What is Lung Cancer?

There is no such thing as a routine lung cancer.

Although it’s the second most diagnosed cancer in the United States (more than 220,000 cases each year), it is by far the leading cancer-causing death in men and women. However, lung cancer survival rates continue to improve, thanks in large part to a decrease in tobacco use as well as new, individualized and targeted therapies like those discovered at OSUCCC – James.

Lung cancer is not just one disease, but many different ones that are treated very differently — often even having subsets within these subsets.


Lung cancer begins in the cells in the lung or the bronchi (tubes that run from the windpipe into the lungs) when normal cell growth and division are disrupted. When specific cancer genes in the cells are damaged, or mutate, it causes cancer cells to grow and multiply. When those cells grow out of control, they can spread to other parts of the body through the lymph nodes or blood vessels near the lungs. Lung cancer remains lung cancer, even after it has spread to other sites like the brain or bones.

Although smoking causes about 80 to 90 percent of lung cancer cases, exposure to secondhand smoke, radon, asbestos, air pollution and other environmental factors causes about 10 to 20 percent of all lung cancers. The effects of smoking are long-lasting, and most people diagnosed today are ex-smokers.

Kinds of Lung Cancer

Lung cancer is identified by the kind of cells within the tumor, and then it is further classified by the patient’s unique genetic makeup of those cells. The two most diagnosed kinds are small cell lung cancer and non-small cell lung cancer. (Cancer starting in other sites in the body can also spread to the lungs, which is called lung metastasis. This is not considered to be lung cancer.)

Non-small Cell Lung Cancer

Non-small cell lung cancer is the most common type, and is usually less aggressive than small cell lung cancer, but individual tumors in each of these lung cancer types is treated differently, depending on each patient’s individual tumor makeup.

Rare Types

There are also other, rarer kinds of lung cancer and even more subtypes within those kinds. Subtypes are classified by the mutated genes that drive the cancer.


At the OSUCCC – James, subspecialists perform actual tumor sequencing tests for every patient to determine his or her unique subtype of lung cancer so that they can develop an individualized plan with the most targeted, effective treatments for that particular patient.

Doing so leads to even more improved outcomes, faster responses to treatment and fewer side effects for each individual.

Learn more about dianosis.

Lung Cancer Risk Factors 

The best way to reduce lung cancer risk is to avoid or stop smoking cigarettes, cigars and pipes and to avoid chewing tobacco. About 80 to 90 percent of lung cancer cases in the United States are related to tobacco use.

Additionally, cancer risk rises with the number of years a person has used tobacco and the amount. The damage done by smoking is also permanent, and while the risk of lung cancer goes down after smoking cessation, it never returns to normal, so even longtime ex-smokers should be aware that they have an increased risk.

According to the Surgeon General National Health Advisory on Radon, indoor radon is the second-leading cause of lung cancer in the United States and breathing it over prolonged periods can present a significant health risk to families all over the country. Radon is a naturally occurring gas that is suspected to be the major cause of lung cancer in non-smokers and a significant factor in smokers, causing approximately 21,000 deaths from lung cancer per year according to the EPA. High, unsafe levels of radon gas is common in the rock, soil and ground-water in all 88 counties of Ohio, and in many other parts of the United States. When radon gas percolates up from the ground and is trapped in occupied buildings such as homes, schools and workplaces, dangerous levels can accumulate. The EPA recommends mitigation if levels are over 4 pCi/L, but levels lower than this are likely also unsafe, especially over 2.7 pCi/L. It is required by Ohio state law for home sellers to disclose known radon levels, but testing is not mandated, and no testing or disclosure is required for renters. Radon testing is also not required in schools or other public buildings, and the majority of new construction does not have to be radon resistant. Thus it is up to individual residents to test and mitigate to reduce lung cancer risk. For more information, visit the Ohio Department of Health (ODH) free test kit website.

Lung cancer risk is also increased for people who have other risk factors, such as: 

  • Family history of lung cancer
  • A personal history of lung cancer
  • Exposure to certain materials such as radiation, arsenic or asbestos
  • A history of radiation therapy to the breast or chest
  • Exposure to secondhand smoke or air pollution
  • A history of lung diseases such as tuberculosis (TB)

Low-dose CT scans have been shown to reduce the number of deaths from lung cancer in people at high risk of the disease. To schedule a lung cancer screening, call the OSUCCC – James at 800-293-5066.

Learn more about our lung cancer screening clinic.

Lung Cancer Symptoms

The inside of the chest is a large space, so lung cancer can grow and advance to a large size before a patient has any symptoms.

All people, but particularly those at high risk for lung cancer, including anyone who smokes cigarettes, has a history of using any kind of tobacco or has had environmental exposures such as radon, diesel exhaust, excessive air pollution and more should watch for common symptoms.

Common lung cancer symptoms:

  • A chronic cough or one that continues to worsen
  • Hoarseness
  • Constant chest pain
  • Frequent lung infections, such as bronchitis or pneumonia
  • Shortness of breath and wheezing
  • Coughing up blood
  • Feeling weak or tired
  • Loss of appetite or unexplained weight loss

If you have received a lung cancer diagnosis, or if you want a second opinion or just want to speak to a lung cancer specialist, we are here to help you. Call 800-293-5066 or 614-293-5066 to make an appointment.

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