Commonly Asked Questions About Women and Lung Cancer

Studies suggest that there are differences in the way lung cancer develops among men and women. Some of these findings include:

• Women seem to be more susceptible to certain types of lung cancer – such as bronchoalveolar carcinoma (BAC) and adenocarcinoma;
• Lung cancer rates are higher among women who have never smoked compared to men. Approximately 20 to 25 percent of all women with lung cancer have never smoked, compared with only five to 10 percent of men;
• Women with lung cancer tend to live longer than men;
• Certain medical therapies seem to be more effective in women.

While breast cancer is diagnosed twice as often as lung cancer, lung cancer accounts for more deaths among women each year than breast, ovarian, and uterine cancers combined.

Risk factors for lung cancer include:

• Smoking;
• Prior history of breast cancer;
• Family history of lung cancer;
• Certain environmental exposures, such as radon, asbestos, and secondhand smoke.

Many patients with early lung cancer do not experience symptoms, or symptoms are attributed to other medical conditions. The following symptoms are common in patients with advanced lung cancer:

• Fatigue;
• Appetite loss and/or weight loss;
• Shortness-of-breath;
• Cough;
• Hemoptysis (coughing up blood);
• Chest pain;
• Pneumonia.

Lung cancer can be difficult to diagnose, and often numerous tests, including imaging studies and biopsies, are needed to determine an accurate diagnosis. Common tests include:

Imaging – Imaging provides pictures of tumors and disease activity and is non-invasive or involves only an injection.

• Chest X-Ray – Images the blood vessels and organs of the chest. It is used to diagnose a number of conditions, including lung cancer;
• CT scan: A chest CT scan is like multiple chest x-rays added together to provide more information, such as the size and location of any tumors. CT scans also indicate how to best treat the cancer;
• PET (positron emission tomography)/CT scan: A PET scan shows evidence of disease activity. It also shows whether cancer has spread from one site to another;
• Bone Scan: A whole body scan, similar to a PET scan, a bone scan uses a radioactive tracer to specifically identify possible sites of tumor spread to bones.

Surgical biopsy – A surgical biopsy is used for conclusive diagnosis. Biopsies can be performed a number of ways:

• Fine Needle Aspiration (FNA): A minor procedure that uses image guidance to obtain a tissue sample. While one of the least invasive biopsy methods, the diagnosis with FNA may be missed, and a more invasive procedure may be needed to be used to obtain a conclusive diagnosis;
• Endobronchial ultrasound: This procedure uses a bronchoscope equipped with ultrasound to enable doctors to biopsy lymph nodes that are positioned beside the airway. This procedure is performed to determine if cancer has spread to these nearby lymph nodes;
• Mediastinoscopy: This day surgery allows larger biopsies of the nearby lymph nodes to be obtained through a small, one-inch incision. General anesthesia is required, and patients return home an hour or two after the procedure;
• Thoracoscopy: This surgical procedure is typically performed under general anesthesia and involves a special breathing tube which allows the lung to deflate for examination. The surgeon inserts a small camera and several small instruments between the ribs, so that the lung and lining can be examined and biopsies taken of suspect areas. Hospital stay can vary between one and several days;
• Thoracotomy: A surgical procedure used when other methods fail or are not applicable, a thoracotomy involves a larger incision on the side of a chest, through which the tumor can be identified and biopsied. Average hospital stay for a thoracotomy is approximately five days.

Lung cancers, like many other cancers, often require treatment using multiple approaches – including surgery, radiation, and medical therapies.

• Surgery – For lung cancer that has not spread (metastasized) to other areas of the body, surgery is often the first choice for treatment and can be combined with radiation and medical therapies to reduce the risk of recurrence. Newer surgical techniques include minimally invasive approaches that use small incisions, enabling a faster recovery and less discomfort;
• Ablation – Cryoablation and radiofrequency ablation are new image-guided approaches that use heat or cold to destroy tumors;
• Radiation Oncology – Stereotactic radiotherapy – an advanced radiation technique – has been shown to be effective for inoperable tumors. Radiation oncologists are also using new techniques for more precise targeting of the tumor and reduction of side effects.
• Medical Therapy – Targeted medical therapies, which affect specific disease pathways, can be used based on characterization of each patient's tumor, enabling a personalized approach to treatment. Clinical trials of new agents and targeted therapies are available.

To learn more about treatment for lung cancer, please click here.

For more information about clinical trials, please click here.

Researchers in our Program are evaluating better ways to stage lung cancer and prevent lung cancer from recurring. We also continue to look at genetic clues to susceptibility to lung cancer and severity of the disease, as well as how that information can help in each patient’s care.

For more information regarding research in the Women’s Lung Cancer Program, please click here.

• Dana-Farber Brigham Cancer Center
• Lung Cancer Alliance
• American Lung Association
• Lungcancer.org
• American Cancer Society