The following is information on lung cancer, one of the 15 health conditions covered by the VA for Camp Lejeune victims. The information is collected from various sources, including Cancer.org, Mayo Clinic, the CDC, and more.
What is Lung Cancer?
There are three main types of lung cancer. Knowing which type you have is important because it affects your treatment options and your outlook (prognosis). If you aren’t sure which type of lung cancer you have, ask your doctor so you can get the right information.
- Non-Small Cell Lung Cancer – This is the most common type of lung cancer. About 85% of lung cancers are non-small cell lung cancers. Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are all subtypes of non-small cell lung cancer. This is the most common lung cancer, accounting for about 85%-90% of all cases. NSCLC has three main types designated by the type of cells found in the tumor. They are:
- Adenocarcinomas are the most common type of NSCLC in the U.S. and comprise up to 40% of NSCLC cases. While adenocarcinomas are associated with smoking like other lung cancers, this type is also seen in non-smokers — especially women — who develop lung cancer. Most adenocarcinomas arise in the outer, or peripheral, areas of the lungs. They also have a tendency to spread to the lymph nodes and beyond. Bronchioloalveolar carcinoma is a subtype of adenocarcinoma that frequently develops at multiple sites in the lungs and spreads along the preexisting alveolar walls. It may also look like pneumonia on a chest X-ray. It is increasing in frequency and is very common in non-smoking women and in the Asian population.
- Squamous cell carcinomas were formerly more common than adenocarcinomas; at present they account for about about 25% of NSCLC cases. Also known as epidermoid carcinomas, squamous cell cancers arise most frequently in the central chest area in the bronchi. This type of lung cancer most often stays within the lung, spreads to lymph nodes, and grows quite large, forming a cavity.
- Large cell carcinomas, sometimes referred to as undifferentiated carcinomas, are the least common type of NSCLC, accounting for 10%-15% of all lung cancers. This type of cancer has a high tendency to spread to the lymph nodes and distant sites.
- Small Cell Lung Cancer – Small cell lung cancer is also called oat cell cancer. About 10%-15% of lung cancers are small cell lung cancers. This type of lung cancer tends to spread quickly. This type of lung cancer is the most aggressive and rapidly growing of all the types. SCLC is strongly related to cigarette smoking with only 1% of these tumors occurring in non-smokers. SCLCs metastasize rapidly to many sites within the body and are most often discovered after they have spread extensively.
- Lung Carcinoid Tumor – Fewer than 5% of lung cancers are lung carcinoid tumors. They are also sometimes called lung neuroendocrine tumors. Most of these tumors grow slowly and rarely spread.
- Bronchial carcinoids account for up to 5% of lung cancers. These tumors are generally small (3-4 cm or less) when diagnosed and occur most commonly in persons under age 40. Unrelated to cigarette smoking, carcinoid tumors can metastasize, and a small proportion of these tumors secrete hormone-like substances. Carcinoids generally grow and spread more slowly than bronchogenic cancers, and many are detected early enough to be surgically removed.
- Cancers of supporting lung tissue such as smooth muscle, blood vessels, or cells involved in the immune response can rarely occur in the lung.
In its early stages, lung cancer normally has no symptoms. When symptoms start to appear, they are usually caused by blocked breathing passages or the spread of cancer further into the lung, surrounding structures, other parts of the body.
Lung cancer symptoms may include:
- Chronic, hacking, raspy coughing, sometimes with blood-streaked mucus
- Recurring respiratory infections, including bronchitis or pneumonia
- Increasing shortness of breath, wheezing, persistent chest pain
- Swelling of the neck and face
- Pain and weakness in the shoulder, arm, or hand
- Fatigue, weakness, loss of weight and appetite, intermittent fever, severe headaches, and body pain
- Difficulty swallowing
A number of factors may increase your risk of lung cancer. Some risk factors can be controlled, for instance, by quitting smoking. And other factors can’t be controlled, such as your family history. Risk factors for lung cancer include:
- Smoking. Your risk of lung cancer increases with the number of cigarettes you smoke each day and the number of years you have smoked. Quitting at any age can significantly lower your risk of developing lung cancer.
- Exposure to secondhand smoke. Even if you don’t smoke, your risk of lung cancer increases if you’re exposed to secondhand smoke.
- Exposure to radon gas. Radon is produced by the natural breakdown of uranium in soil, rock and water that eventually becomes part of the air you breathe. Unsafe levels of radon can accumulate in any building, including homes. Radon testing kits, which can be purchased at home improvement stores, can determine whether levels are safe. If unsafe levels are discovered, remedies are available.
- Exposure to asbestos and other chemicals. Workplace exposure to asbestos and other substances known to cause cancer — such as arsenic, chromium and nickel — also can increase your risk of developing lung cancer, especially if you’re a smoker.
- Family history of lung cancer. People with a parent, sibling or child with lung cancer have an increased risk of the disease.
Regarding Camp Lejeune, NC:
Breathing TCE or PCE in small amounts may cause headaches, lung irritation, dizziness, poor coordination, and difficulty concentrating. Breathing large amounts of trichloroethylene may cause impaired heart function, unconsciousness, and death. Breathing it for long periods may cause nerve, kidney, and liver damage.
In its 9th Report on Carcinogens, the National Toxicology Program (NTP) determined that trichloroethylene is “reasonably anticipated to be a human carcinogen.” The International Agency for Research on Cancer (IARC) has determined that trichloroethylene is “probably carcinogenic to humans.”
The Department of Health and Human Services (DHHS) has determined that tetrachloroethylene may reasonably be anticipated to be a carcinogen.
Reported health problems in people of all ages from drinking water contaminated with TCE and/or PCE include—
- Non-Hodgkins lymphoma
- Bladder cancer
- Breast cancer
- Lung cancer
Occupation as a cause of lung cancer is common. It has been estimated that 13 to 29% of lung cancers in men are secondary to on-the-job exposure to chemicals and materials that increase the risk of lung cancer. Occupational substances associated with an increased risk in lung cancer include:
- Diesel fumes
- Natural fibers – asbestos, silica, wood dust
- Metals – aluminum, arsenic, beryllium, cadmium, chromium, nickel
- Reactive chemicals – bis(chloromethyl) ether, mustard gas, vinyl chloride
- Second-hand smoke
- Solvents – benzene, toluene
The prognosis for lung cancer is grim. It is one of the most deadliest forms of cancer. For instance, 52 percent, or about half, of people diagnosed with early-stage lung cancer live for at least five years after diagnosis. The five-year survival rate for people diagnosed with late-stage lung cancer that has spread (metastasized) to other areas of the body is a mere 4 percent.