SKIN CANCER DIAGNOSIS AND TREATMENT

Skin cancers  (neoplasms) 

are named after the type of skin cell from which they arise. Basal cell cancer originates from the lowest layer of the epidermis, and is the most common but least dangerous skin cancer. Squamous cell cancer originates from the middle layer, and is less common but more likely to spread and, if untreated, become fatal. Melanoma, which originates in the pigment-producing cells (melanocytes), is the least common, but most aggressive, most likely to spread and, if untreated, become fatal.^[1][2] Still, melanoma has one of the higher survival rates among major cancer, with over 75% of patients surviving 10 years in the UK during 2005-2007^.

 ^{basal cell carcinoma?}

^{Basal cell carcinoma is the most common form of skin cancer and accounts for more than 90% of all skin cancer in the U.S. These cancers almost never spread (metastasize) to other parts of the body. They can, however, cause damage by growing and invading surrounding tissue.}

What are risk factors for developing basal cell carcinoma?

Light-colored skin, sun exposure, and age are all important factors in the development of basal cell carcinomas. People who have fair skin and are older have higher rates of basal cell carcinoma. About 20% of these skin cancers, however, occur in areas that are not sun-exposed, such as the chest, back, arms, legs, and scalp. The face, however, remains the most common location for basal cell lesions. Weakening of the immune system, whether by disease or medication, can also promote the risk of developing basal cell carcinoma. Other risk factors include

• exposure to sun. There is evidence that, in contrast to squamous cell carcinoma, basal cell carcinoma is promoted not by accumulated sun exposure but by intermittent sun exposure like that received during vacations, especially early in life. According to the U.S. National Institutes of Health, ultraviolet (UV) radiation from the sun is the main cause of skin cancer. The risk of developing skin cancer is also affected by where a person lives. People who live in areas that receive high levels of UV radiation from the sun are more likely to develop skin cancer. In the United States, for example, skin cancer is more common in Texas than it is in Minnesota, where the sun is not as strong. Worldwide, the highest rates of skin cancer are found in South Africa and Australia, which are areas that receive high amounts of UV radiation.
• age. Most skin cancers appear after age 50, but the sun's damaging effects begin at an early age. Therefore, protection should start in childhood in order to prevent skin cancer later in life.
• exposure to ultraviolet radiation in tanning booths. Tanning booths are very popular, especially among adolescents, and they even let people who live in cold climates radiate their skin year-round.
• therapeutic radiation, such as that given for treating other forms of cancer.

How is basal cell carcinoma diagnosed?

To make a proper diagnosis, doctors usually remove all or part of the growth by performing a biopsy. This usually involves taking a sample by injecting a local anesthesia and scraping a small piece of skin. This method is referred to as a shave biopsy. The skin that is removed is then examined under a microscope to check for cancer cells.

How is basal cell carcinoma treated?

There are many ways to successfully treat a basal cell carcinoma with a good chance of success of 90% or more. The doctor's main goal is to remove or destroy the cancer completely with as small a scar as possible. To plan the best treatment for each patient, the doctor considers the location and size of the cancer, the risk of scarring, and the person's age, general health, and medical history.

Squamous cell carcinoma

Squamous cell carcinoma is cancer that begins in the squamous cells, which are thin, flat cells that look like fish scales under the microscope. The word squamous came from the Latin squama, meaning "the scale of a fish or serpent" because of the appearance of the cells.

How is squamous cell carcinoma diagnosed?

As with basal cell carcinoma, doctors usually perform a biopsy to make a proper diagnosis. This involves taking a sample by injecting local anesthesia and punching out a small piece of skin using a circular punch blade. Usually the method used referred to as a punch biopsy. The skin that is removed is then examined under a microscope to check for cancer cells.

How is squamous cell carcinoma treated?

