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Causes

By Mayo Clinic staff

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Illustration showing lung anatomy 
Bronchioles and alveoli

Living With Cancer

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Smoking causes the majority of lung cancers — both in smokers and in people exposed to secondhand smoke. But lung cancer also occurs in people who never smoked and in those who never had prolonged exposure to secondhand smoke. In these cases, there may be no clear cause of lung cancer.

How smoking causes lung cancer
Doctors believe smoking causes lung cancer by damaging the cells that line the lungs. When you inhale cigarette smoke, which is full of cancer-causing substances (carcinogens), changes in the lung tissue begin almost immediately. At first your body may be able to repair this damage. But with each repeated exposure, normal cells that line your lungs are increasingly damaged. Over time, the damage causes cells to act abnormally and eventually cancer may develop.

Types of lung cancer
Doctors divide lung cancer into two major types based on the appearance of lung cancer cells under the microscope. Your doctor makes treatment decisions based on which major type of lung cancer you have. The two general types of lung cancer include:

  • Small cell lung cancer. Small cell lung cancer occurs almost exclusively in heavy smokers and is less common than non-small cell lung cancer.
  • Non-small cell lung cancer. Non-small cell lung cancer is an umbrella term for several types of lung cancers that behave in a similar way. Non-small cell lung cancers include squamous cell carcinoma, adenocarcinoma and large cell carcinoma.
References
  1. Non-small cell lung cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Oct. 12, 2011.
  2. Estimated new cancer cases and deaths by sex for all sites, US, 2011. American Cancer Society. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-029817.pdf. Accessed Oct. 12, 2011.
  3. Small cell lung cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Oct. 12, 2011.
  4. Johnson DH, et al. Cancer of the lung: Non-small cell lung cancer and small cell lung cancer. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008:1307.
  5. What you need to know about lung cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/lung/AllPages. Accessed Oct. 7, 2011.
  6. Lung cancer prevention (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/prevention/lung/Patient/AllPages. Accessed Oct. 7, 2011.
  7. Aberle DR, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. The New England Journal of Medicine. 2011;365:395.
  8. Greaves SM, et al. The new staging system for lung cancer: Imaging and clinical implications. Journal of Thoracic Imaging. 2011;26:119.
  9. Xalkori (prescribing information). New York, N.Y.: Pfizer Labs; 2011. www.pfizerpro.com/Xalkori. Accessed Oct. 14, 2011.
  10. Avastin (prescribing information). South San Francisco, Calif.: Genentech Inc.; 2011. http://www.avastin.com/avastin/hcp/index.html. Accessed Oct. 14, 2011.
  11. Tarceva (prescribing information). Melville, N.Y.: OSI Pharmaceuticals Inc.; 2011. http://www.tarceva.com/patient/considering/index.jsp. Accessed Oct. 14, 2011.
  12. Kvale PA, et al. Palliative care in lung cancer. Chest. 2007;132(suppl):368S.
  13. Cassileth BR, et al. Complementary therapies and integrative oncology in lung cancer. Chest. 2007:132(suppl):340S.
  14. Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). RadiologyInfo.org. http://www.radiologyinfo.org/en/info.cfm?pg=stereotactic. Accessed Oct. 14, 2011.
  15. Temel JS, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. The New England Journal of Medicine. 2010;363:733.
  16. Li Y, et al. Effect of emphysema on lung cancer risk in smokers: A computed tomography-based assessment. Cancer Prevention Research. 2010;4:53.
  17. Rosenow EC (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 19, 2011.
  18. 2008 physical activity guidelines for Americans. U.S. Department of Health and Human Services. http://www.health.gov/paguidelines/guidelines/default.aspx. Accessed Nov. 8, 2011.
DS00038 April 17, 2012

© 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

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