Lung Cancer in Women
In the United States, lung cancer is the second most common cancer diagnosis in women and the leading cause of cancer-related mortality. The risk of developing lung cancer during her lifetime is about 1 in 17 for women. Lung cancer affects both tobacco smokers and non-smokers; for smokers the risk is higher. The rates of lung cancer have been increasing over the past several years for women, particularly adenocarcinoma.
- Lung cancer is one of the most common forms of cancer in the U.S., as well as one of the most fatal. More women die each year from lung cancer than breast cancer and colorectal cancers combined. Tobacco is a major risk factor for getting lung cancer, but non-smokers can also be affected.
- Lung cancer can generally be thought of in two types: small cell lung cancer and non-small cell lung cancer (NSCLC). Small cell lung cancer is more aggressive than NSCLC, but also more rare.
- NSCLC represents the majority of lung cancer cases and includes subtypes like adenocarcinoma and squamous cell cancer. Adenocarcinoma has become more common in women over the past several years.
- Treatment for lung cancer is the same for women and men. The type of treatment will depend on how aggressive the cancer is and the health of the patient. Treatment options may include chemotherapy, radiation therapy, or lung transplantation.
The underlying cause of lung cancer is when the DNA within lung cells undergoes an abnormal change or mutation that makes the cells multiply. Mutations can be the result of various factors, although the most common for lung cells is smoke. Tobacco smoke (from cigarettes, cigars, or secondhand) contains thousands of cancer-causing chemicals (carcinogens) that damage the cells and cause immediate changes in lung tissue. Although this damage can be repaired in the beginning, repeated exposure over time will lead to cancer.
Other causes of lung cancer include the following:
- Asbestos: Breathing in asbestos (or other similar carcinogens) is associated with an increased risk of developing lung cancer.
- Genetics: Having a family history of lung cancer makes it more likely for someone to develop it themselves.
- Radiation: Receiving radiation therapy to the chest for a previous type of cancer can raise the risk of developing lung cancer later on.
- Radon Gas: Long-term exposure to high levels of radon gas can lead to lung cancer.
Symptoms of lung cancer will usually only show up once the disease has advanced. They may include the following:
- Chest pain
- Chronic cough or wheezing
- Coughing up blood
- Difficulty swallowing
- Hoarse voice
- Shortness of breath
- Recurrent respiratory tract infections (e.g., pneumonia)
- Weight loss
There are a variety of ways to test for lung cancer. In general, the earlier it is detected, the higher chance any treatment will be successful. Anyone who is at a higher risk of lung cancer, such as long-term smokers or people with a family history of lung cancer, should consider getting regular lung cancer screenings.
The following are some common methods of diagnosing lung cancer:
- Imaging Tests: Doctors use these to take detailed images of the lungs and chest to look for any signs of cancer. They can include x-rays, computerized tomography (CT) scans, or positron emission tomography (PET) scans.
- Sputum Cytology: Sputum is a type of mucus that is coughed up from the lungs. This test examines sputum under a microscope to see if any cancerous cells are present.
- Thoracentesis: If there is fluid collecting around the lungs, this test will remove a sample to test for cancerous cells and rule out other conditions.
- Tissue Biopsy: This involves taking a sample of lung tissue and testing it for cancerous cells. This is usually done using a thin, hollow needle.
Types of Lung Cancer
Part of the diagnostic process is identifying the type of lung cancer. This will help determine the kind of treatment that is best. There are two main types of lung cancer:
- Small Cell Lung Cancer: This type of lung cancer occurs in about 10 to 15 percent of patients. It grows quickly and spreads aggressively to other organs.
- Non-Small Cell Lung Cancer: This type of lung cancer occurs in about 80 percent of patients. It includes several subtypes of lung cancer, such as squamous cell carcinoma, adenocarcinoma, and large cell carcinoma.
Stages of Lung Cancer
During diagnosis, doctors will also try to determine the stage of the cancer, or whether and how far it has spread. This will help them understand how serious the cancer is so they can identify the best treatment.