Techniques for treating squamous cell carcinoma are similar to those for basal cell carcinoma (for detailed descriptions, see above under treatment of basal cell carcinoma):

• Curettage and desiccation: Dermatologists often prefer this method, which consists of scooping out the basal cell carcinoma by using a spoon like instrument called a curette. Desiccation is the additional application of an electric current to control bleeding and kill the remaining cancer cells. The skin heals without stitching. This technique is best suited for small cancers in non-crucial areas such as the trunk and extremities.
• Surgical excision: The tumor is cut out and stitched up.
• Radiation therapy: Doctors often use radiation treatments for skin cancer occurring in areas that are difficult to treat with surgery. Obtaining a good cosmetic result generally involves many treatment sessions, perhaps 25 to 30.
• Cryosurgery: Some doctors trained in this technique achieve good results by freezing basal cell carcinomas. Typically, liquid nitrogen is applied to the growth to freeze and kill the abnormal cells.
• Mohs micrographic surgery: Named for its pioneer, Dr. Frederic Mohs, this technique of removing skin cancer is better termed, "microscopically controlled excision." The surgeon meticulously removes a small piece of the tumor and examines it under the microscope during surgery. This sequence of cutting and microscopic examination is repeated in a painstaking fashion so that the basal cell carcinoma can be mapped and taken out without having to estimate or guess the width and depth of the lesion. This method removes as little of the healthy normal tissue as possible. Cure rate is very high, exceeding 98%. Mohs micrographic surgery is preferred for large basal cell carcinomas, those that recur after previous treatment, or lesions affecting parts of the body where experience shows that recurrence is common after treatment by other methods. Such body parts include the scalp, forehead, ears, and the corners of the nose. In cases where large amounts of tissue need to be removed, the Mohs surgeon sometimes works with a plastic (reconstructive) surgeon to achieve the best possible postsurgical appearance.
• Medical therapy using creams that attack cancer cells (5-Fluorouracil--5-FU, Efudex, Fluoroplex) or stimulate the immune system (Aldara). These are applied several times a week for several weeks. They produce brisk inflammation and irritation. The advantages of this method is that it avoids surgery, lets the patient perform treatment at home, and may give a better cosmetic result. Disadvantages include discomfort, which may be severe, and a lower cure rate, which makes medical treatment unsuitable for treating most skin cancers on the face.

The possibility of metastasis makes it especially important to diagnose squamous cell carcinomas early and treat them adequately.

How is squamous cell carcinoma prevented?

Even more so than is the case with basal cell carcinoma, the key principles of prevention are minimizing sun exposure and getting regular checkups.

Common-sense preventive techniques are the same as for basal cell carcinoma and include

• limiting recreational sun exposure;
• avoiding unprotected exposure to the sun during peak radiation times (the hours surrounding noon);
• wearing broad-brimmed hats and tightly-woven protective clothing while outdoors in the sun;
• regularly using a waterproof or water-resistant sunscreen with UVA protection and SPF 30 or higher;
• undergoing regular checkups and bringing any suspicious-looking or changing lesions to the attention of a doctor.

BRAIN CANCER

Brain tumor - primary - adults

Glioblastoma multiforme - adults; Ependymoma - adults; Glioma - adults; Astrocytoma - adults; Medulloblastoma - adults; Neuroglioma - adults; Oligodendroglioma - adults; Lymphoma - adults; Vestibular schwannoma (acoustic neuroma) - adults; Meningioma - adults; Cancer - brain tumor (adults)

A primary brain tumor is a group (mass) of abnormal cells that start in the brain. This article focuses on primary brain tumors in adults.

See also:

• Brain tumor - metastatic (cancer that has spread to the brain from elsewhere in the body)
• Brain tumor - children

Causes, incidence, and risk factors

Primary brain tumors include any tumor that starts in the brain. Primary brain tumors can start from brain cells, the membranes around the brain (meninges), nerves, or glands.

Tumors can directly destroy brain cells. They can also damage cells by producing inflammation, placing pressure on other parts of the brain, and increasing pressure within the skull.

The cause of primary brain tumors is unknown. There are many possible risk factors that could play a role.

• Radiation therapy to the brain, used to treat brain cancers, increases the risk for brain tumors up to 20 or 30 years afterwards.
• Exposure to radiation at work or to power lines, as well as head injuries, smoking, and hormone replacement therapy have NOT been proven to be risk factors.
• The risk of using cell phones is hotly debated. However, most recent studies have found that cell phones, cordless phones, and wireless devices are safe and do not increase the risk.
• Some inherited conditions increase the risk of brain tumors, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome.
• Lymphomas that begin in the brain in people with a weakened immune system are sometimes linked to the Epstein-Barr virus. 

