancer deaths. Risk is up to 30 times greater for smokers than non-smokers and increases with the amount and duration of smoking.
• Previous radiation treatment, such as for another cancer, can cause lung cancer.
• Environmental exposures such as second-hand smoke, radon, asbestos, diesel exhaust and metals like arsenic, chromium and nickel are risk factors.
• Chronic obstructive pulmonary disease (COPD) carries an of lung cancer, which a small percentage of people inherit.

2. How can I prevent it?

The greatest action you can take to prevent lung cancer is to never start smoking â€� this includes marijuana and vaping. If you or someone you know smokes, smoking cessation is the best form of prevention.

3. Can nonsmokers or former smokers still get lung cancer?

Yes, but the risk for lung cancer differs between those who never smoked and those who used to smoke.

• According to the American Cancer Society, up to of people who develop lung cancer have never smoked.
• For those who used to smoke but have quit, the risk of lung cancer will always be higher than for those who never smoked. However, the risk decreases within five years of quitting, and after 15 years, it’s 80% to 90% lower than for current smokers.

If you have been diagnosed with lung cancer, quitting smoking is important as it can decrease your risk of developing other smoking-related diseases, lung cancer recurrence or a second lung cancer.

4. Is lung cancer hereditary?

Lung cancer is usually not hereditary. The majority of cases are caused by gene mutations that are acquired during your lifetime from factors like smoking, exposure to carcinogens and air pollution. These are called somatic mutations.

However, germline mutations � changes in your DNA that are passed down from your parents � can also increase your risk of getting lung cancer. Germline mutations in genes like BRCA1, BRCA2, ATM and CHEK2 have been linked to lung cancer risk. shows that testing people with lung cancer for these germline mutations may help guide treatment, as some may respond better to therapy that targets specific mutations.

It is important to note that not everyone with inherited mutations develops lung cancer.

5. What are the most common signs and symptoms?

Unfortunately, early lung cancer often doesn’t cause noticeable symptoms. This is why screening is important for high-risk people. However, as cancer progresses, you may experience:

• Persistent cough that worsens or doesn’t go away
• Shortness of breath or trouble breathing
• Wheezing
• Persistent chest pain, often worsened by deep breathing, coughing or laughing
• Hoarse voice
• Coughing up blood (hemoptysis)
• Unexplained weight loss
• Shoulder or neck pain
• Bone pain
• Recurrent pneumonia or bronchitis
• Enlarged lymph nodes (part of your immune system) in the neck
• Jaundice (yellowing of skin and whites of eyes)
• Seizures, headache or confusion
• Drooping eyelid

6. Should I get screened for it?

The U.S. Preventive Services Task Force (USPSTF) annual screening for lung cancer with low-dose computed tomography (LDCT), a type of CT scan that uses less radiation, for adults who meet the following criteria:

• Are 50 to 80 years old
• Have a 20 pack-year smoking history (one pack per day for 20 years or the equivalent)
• Currently smoke or have quit within the past 15 years

The USPSTF does not recommend lung cancer screening for people who have never smoked. That’s because the possible harms of screening outweigh the possible benefits (finding lung cancer early) for this group.

7. How do you diagnose lung cancer?

Lung cancer diagnosis involves a combination of medical history review, physical examination, imaging tests and tissue sampling (biopsy) for microscopic examination. Imaging tests may include chest X-rays, CT scans and PET scans.

8. What are the stages of lung cancer?

The stages of lung cancer are determined by using the standard cancer staging system. Most cancer care teams use the TNM staging system developed by the American Joint Committee on Cancer:

T = Tumor

Where is the primary tumor and how large is it?

N = Nodes

Has the tumor spread to nearby lymph nodes?

M = Metastasis

Has cancer spread to other parts of the body?

Once the T, N and M categories are determined, they are typically combined to assign an overall stage to the cancer, usually ranging from stage 0 to stage IV. The higher the stage number, the more the cancer has spread. Treatment depends on the stage at diagnosis � the earlier the diagnosis, the better the chances of a cure.

9. What are the treatment options?

Surgery, radiation therapy, chemotherapy, targeted therapy and immunotherapy may all be involved in lung cancer treatment. If the cancer is caught at its earliest stage, lung cancer treatment may only involve the surgical removal of the tumor. For more advanced disease, treatment plans often include multiple types of therapy. This may include enrollment in a clinical trial.

Advancements in targeted therapy, immunotherapy and lung transplants are also showing promising results. These treatments are helping people with lung cancer live longer and, in some cases, achieve long-term remission even in advanced stages.

10. Is lung cancer curable?

Lung cancer can be curable, especially when detected and treated early. However, curability depends on several factors, including:

• Stage of cancer at diagnosis. When cancer is confined to the lungs and hasn’t spread to other sites, surgery to remove the tumor offers the best chance of a cure.If it spreads to nearby lymph nodes or other organs, the likelihood of a cure decreases. Treatment in these stages focuses more on slowing the progression of the disease, managing symptoms and improving quality of life.
• Type of lung cancer. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, and in its early stage can be curable. Small cell lung cancer (SCLC) is more aggressive and tends to spread quickly, making a cure less likely.
• Treatment options available and your response to them. Advancements in targeted therapy and immunotherapy are improving outcomes.

Discuss your risk factors for lung cancer with your physician and, if appropriate, get screened.