Adenocarcinoma Of The Lung

 

What Is It?

Adenocarcinoma of the lung is a type of lung cancer.

Like other cancers, adenocarcinoma is the growth of abnormal cells. These cancerous cells multiply out of control, and form a tumor. As the tumor grows, it destroys parts of the lung. Eventually, the tumor’s abnormal cells can spread (metastasize) to other parts of the body, including the brain.

Adenocarcinoma is more likely than other types of lung cancer to be contained in one area of the body. It also responds better than other lung cancers to treatment.

Adenocarcinoma is the most common form of lung cancer. Most of this type of cancer is found in smokers. However, it also is the most frequent type of lung cancer seen in nonsmokers. It also is the most common form of lung cancer seen in women and people younger than 45.

As with other forms of lung cancer, you are more likely to get adenocarcinoma if you:

  • Smoke cigarettes — Smokers have 13 times more risk of developing lung cancer than nonsmokers. Cigarette smoke is associated with most cases of adenocarcinoma.


  • Breathe cigarette smoke — Nonsmokers who inhale the cigarette fumes of smokers have an increased risk of lung cancer.


  • Are exposed to radon gas — Radon is a colorless, odorless radioactive gas that is formed in the ground. It seeps into the lower floors of homes and public buildings, and can contaminate drinking water. Radon exposure is the second leading cause of lung cancer.


  • Are exposed to asbestos — Asbestos is a fibrous mineral that is used in home insulation, fireproofing, tiles for floors and ceilings, automobile brake linings and other products. It is believed that asbestos fibers can cause lung cancer. People at risk of lung cancer include workers who are exposed to asbestos on the job (miners, construction workers, shipyard workers, and auto mechanics who work with brakes), and people who live or work in buildings in which building products that contain asbestos are deteriorating.


  • Are exposed to other carcinogens in the workplace — These include uranium, arsenic, vinyl chloride, nickel chromates, coal products, mustard gas, chloromethyl ethers, gasoline, diesel exhaust and high levels of talc dust.

Symptoms

Symptoms of adenocarcinoma are the same as for other forms of lung cancer. They can include:

  • Cough
  • Coughing up blood
  • Wheezing
  • Shortness of breath
  • Discomfort during breathing
  • Chest pain
  • Fever and a mucus-producing cough
  • Discomfort during swallowing
  • Hoarseness
  • Weight loss and poor appetite
  • Other symptoms, if cancer has spread to the brain, bones or elsewhere

Diagnosis

Your doctor will ask you whether you smoke or whether you live with a smoker. If you smoke, your doctor will ask you how much you smoke and how long you have smoked. Your doctor also will ask whether you have worked in an industry where you may have been exposed to asbestos or other carcinogens.

Your doctor may suspect that you have some form of lung cancer based on your symptoms and your history. Your doctor will do a physical examination with special attention to your lungs and chest. To confirm the diagnosis, your doctor will order a chest X-ray to see if there are any masses that could be cancer. If the X-ray shows anything suspicious, a computed tomography (CT) scan will be done to confirm the size and location of any mass or tumor. If cancer is suspected, further tests will be done to make the diagnosis, establish the specific type of lung cancer and determine how far it has spread. These tests may include:

  • Sputum sample — In this test, coughed-up mucus is checked in the laboratory for the presence of cancer cells.


  • biopsy — In this test, a sample of abnormal lung tissue is removed and examined under a microscope in a laboratory. Although this test often can be done using bronchoscopy, surgery sometimes is necessary to expose the suspicious lung area.


  • Bronchoscopy — In this procedure, a tubelike instrument is passed into the lungs through the airways. The goal is to look for cancer inside of the lungs directly and to obtain a small piece of the lung for a biopsy.


  • Mediastinoscopy — In this procedure, a tubelike instrument is used to biopsy lymph nodes or any masses seen between the lungs (the mediastinum). A biopsy obtained this way can diagnose the type of lung cancer and check to see if the cancer has spread to lymph nodes.


  • Fine-needle aspiration — In this procedure, a tiny needle is inserted into a suspicious area of the lungs with the help of a CT scan done at the same time. The needle removes a small sample of tissue so it can be examined in a laboratory to diagnose the type of cancer.


  • Thoracentesis — This procedure is used when lung cancer has caused fluid to accumulate in the chest. A sterile needle is used to withdraw a sample of the fluid so it can be examined in a laboratory.


  • CT and bone scans — These scans will check if lung cancer has spread to the brain, bones or other places in the body.

Expected Duration

Once it develops, adenocarcinoma of the lung will continue to grow and spread until it is treated.

Prevention

To reduce your risk of adenocarcinoma and other forms of lung cancer, you can:

  • Avoid cigarette smoking — If you already smoke, ask your doctor about proven ways to help you quit.


  • Avoid secondhand smoke — Choose smoke-free areas of restaurants and hotels. Also, ask guests to smoke outdoors, especially if there are children in your home.


  • Reduce exposure to radon — Have your home checked for radon gas. A radon level above 4 picocuries/liter is unsafe. If you have a private well, have your drinking water tested for radon.


  • Reduce exposure to asbestos — Because there is no safe level of asbestos exposure, any exposure is too much. If you have an older home, check if any insulation or other material that contains asbestos is exposed or deteriorating. The asbestos in these areas must be removed or safely sealed away professionally. Workers who deal with asbestos-containing materials routinely should use approved measures to limit their exposure and to keep from bringing asbestos dust home on their clothing.

Treatment

Surgery is the primary treatment for all non-small cell lung cancers. Three types of surgery can be used:

  • Wedge resection — Removal of only a small part of the lung
  • Lobectomy — Removal of one lobe of the lung
  • Pneumonectomy — Removal of the entire lung

Depending on how far the cancer has spread (the stage), treatments can include chemotherapy and radiation therapy before and/or after surgery. Stages are defined by the size of the tumor and how far it has spread. Stages I through III are further divided into two “A” and “B” categories. Stage I tumors are small and have not invaded the surrounding tissue or organs. Stage II and III tumors have invaded surrounding tissue and/or organs and have spread to lymph nodes. Stage IV tumors have spread outside the chest area.

People with serious medical problems that make it difficult for them to withstand surgery may receive radiation therapy to shrink the tumor, or a combination of radiation and chemotherapy.

When there is significant tumor spread, chemotherapy drugs may be recommended to slow down cancer growth even if it cannot provide a cure. Chemotherapy has been shown to decrease symptoms and prolong life in advanced cases of lung cancer. Radiation therapy also may be recommended to relieve symptoms.

When To Call A Professional

Call your doctor promptly if you have any of the symptoms of lung cancer, especially if you are a smoker or you have worked in an industry with high exposure to asbestos.

Prognosis

The prognosis depends on the stage of the cancer and the overall health of the patient. About 17 percent of patients with adenocarcinoma survive more than five years after diagnosis.

 

Johns Hopkins patient information

Last revised: December 4, 2012
by Harutyun Medina, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.