SPECIFIC TUMOR TYPES

Brain tumors are classified depending on:

• The location of the tumor
• The type of tissue involved
• Whether they are noncancerous (benign) or cancerous (malignant)
• Other factors

Sometimes, tumors that start out less aggressive can become more aggrssive.

Tumors may occur at any age, but many types of tumors are most common in a certain age group. In adults, gliomas and meningiomas are most common.

Gliomas come from glial cells such as astrocytes, oligodendrocytes, and ependymal cells. The gliomas are divided into three types:

• Astrocytic tumors include astrocytomas (can be noncancerous), anaplastic astrocytomas, and glioblastomas.
• Oligodendroglial tumors. Some primary brain tumors are made up of both astrocytic and oligodendrocytic tumors. These are called mixed gliomas.
• Glioblastomas are the most aggressive type of primary brain tumor.

Meningiomas and schwannomas are two other types of brain tumor. These tumors:

• Occur most often between ages 40 and 70
• Are usually noncancerous, but still may cause serious complications and death from their size or location. Some are cancerous and aggressive.

Meningiomas are much more common in women. Schwannomas affect both genders equally.

Other primary brain tumors in adults are rare. These include:

• Ependymomas
• Craniopharyngiomas
• Pituitary tumors
• Primary CNS lymphoma
• Primary lymphoma of the brain
• Pineal gland tumors
• Primary germ cell tumors of the brain

Symptoms

Some tumors may not cause symptoms until they are very large. Then they can quickly damage a person's health. Other tumors have symptoms that develop slowly.

The symptoms depend on the tumor's size, location, how far it has spread, and whether there is swelling. The most common symptoms are:

• Changes in the person's mental function
• Headaches
• Seizures (especially in older adults)
• Weakness in one part of the body

Headaches caused by brain tumors may:

• Be worse when the person wakes up in the morning, and clear up in a few hours
• Occur during sleep
• Occur with vomiting, confusion, double vision, weakness, or numbness
• Get worse with coughing or exercise, or with a change in body position

Other symptoms may include:

• Change in alertness (including sleepiness, unconsciousness, and coma)
• Changes in hearing
• Changes in taste or smell
• Changes that affect touch and the ability to feel pain, pressure, different temperatures, or other stimuli
• Clumsiness
• Confusion or memory loss
• Difficulty swallowing
• Difficulty writing or reading
• Dizziness or abnormal sensation of movement (vertigo)
• Eye problems
  • Eyelid drooping
  • Pupils of different sizes
  • Uncontrollable movements
• Hand tremor
• Lack of control over the bladder or bowels
• Loss of balance
• Loss of coordination
• Muscle weakness in the face, arm, or leg (usually on just one side)
• Numbness or tingling on one side of the body
• Personality, mood, behavior, or emotional changes
• Problems with eyesight, including decreased vision, double vision, or total loss of vision
• Trouble speaking or understanding others who are speaking
• Trouble walking

Other symptoms that may occur with a pituitary tumor:

• Abnormal nipple discharge
• Absent menstruation (periods)
• Breast development in men
• Enlarged hands, feet
• Excessive body hair
• Facial changes
• Low blood pressure
• Obesity
• Sensitivity to heat or cold

Signs and tests

Most brain tumors increase pressure in the skull and press on brain tissue because of their size and weight.

The following tests may confirm the presence of a brain tumor and find its location:

• CT scan of the head
• EEG
• Examination of tissue removed from the tumor during surgery or CT-guided biopsy (may confirm the type of tumor)
• Examination of the cerebral spinal fluid (CSF) (may show cancerous cells)
• MRI of the head

Treatment

Treatment can involve surgery, radiation therapy, and chemotherapy. Brain tumors are best treated by a team that includes: 

• Neuro-oncologist
• Neurosurgeon
• Oncologist
• Radiation oncologist
• Other health care providers, such as neurologists and social workers

Early treatment often improves the chance of a good outcome. How you are treated depends on the size and type of tumor and your general health. The goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or comfort.

Surgery is often needed for most primary brain tumors. Some tumors may be completely removed. Those that are deep inside the brain or that enter brain tissue may be debulked instead of removed. Debulking is a procedure to reduce the tumor's size.

Tumors can be hard to remove completely by surgery alone, because the tumor invades surrounding brain tissue much like roots from a plant spread through soil. When the tumor cannot be removed, surgery may still help reduce pressure and relieve symptoms.

