Dr. Thomas Hensing (NorthShore)
No, if a lung cancer is being called inoperable, it still may be treated with radiation and/or chemotherapy depending on the final stage.

Dr. Thomas Hensing (NorthShore)
Hi Audra. Yes, screening for lung cancer with an annual low dose CT scan of the chest was recently shown to reduce the risk of dying from lung cancer by approximately 20%. The individuals screened for this trial were between the ages of 55 and 74 with a significant smoking history (defined 30 "pack-years" (i.e. average 1 pack per day for 30 years), including current smokers or people who quit within the last 15 years). The US Centers for Medicare and Medicaid services (CMS) recently supported a proposal to reimburse low dose CT screening for individuals with these characteristics.

Dr. Thomas Hensing (NorthShore)
Hi Mac. Thank you for your question. Please see my previous answer about screening. Lung cancer often dose cause symptoms such as cough or shortness of breath, but people can also present without any symptoms. Ultimately, it is important to work with your primary care physician to address risk factors for developing lung cancer, such as a smoking history or a family history of lung cancer. Screening may be indicated for asymptomatic individuals with the characteristics I mentioned in my previous post. For individuals with risk factors and new symptoms, such as cough or shortness of breath, a work up with a CT scan of the chest may also be indicated.

Dr. Thomas Hensing (NorthShore)
Abouth 90% of lung cancer is non-small cell lung cancer. 10% of patients will have small cell lung cancer, which is associated with a heavier smoking history. Small cell lung cancer is usually (but not always) treated with chemotherapy with or without radiation, rather than surgery. About 10% of patients with lung cancer will be never smokers. Most of those patients will have a subtype of non-small cell lung cancer called adenocarcinoma.

Dr. Thomas Hensing (NorthShore)
Hi Jose. Thank you for your question. It definitely pays to quit. The risk for developing lung cancer in individuals who used to smoke drops significantly over time, and in individuals with a limited smoking history such as yourself, the risk can get close to that of a never smoker.

Dr. Thomas Hensing (NorthShore)
Hi Anthony - A significant "driver" of the low survival rates is that most individuals are still diagnosed with an advanced stage of lung cancer. As is true with cancer in general, the survival rates are much higher if lung cancer is diagnosed early. Hopefully the combination of finding lung cancer earlier through screening, reducing tobacco consumption and the continued development of new therapies, we will see significant improvement in lung cancer survival rates over time.

Dr. Thomas Hensing (NorthShore)
Hi Cameron - The side effects will depend also on whether or not he will be receiving chemotherapy with radiation and the specific agents that he will receive. However, in general, the most common risks associated with radiation to the chest include "esophagitis" (pain after swallowing) and "pneumonitis" (inflammation of the lung that can result in cough or shortness of breath). The risk of both side effects depends on the dose of radiation and the size of the radiation field. Typically, esophagitis occurs towards the end of radiation (a few weeks after starting) and pneumonitis is usually a delayed side effect that can develop a couple months after radiation is complete. I would make sure that he addresses all of the risks with his treatment team before starting. I would say, however, that most people feel ok initially and the risk for the side effects increases towards the end of the planned radiation course. I hope this helps - best of luck to your father.

Dr. Thomas Hensing (NorthShore)
Hi Robbie - yes, about 10% of patients with lung cancer are never smokers. Some of those patients may have been exposed to 2nd hand tobacco, but many have not. In general, never smokers with lung cancer tend to be younger and a higher proportion are women for reasons that are unknown. There are many theories about why lung cancer may occur in a never smoker, but we don't yet have an answer for most patients.

Dr. Thomas Hensing (NorthShore)
Thanks Jose. If possible, I would typically advise someone to start with their primary care physician to see what resources are available in the community. We started a smoking cessation clinic for our patients several years ago and we've learned that it often takes multiple different approaches to help someone stop smoking (i.e. nicotine replacement (patch, etc), occasional medications, counseling, etc). There is no one standard approach for all individuals. Many primary care physicians can get the process started and then refer to local resources if available.

Dr. Thomas Hensing (NorthShore)
Hi Tom - There are no stupid questions here... I would say that there are no "safe" cigarettes. Regardless of how they are produced, there are a number of carcinogens in all cigarettes that can increase the risk for many cancers, including lung cancer.

Dr. Thomas Hensing (NorthShore)
Hi Brittany - I would emphasize that the safety of e-cigs has not been established and there is no evidence that I am aware of that they are safer than cigarettes.

Dr. Thomas Hensing (NorthShore)
Hi Candice - I would say that in general, if someone is asking about whether or not to get a 2nd opinion, I typically advise them to go ahead and get one. 2nd opinions can be helpful to increase overall understanding of the diagnosis, as well as the prognosis and available treatment options. They can usually be done quickly so as not to delay starting treatment. Most centers will typicically get someone in for a 2nd opinion within a week.