- Stage 0: The cancer is small and has not spread into deeper tissues of the lungs.
- Stage 1: The cancer is in the lung tissue but has not spread anywhere else.
- Stage 2: The cancer is in the lung tissue and may have spread to nearby lymph nodes or other tissue.
- Stage 3: The cancer is in the lung tissue and is actively spreading to nearby lymph nodes and other tissue, such as the heart and intestinal tract.
- Stage 4: The cancer is in the lung tissue and has spread throughout the body to distant lymph nodes and tissue, such as the brain.
Within each of these stages, there are several substages. See the American Cancer Society for more information on lung cancer staging.
There are multiple treatment options for lung cancer. Which treatment is best will depend on the unique circumstances of each patient, such as the stage of their cancer, their overall health, and their personal preferences.
The following are some common ways to treat lung cancer:
Chemotherapy uses medicine (often a combination of different types of medicines) to damage and destroy cancer cells. In systemic chemotherapy, these drugs travel through the bloodstream and attack cancer cells throughout the body instead of in just one specific area. This makes it a good option for cancer that has spread (metastasized) beyond the original tumor.
Chemotherapy drugs used to treat lung cancer include:
Chemotherapy is often used in combination with other types of treatments, such as surgery.
This treatment uses the body’s own immune system to fight cancer. Because cancer often develops from normal cells, the immune system may not recognize it as something it should remove. Immunotherapy solves this by helping the immune system find the cancer, then slow or stop it from spreading.
This treatment uses highly focused beams of radiation, such as x-rays, to destroy cancerous cells. This form of treatment is typically used in combination with chemotherapy and surgery to ensure the removal of all cancerous cells.
Targeted Drug Therapy
This type of treatment uses drugs designed to target key features identified within cancer cells. By disabling these features, the drugs destroy the cancer. Targeted drug therapy can be used alongside other treatments, such as chemotherapy, or on its own.
Surgery is often a good option when the cancer has not spread beyond the lungs. However, the type and extent of surgery will depend on the size of the tumor, its location, and the cancer type.
The following are some common forms of surgery for lung cancer:
- Wedge Resection: The removal of a small section of lung containing cancerous cells.
- Segmentectomy: The removal of a segment of lung (each lobe has three to five segments).
- Lobectomy: The removal of a lobe of one lung (the right lung has three lobes, while the left lung has two lobes).
- Pneumonectomy: The removal of an entire lung.
In some cases, a patient may be eligible for a lung transplantation. This involves removing the cancerous lung or lungs and replacing them with healthy lungs from a deceased donor. Patients with lung cancer are rarely eligible for lung transplantations due to the risk of recurrence.
Successfully treating lung cancer will depend on a variety of factors, such as the type and stage of the cancer, the health of the patient, and any underlying conditions.
Lung cancer is most likely to come back (recur) in the first five years after treatment. Because of this, patients will have to regularly return for follow-up appointments. Doctors will monitor for any possible symptoms and may recommend additional imaging tests. As more time passes since treatment, the risk of recurrence gradually lowers.
Data from the American Cancer Society divides the five-year survival rates for lung cancer into three general categories depending on if the cancer is only in the lung (localized), has spread to nearby organs or lymph nodes (regional), or has spread throughout the body (distant).
The following are the 5-year survival rates for small cell lung cancer:
- Localized: 27%
- Regional: 16%
- Distant: 3%
The following are the 5- year survival rates for non-small cell lung cancer:
- Localized: 61%
- Regional: 35%
- Distant: 6%
If you’ve recently received a lung cancer diagnosis, our team of experts is ready to take care of you. At our Women’s Lung and Health Center, we understand the unique ways lung cancer affects women, and are focused on helping diagnose, treat, and prevent lung cancer specifically for women. To do this, our team includes experienced doctors across a variety of specialties. This ensures we can give you both personalized attention and comprehensive care.
To ask a question or schedule an appointment, call (212) 305-3408 for existing patients, (212) 304-7535 for new patients, or request an appointment online to get started today.