Radiation therapy is used for certain tumors.

Chemotherapy may be used with surgery or radiation treatment.

Other medications used to treat primary brain tumors in children may include:

• Corticosteroids, such as dexamethasone, to reduce brain swelling
• Medicines such as urea or mannitol to reduce brain swelling and pressure
• Anticonvulsants, such as evetiracetam (Keppra), to reduce seizures
• Pain medications
• Antacids or histamine blockers to control stress ulcers

Comfort measures, safety measures, physical therapy, and occupational therapy may be needed to improve quality of life. Counseling, support groups, and similar measures can help people cope with the disorder.

You may consider enrolling in a clinical trial after talking with your treatment team.

Legal advice may be helpful for creating advanced directives such as a power of attorney.

Support Groups

For additional information, see cancer resources.

Complications

• Brain herniation (often fatal)
  • Uncal herniation
  • Foramen magnum herniation
• Loss of ability to interact or function
• Permanent, worsening, and severe loss of brain function
• Return of tumor growth
• Side effects of medications, including chemotherapy
• Side effects of radiation treatments

Calling your health care provider

Call your health care provider if you develop any new, persistent headaches or other symptoms of a brain tumor.

Call your provider or go to the emergency room if you start having seizures, or suddenly develop stupor (reduced alertness), vision changes, or speech changes.

COLON CANCER

Colorectal cancer; Cancer - colon; Rectal cancer; Cancer - rectum; Adenocarcinoma - colon; Colon - adenocarcinoma

Colon, or colorectal, cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon).

Other types of cancer can affect the colon, such as lymphoma, carcinoid tumors, melanoma, and sarcomas. These are rare. In this article, use of the term "colon cancer" refers to colon carcinoma only.

Causes, incidence, and risk factors

According to the American Cancer Society, colorectal cancer is one of the leading causes of cancer-related deaths in the United States. However, early diagnosis can often lead to a complete cure.

Almost all colon cancer starts in glands in the lining of the colon and rectum. When doctors talk about colorectal cancer, this is usually what they are talking about.

There is no single cause of colon cancer. Nearly all colon cancers begin as noncancerous (benign) polyps, which slowly develop into cancer.

You have a higher risk for colon cancer if you:

• Are older than 60
• Are African American of eastern European descent
• Eat a diet high in red or processed meats
• Have cancer elsewhere in the body
• Have colorectal polyps
• Have inflammatory bowel disease (Crohn's disease or ulcerative colitis)
• Have a family history of colon cancer
• Have a personal history of breast cancer

Certain genetic syndromes also increase the risk of developing colon cancer. Two of the most common are:

• Familial adenomatous polyposis (FAP)
• Hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome

What you eat may play a role in your risk of colon cancer. Colon cancer may be associated with a high-fat, low-fiber diet and red meat. However, some studies have found that the risk does not drop if you switch to a high-fiber diet, so this link is not yet clear.

Smoking cigarettes and drinking alcohol are other risk factors for colorectal cancer.

Symptoms

Many cases of colon cancer have no symptoms. The following symptoms, however, may indicate colon cancer:

• Abdominal pain and tenderness in the lower abdomen
• Blood in the stool
• Diarrhea, constipation, or other change in bowel habits
• Narrow stools
• Weight loss with no known reason

Signs and tests

With proper screening, colon cancer can be detected before symptoms develop, when it is most curable.

Your doctor will perform a physical exam and press on your belly area. The physical exam rarely shows any problems, although the doctor may feel a lump (mass) in the abdomen. A rectal exam may reveal a mass in patients with rectal cancer, but not colon cancer.

A fecal occult blood test (FOBT) may detect small amounts of blood in the stool, which could suggest colon cancer. However, this test is often negative in patients with colon cancer. For this reason, a FOBT must be done along with colonoscopy or sigmoidoscopy. It is also important to note that a positive FOBT doesn't necessarily mean you have cancer.

Imaging tests to screen for and potentially diagnose colorectal cancer include:

• Colonoscopy
• Sigmoidoscopy

Note: Only colonoscopy can see the entire colon, and this is the best screening test for colon cancer.

