11 Things About Lung Cancer Doctors Wish You Knew

Updated: Mar. 08, 2022

You probably know smoking leads to lung cancer, but that's only part of the story. Here's the latest on prevention and treatment of this deadly disease.

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Lung cancer causes the most cancer deaths

The 23 best ways to stop smoking can reduce your chances of getting lung cancer. But if you’re still lighting up, here’s exactly what it’s doing to your body to cause the condition: “Smoking introduces various toxic substances into the lungs that can affect the DNA of lung cells,” says Jacob Sands, MD, an oncologist and lung cancer researcher at the Dana-Farber Cancer Institute. “These toxins increase the chance of mutations, or changes, developing in the DNA of lung cells.” When certain mutations replicate out of control, that’s cancer. According to the American Cancer Society, lung cancer is the leading cause of cancer death in U.S. adults—more than colon, breast, and prostate cancers combined.

Cigarette butts. Smoking is bad for your health.

Your risk is dose-dependent

The more you smoke (or did in the past), the greater the risk of lung cancer. “Although quitting is the best way to decrease the risk of being diagnosed with lung cancer, it does not make the risks go away,” Dr. Sands says. Fifty percent of those diagnosed with lung cancer are former smokers, he says. But this doesn’t mean you shouldn’t bother quitting. “The risk decreases the longer the person has refrained from smoking,” he says. According to Harvard Medical School, a former smoker’s lung cancer risk is cut by 50 percent in ten years, but is still elevated after 15 years. Find out other mind-blowing ways your body heals after you quit smoking.

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“Social smokers” are still at risk

One of the rampant health myths that need to die is that smoking just a little when you’re out with friends doesn’t mean you’re a smoker. “It is common for people to believe that ‘social smoking’ will not affect them,” Dr. Sands says. “Each cigarette one smokes actually creates measurable changes that can be observed.” The risk for developing lung cancer increases after 100 lifetime cigarettes, he says. “Many people find that to be a shockingly low number,” he says. But even light and intermittent smoking can cause substantial health risks, according to a review of research.

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Second and third-hand smoke can lead to cancer

Twenty-five percent of lung cancer victims have never smoked, says Bernard Park, MD, Deputy Chief of Clinical Affairs of the Thoracic Surgery Service at Memorial Sloan Kettering Cancer Center. But, secondhand smoke—and potentially thirdhand smoke, which is nicotine residue left on clothing and surfaces—can increase your risk. “It is well-documented that secondhand smoke exposure is associated with increased lung cancer risk in never smokers, particularly those who live with active smokers,” Dr. Park says. “The risk, much like with direct cigarette smoking, is dose-dependent and can be as high as 25 percent compared to never smokers who live in a smoke-free environment.” If you live with a smoker, have them go outside to smoke, wash their hands afterward and their clothes frequently. And yes, thirdhand smoke is real.

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All kinds of smoke can cause lung cancer

Quitting smoking is the number one thing you can do to reduce your risk—find out what helped ex-smokers actually quit for good—and that means all types of lighting up. “Other tobacco exposure, such as cigars, pipes, or marijuana, [also cause the disease],” Dr. Parks says. According to the American Cancer Society, there is no “safer” tobacco product, including hand-rolled, herbal, menthol, clove, and those marketed as “natural.” Hookahs are also linked with cancer; although the jury is still out on e-cigarettes, your best bet is to avoid them, too. This “harmless” teen habit could be as dangerous as smoking a pack a day.

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Beware of radon

There are things every homeowner should know about radon testing. “Radon, a colorless and odorless gas present in soil and fairly common in the United States, is the second leading cause of lung cancer,” Dr. Sands says. When radon becomes trapped in enclosed spaces such as the low floors of homes and basements, it can cause radon levels to increase to unhealthy amounts. “It is important to test radon levels, and kits are available at hardware stores and often through state departments of public health,” Dr. Sands says.

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Other surprising causes of lung cancer

“Radiation exposure—environmental or occupational; asbestos; chronic inflammatory lung disease like bronchiectasis or chronic bronchitis; environmental exposures including pollution and dust” can all lead to lung cancer, Dr. Park says. “Wear protective respiratory gear if engaged in an occupation where respiratory exposure to particulate matter is high.” In addition, there may be a genetic element to lung cancer, but that probably doesn’t come into play unless you actually smoke, Dr. Sands says.

Early lung cancer symptoms are rare

You may be ignoring the signs of lung cancer. But unfortunately, the symptoms frequently show up only after the cancer is advanced. “This is why so many people diagnosed with lung cancer have metastatic disease [cancer that’s spread],” Dr. Sands says. “Seventy percent of lung cancers diagnosed from symptoms are stage 4 and not curable.” Plus, symptoms of lung cancer are so common among smokers, they’re not reliable for diagnosis. Even so, see your doctor if you have symptoms under the acronym BREATHE: Blood when coughing, recurring respiratory infections, enduring cough, aches in the shoulder, back, or chest, trouble breathing, hoarseness or wheezing, or exhaustion.

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Some people should be screened

Many serious cases of cancer could be avoided with preventative screenings. “If one meets criteria of high risk used in the recent National Lung Screening Trial—age between 55 and 75; history of cigarette smoking one pack per day for 30 years; or quit smoking less than 15 years ago—one should have annual screening with a low-dose CT chest scan,” Dr. Park says. This will greatly increase the chances of catching cancer in an earlier, and curable, stage, Dr. Sands says. “About 70 percent of people diagnosed in a lung screening program are discovered at stage 1,” he says. “Unfortunately, less than five percent of people who qualify are currently getting these scans.” Here are smart habits that can prevent lung cancer to begin with.

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Recovery is possible

If you’re diagnosed, your first thought is probably what your prognosis is. “Patients who do the best are diagnosed at early stages and have excellent lung function and overall health such that they can tolerate any of a number of treatments, including but not limited to surgery, chemotherapy, radiation, targeted therapy, and immunotherapy,” Dr. Park says. “In addition, there are many sub-types of lung cancer that are extremely slow-growing and very treatable.” A stage 1 lung cancer diagnosed in a lung-screening program has a 90 percent five-year survival rate, Dr. Sands says. These are other hopeful cancer statistics everyone should know.

New advances in treatment

The most groundbreaking cancer research of the past decade includes new treatments for lung cancer. “It is almost an entirely different field from what it was,” Dr. Sands says. “We now have various medications that can target cancer cells with specific DNA mutations more common in people with a limited smoking history.” These targeted therapies work better and longer than chemo with fewer side effects, he says. In addition, “every oncologist that treats lung cancer has patients alive specifically due to the impact of immunotherapy, medications that help a person’s immune system recognize the cancer,” he says. Current studies are trying to increase the number of patients that benefit from this remarkable therapy. Watch out for these other 12 silent symptoms of lung disease.