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Lung cancer and smoking

The Risks of Smoking

You have undoubtedly heard the warnings: if you smoke cigarettes, stop now, and if you don't smoke, don't start. Why? Because cigarette smoke is made up of over 4,000 chemicals, including 43 known to cause cancer. According to the American Cancer Society, tobacco use accounts for 30 percent of all cancer deaths in the United States, and smoking is responsible for 90 percent of lung cancers in men and more then 70 percent in women. The ACS estimates that 28 percent of men, 23 percent of women, and about 30 percent of adolescents smoke.

According to the American Lung Association, the more you smoke and the longer you smoke, the more likely you are to develop lung cancer. But the ACS contends that if you quit smoking when precancerous signs are found, the damaged lung tissue often may return to normal, oftentimes within five years.

There has been some debate, however, on this subject. In 1997, researchers at the University of Pittsburgh Cancer Institute concluded after a preliminary study, that just because people quit smoking doesn't mean they won't develop lung cancer at some point in their lives. The study, which was published in the American Journal of Respiratory and Critical Care Medicine, determined that 77 percent of the people who smoked at least a pack of cigarettes a day for 25 years had irregularities in their lung cells even if they weren't smoking at the time the lung tissue was examined. While those who smoked fewer cigarettes weren't home free, they were less likely to develop abnormal lung cells. Only about 15 percent of the people who smoked for less than 25 years showed similar cellular changes.

More research still needs to be conducted on this topic, and most doctors still recommend that people stop smoking, no matter how long they've been keeping up the habit. This is especially true for people who have been diagnosed with lung cancer. "People with lung cancer who stop smoking live longer and have higher cure rates and lower rates of second cancers, which is a major problem for these patients," says Paul Bunn Jr., M.D., director of the University of Colorado Cancer Center and past president of the International Association for the Study of Lung Cancer. "They also have lowered risk of death from other problems such as heart disease." Bunn says it's a myth that most lung cancer patients don't quit smoking; in fact, they have a much higher quit rate, he says.

For more information on how to quit smoking, see "It's Quittin' Time" in the November-December 1997 FDA Consumer.

Lung Cancer Warning Signs

Detecting lung cancer in its early stages can lead to a cure for some people and extend the life of others, according to the American Cancer Society. So, if you are experiencing any of the following problems or symptoms, seek medical attention at once:
a persistent cough
chest pain
weight loss and/or decreased appetite
bloody phlegm
shortness of breath
a fever for an unknown reason
recurring infections, such as bronchitis and pneumonia.

Some of these symptoms may be related to another disease or condition. The only way to know if you have lung cancer is for a doctor to perform the necessary tests.
Stages of Lung Cancer

Lung cancer treatment depends on tumor size and on how far the cancer has spread. To help doctors decide on the best treatment plan for their patients, a system of stages that describes the growth and spread of the cancer has been developed.

There are two stages for small cell lung cancer. In the limited stage, the tumor is usually confined to one lung and lymph nodes on the same side of the chest. In the extensive stage, the cancer has spread to the other lung and to lymph nodes on the other side of the chest, or to distant organs.

The stages of non-small cell lung cancer are:
Occult Stage:
Cancer can be detected in patient's saliva, but tumors cannot be found in the lungs.
Stage 0:
Cancer is localized in a few layers of cells and has not grown through the lung's top lining.
Stage I:
The tumor is only in the lung and surrounded by normal tissue.
Stage II:
Cancer has spread to nearby lymph nodes.
Stage III:
Cancer has spread to the chest wall or diaphragm near the lung, or to the lymph nodes in the mediastinum (the area that separates the two lungs), or to the lymph nodes on the other side of the chest or in the neck. This stage is divided into IIIA, which can usually be operated on, and stage IIIB, which usually cannot withstand surgery.
Stage IV:
The cancer has spread to other parts of the body.
Cancer has returned after treatment.
To Find Out More

For more information about lung cancer, contact the following organizations:

The American Cancer Society
1599 Clifton Road, N.E.
Atlanta, GA 30329-4251

American Lung Association
1740 Broadway
New York, NY 10019
1-800-LUNG-USA (1-800-586-4872)

National Cancer Institute
31 Center Drive, NSC 2580
Building 31, Room 10A07
Bethesda, MD 20892-2580
1-800-4-CANCER (1-800-422-6237)

Questions concerning the editorial content of FDA Consumer should be directed to FDA's Office of Public Affairs.


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