Blood tests that may be done include:

• Complete blood count (CBC) to check for anemia
• Liver function tests

If your doctor learns that you do have colorectal cancer, more tests will be done to see if the cancer has spread. This is called staging. CT or MRI scans of the abdomen, pelvic area, chest, or brain may be used to stage the cancer. Sometimes, PET scans are also used.

Stages of colon cancer are:

• Stage 0: Very early cancer on the innermost layer of the intestine
• Stage I: Cancer is in the inner layers of the colon
• Stage II: Cancer has spread through the muscle wall of the colon
• Stage III: Cancer has spread to the lymph nodes
• Stage IV: Cancer has spread to other organs

Blood tests to detect tumor markers, including carcinoembryonic antigen (CEA) and CA 19-9, may help your physician follow you during and after treatment.

Treatment

Treatment depends on many things, including the stage of the cancer. In general, treatments may include:

• Surgery (most often a colectomy) to remove cancer cells
• Chemotherapy to kill cancer cells
• Radiation therapy to destroy cancerous tissue

SURGERY

Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy. For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous. (See: Colon resection)

CHEMOTHERAPY

Almost all patients with stage III colon cancer should receive chemotherapy after surgery for approximately 6 - 8 months. This is called adjuvant chemotherapy. The chemotherapy drug 5-fluorouracil has been shown to increase the chance of a cure in certain patients.

Chemotherapy is also used to improve symptoms and prolong survival in patients with stage IV colon cancer.

• Irinotecan, oxaliplatin, capecitabine, and 5-fluorouracil are the three most commonly used drugs.
• Monoclonal antibodies, including cetuximab (Erbitux), panitumumab (Vectibix), bevacizumab (Avastin), and other drugs have been used alone or in combination with chemotherapy.

You may receive just one type, or a combination of these drugs. There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery. You should discuss this with your oncologist.

RADIATION

Although radiation therapy is occasionally used in patients with colon cancer, it is usually used in combination with chemotherapy for patients with stage III rectal cancer.

For patients with stage IV disease that has spread to the liver, various treatments directed specifically at the liver can be used. This may include:

• Burning the cancer (ablation)
• Delivering chemotherapy or radiation directly into the liver
• Freezing the cancer (cryotherapy)
• Surgery

Support Groups

For additional resources and information, see: Colon cancer support groups.

Expectations (prognosis)

Colon cancer is, in many cases, a treatable disease if it is caught early.

How well you do depends on many things, especially the stage of the cancer. In general, when treated at an early stage, many patients survive at least 5 years after their diagnosis. (This is called the 5-year survival rate.)

If the colon cancer does not come back (recur) within 5 years, it is considered cured. Stage I, II, and III cancers are considered potentially curable. In most cases, stage IV cancer is not considered curable, although there are exceptions.

Complications

• Blockage of the colon
• Cancer returning in the colon
• Cancer spreading to other organs or tissues (metastasis)
• Development of a second primary colorectal cancer

Calling your health care provider

Call your health care provider if you have:

• Black, tar-like stools
• Blood during a bowel movement
• Change in bowel habits
• Unexplained weight loss

Prevention

The death rate for colon cancer has dropped in the last 15 years. This may be due to increased awareness and screening by colonoscopy.

Colon cancer can almost always be caught by colonoscopy in its earliest and most curable stages. Almost all men and women age 50 and older should have a colon cancer screening. Patients at risk may need earlier screening.

Colon cancer screening can often find polyps before they become cancerous. Removing these polyps may prevent colon cancer.

For information, see:

• Colon cancer screening
• Colonoscopy

Changing your diet and lifestyle is important. Some evidence suggests that low-fat and high-fiber diets may reduce your risk of colon cancer.

Some studies have reported that NSAIDs (aspirin, ibuprofen, naproxen, celecoxib) may help reduce the risk of colorectal cancer. However, these medicines can increase your risk for bleeding and heart problems. Most expert organizations do not recommend that most people take these medicines to prevent colon cancer. Talk to your health care provider about this issue.

LUNG CANCER

Lung cancer - small cell

Cancer - lung - small cell; Small cell lung cancer; SCLC

Last reviewed: August 24, 2011.

Small cell lung cancer (SCLC) is a fast-growing type of lung cancer. It spreads much more quickly than non-small cell lung cancer.

