Ryan Levy, MD, chief of thoracic surgery at UPMC Passavant

Lung cancer is the leading cause of cancer deaths worldwide, in part because it has no symptoms. That means it is often found at an advanced stage when it is difficult to treat.

“Lung cancer is the highest cause of cancer death in the United States,” says David Wilson, MD, a pulmonologist who specializes in treating patients with lung cancer at UPMC. “More people die of lung cancer than the next three cancers combined, which would be colon, breast, and prostate.” 

But detection and treatment get better every day. Here are 6 things you need to know about lung nodules and lung cancer.

1. Early Detection of Lung Cancer Saves Lives

The good news is that when diagnosed early, the average 5-year survival rate for lung cancer is 92%.

That’s why early detection is so critical. And new systems and tools hold potential to help us make a diagnosis earlier by providing improved reach, vision, and control for diagnostic lung procedures.

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2. Most Lung Nodules Are Not Cancerous

Lung cancer is usually first detected as a lung nodule that shows up on an x-ray or CT scan. Most nodules, however, are not cancerous. They can be caused by a variety of conditions, according to the American Thoracic Society, including:

  • Scar tissue.
  • An infection.
  • A noncancerous growth.
  • Airborne irritants.
  • Tumors that originate in other parts of the body.

Most lung nodules seen on CT scans are not cancerous but should be checked for early signs of lung cancer.

3. Some Factors Increase Your Risk of Lung Cancer

You may be at a higher risk for cancerous lung nodules if you:

  • Have inflammation in the lungs from an occupational hazard, such as exposure to asbestos or coal dust.
  • Have a history of smoking.
  • Had an infection in the lungs.
  • Have a family history of lung cancer.

4. Regular Screenings Can Help Detect Lung Cancer Earlier

For most people, nodules are found when having a chest x-ray or CT scan for another condition.

For people at high risk of cancer, regular lung screenings like those offered at UPMC can be a life saver.

At your lung cancer screening, you will meet with a respiratory therapist and have a low-dose CT chest scan, which takes about two to three minutes. Low-dose CT scans can detect nodules up to 10 times smaller than those seen by x-ray. This type of screening offers the best chance of finding lung cancer in its earliest, most curable stages.

A lung cancer screening is recommended for individuals:

  • Age 55 to 77.
  • Who are current or former heavy smokers with at least a 30 pack-years history of smoking.
  • No symptoms of lung cancer, coughing up blood, or chest pain.

“Lung cancer screening is an early detection test for high-risk individuals for lung cancer,” says Dr. Wilson. “It’s similar to mammography for breast cancer or colonoscopy for colon cancer. It involves a low dose CT scan, which is about one-eighth of the radiation of a standard diagnostic CT scan. It’s designed to be done annually. Unfortunately, when people are diagnosed with lung cancer, it’s usually at an advanced stage, which makes it much less likely to be cured,  

“Lung cancer screening with low-dose CT scan detects the cancer at an earlier stage and, if in fact it’s an early stage cancer, there’s an 80% chance of cure,” Dr. Wilson adds. 

UPMC is the only hospital in central Pennsylvania designated as a Lung Cancer Screening Center of Excellence by the GO2 Foundation for Lung Cancer.

5. State-of-the-Art Tools Are Improving Lung Nodule and Cancer Detection

New tools are making detecting lung cancer even better.

UPMC West Shore is the first hospital in the region to use the Ion® robotic bronchoscopy system. This lung biopsy technique diagnoses lung cancer in its earliest stage. The advanced technology uses minimally invasive endoscopy, which allows for increased accuracy, reach, and patient safety in examining small and hard-to-reach lung nodules.

The robotic bronchoscope uses a tiny camera and “shape sensing” technology, which allows doctors to look deep into the lung. Once there, they can perform a variety of biopsy techniques to diagnose a lung nodule.

Combining traditional endoscopic views into the lung with computer-assisted navigation, the robot provides a continuous bronchoscope vision during the entire procedure. In the very near future, this may be coupled with the advanced imaging technology of a hybrid operating room for location confirmation. Doctors will then be able to perform a tumor ablation (a form of tumor destruction) at the same time.

While there are a variety of diagnostic options currently available to detect lung cancer, all have limitations in accuracy, safety, or invasiveness. These limitations could lead to false positives, false negatives, or side effects such as collapsed lung and hemorrhage, which may increase health care costs and extend hospital stays. The Ion provides better reach, greater stability, and more precision for lung biopsy.

6. A Wide Range of Treatment Options Exist for Lung Nodules and Lung Cancer

If the cause of a nodule is clear (for example, if it’s caused by an infection or inflammation), you may only need medicine to treat that problem.

If the cause is not clear, you may need more tests or treatment, depending on the risk that the nodule may be cancerous.

If the risk of cancer is small, your doctor may just want to watch to see if the nodule changes over time. Or he or she may want you to have regular follow-up appointments and tests. For example, you may have a CT scan every 3 to 6 months to see if the nodule is growing. 

  • If the risk of cancer is small, your doctor may just want to watch to see if the nodule changes over time. Or he or she may want you to have regular follow-up appointments and tests. For example, you may have a CT scan every 3 to 6 months to see if the nodule is growing.
  • If there is a higher risk of cancer or the nodule appears to grow, you may need more tests like a PET scan or biopsy (a tissue sample). If the nodule is cancerous, you may need treatment.

Patients and doctors now have a wide range of treatment options for lung cancer, including minimally invasive surgery, radiation, and chemotherapy. Advanced programs like those you’ll find at UPMC Pinnacle West Shore combine the expertise of thoracic surgeons, oncologists, pulmonologists, and pathologists to provide a complete continuum of care and an individualized treatment plan. And equipped with the latest in diagnostic technology and high-end treatment techniques, patients have access to comprehensive lung care in one location.

To find out more about lung nodules and lung cancer, or to get a lung screening exam, go to UPMC.com/services/south-central-pa/lung.

Editor's Note: This article was originally published on , and was last reviewed on .

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Press Release on Ion by Intuitive

West Shore Connect Article

About UPMC Hillman Cancer Center

When you are facing cancer, you need the best care possible. UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 70 locations throughout Pennsylvania, Ohio, and New York, with more than 200 oncologists – making it easier for you to find world-class care close to home. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment. Most of all, we are here for you. Our patient-first approach aims to provide you and your loved ones the care and support you need. To find a provider near you, visit our website.

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