There are two different types of SCLC:

• Small cell carcinoma (oat cell cancer)
• Combined small cell carcinoma

Most SCLCs are of the oat cell type.

Causes, incidence, and risk factors

About 15% of all lung cancer cases are SCLC. Small cell lung cancer is slightly more common in men than women.

Almost all cases of SCLC are due to cigarette smoking. SCLC is rare in people who have never smoked.

SCLC is the most aggressive form of lung cancer. It usually starts in the breathing tubes (bronchi) in the center of the chest. Although the cancer cells are small, they grow very quickly and create large tumors. These tumors often spread rapidly (metastasize) to other parts of the body, including the brain, liver, and bone.

Symptoms

• Bloody sputum (phlegm)
• Chest pain
• Cough
• Loss of appetite
• Shortness of breath
• Weight loss
• Wheezing

Other symptoms that may occur with this disease:

• Facial swelling
• Fever
• Hoarseness or changing voice
• Swallowing difficulty
• Weakness

Signs and tests

Your health care provider will perform a physical exam and ask questions about your medical history. You will be asked whether you smoke, and if so, how much and for how long you have smoked.

When listening to your chest with a stethoscope, your health care provider can sometimes hear fluid around the lungs or areas where the lung has partially collapsed. Each of these findings could (but does not always) suggest cancer.

SCLC has usually spread to other parts of your body by the time it is diagnosed.

Tests that may be performed include:

• Bone scan
• Chest x-ray
• Complete blood count (CBC)
• CT scan
• Liver function tests
• MRI
• Positron emission tomography (PET) scan
• Sputum test (cytology, looking for cancer cells)
• Thoracentesis (removal of fluid from the chest cavity around the lungs)

In most cases, your health care provider may need to remove a piece of tissue from your lungs or other areas to be examined under a microscope. This is called a biopsy. There are several ways to do a biopsy:

• Bronchoscopy combined with biopsy
• CT scan-directed needle biopsy
• Endoscopic esophageal ultrasound (EUS) with biopsy
• Mediastinoscopy with biopsy
• Open lung biopsy
• Pleural biopsy
• Video-assisted thoracoscopy

Usually if a biopsy shows cancer, more imaging tests are done to find out the stage of the cancer. (Stage means how big the tumor is and how far it has spread.) SCLC is classified as either:

• Limited (cancer is only in the chest and can be treated with radiation therapy)
• Extensive (cancer has spread outside the chest)

Treatment

Because SCLC spreads quickly throughout the body, treatment must include cancer-killing drugs (chemotherapy) taken by mouth or injected into the body. Usually, the chemotherapy drug etoposide (or sometimes irinotecan) is combined with either cisplatin or carboplatin.

Combination chemotherapy and radiation treatment is given to people with SCLC that has spread throughout the body. However, the treatment only helps relieve symptoms. It does not cure the disease.

Radiation therapy uses powerful x-rays or other forms of radiation to kill cancer cells. Radiation therapy can be used with chemotherapy if surgery is not possible. Radiation may be used to:

• Treat the cancer, along with chemotherapy, if surgery is not possible
• Help relieve symptoms caused by the cancer, such as breathing problems and swelling
• Help relieve cancer pain when the cancer has spread to the bones

Often, SCLC may have already spread to the brain, even when there are no symptoms or other signs of cancer in the brain. As a result, some patients with smaller cancers, or who had a good response in their first round of chemotherapy may receive radiation therapy to the brain. This method is called prophylactic cranial irradiation (PCI).

Surgery helps very few patients with SCLC because the disease has often spread by the time it is diagnosed. Surgery may be done when there is only one tumor that has not spread. If surgery is done, chemotherapy orradiation therapy will still be needed.

Support Groups

For additional information and resources, see cancer support group.

Expectations (prognosis)

How well you do depends on how much the lung cancer has spread. This type of cancer is very deadly. Only about 6% of people with this type of cancer are still alive 5 years after diagnosis.

Treatment can often prolong life for 6 - 12 months, even when the cancer has spread.

Complications

• Cancer spreads to other parts of the body
• Side effects of surgery, chemotherapy, or radiation therapy

Calling your health care provider

Call your health care provider if you have symptoms of lung cancer (particularly if you smoke).

Prevention

If you smoke, stop smoking. It's never too late to quit. In addition, you should try to avoid secondhand smoke.