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Lung Cancer

Lung cancer is the number one cause of cancer-related deaths among both men and women in the United States; the disease is more lethal than breast, ovarian, prostate, and colon cancers put together.

Lung cancer is the number one cause of cancer-related deaths among both men and women in the United States; the disease is more lethal than breast, ovarian, prostate, and colon cancers put together.

Overview

In their lifetimes, men have an approximately 1 in 15 chance of developing lung cancer, and women’s chances are about 1 in 17. The disease’s average age of diagnosis is 701https://www.cancer.org/cancer/small-cell-lung-cancer/about/key-statistics.html.

The American Cancer Society lists chest x-rays and CT scans as two commonly used tests in detecting lung cancer2https://www.cancer.org/cancer/lung-cancer/prevention-and-early-detection/exams-and-tests.html. Both can expose you to potentially harmful doses of radiation3https://www.fda.gov/consumers/consumer-updates/reducing-radiation-medical-x-rays 4https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/what-are-radiation-risks-ct.

Symptoms

Early stage lung cancer is typically asymptomatic, with signs presenting only once the disease has reached an advanced stage. Symptoms of lung cancer could include5https://www.mayoclinic.org/diseases-conditions/lung-cancer/symptoms-causes/syc-20374620:

  • Coughing up blood, even in small amounts
  • Shortness of breath
  • A new, persistent cough
  • Hoarseness of voice
  • Headache
  • Bone pain
  • Unintentional weight loss

If you are having any of the above symptoms you need to talk to a doctor about the appropriate diagnostic work up. The Ezra scan is a screening test for asymptomatic individuals and it is not designed to diagnose existing or suspected cancers.

Causes

It is difficult for researchers to pinpoint precisely what causes lung cancer, though they do know that lung cancer originates in genetic changes, or mutations, found in the DNA of normal lung cells. Sometimes, these mutations can occur in oncogenes or tumor suppressor genes, which are the genes in charge of when cells grow, divide into daughter cells, or die. Such mutations can at least in part be responsible for cancer and can be inherited from one’s parents or be picked up randomly during one’s life. Furthermore, some lung cancer risk factors are known to sometimes cause changes specifically in lung cell DNA6https://www.cancer.org/cancer/small-cell-lung-cancer/causes-risks-prevention/what-causes.html.

Along with faulty DNA repair mechanisms, people can inherit genes that make it more difficult for their bodies to get rid of carcinogens, leaving them at a higher risk of getting lung cancer7https://www.cancer.org/cancer/small-cell-lung-cancer/causes-risks-prevention/what-causes.html.

Smokers are at the greatest risk of developing lung cancer, but non-smokers can also develop the disease. A smoker’s risk of lung cancer increases with the number of cigarettes and amount of time they have been smoking for. However, smokers can significantly cut down their risk of lung cancer if they quit–even after having smoked for a number of years8https://www.mayoclinic.org/diseases-conditions/lung-cancer/symptoms-causes/syc-20374620.

Other risk factors that can increase one’s likelihood of developing lung cancer include9https://www.cancer.org/cancer/small-cell-lung-cancer/causes-risks-prevention/risk-factors.html:

  • Air pollution
  • Exposure to secondhand smoke
  • A family history of lung cancer
  • Exposure to chemicals such as radon or asbestos

Detection

Because of lung cancer’s often asymptomatic nature, more than half the individuals who are diagnosed with the disease die within a year of being diagnosed10https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931124/, making early detection critical. 

Common lung cancer screening tests include X-ray imaging and CT scans. The former can expose abnormal nodules or masses, while the latter can show smaller lesions11https://www.mayoclinic.org/diseases-conditions/lung-cancer/diagnosis-treatment/drc-20374627. Both, however, expose patients to potentially harmful radiation, which may be cancer-causing on its own12https://www.fda.gov/consumers/consumer-updates/reducing-radiation-medical-x-rays 13https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/what-are-radiation-risks-ct. Another common test for lung cancer detection is called sputum cytology. It involves taking a sample of sputum produced by a persistent cough, and examining it under a microscope to see if there are any cancerous cells present14https://www.mayoclinic.org/diseases-conditions/lung-cancer/diagnosis-treatment/drc-20374627. MRI, which is radiation-free15https://stanfordhealthcare.org/medical-tests/m/mri/risk-factors.html, can in some cases correctly identify malignant lung nodules of at least 5mm with the help of computer assisted detection16http://jtd.amegroups.com/article/view/3077/html_1. If a malignancy is found, a biopsy will be performed to take a sample for further analysis17https://www.mayoclinic.org/diseases-conditions/lung-cancer/diagnosis-treatment/drc-20374627.

Diagnosis

Specialists separate lung cancer into two major subtypes based on how the cancer cells look under a microscope18https://www.mayoclinic.org/diseases-conditions/lung-cancer/symptoms-causes/syc-20374620:

Physicians will often use stages to describe lung cancers once they have diagnosed them. 

Small cell lung cancers are generally staged as either limited or extensive. Limited-stage lung cancers have not spread further than one lung and its nearby lymph nodes, while extensive-stage lung cancers have malignancies present in both lungs as well as other parts of the body21https://lungcanceralliance.org/what-is-lung-cancer/stages-of-lung-cancer/.

On the other hand, non-small cell lung cancers are staged using the TNM system:

  • T stands for tumor – how big is the tumor, where is it, and has it spread to tissue in the area?
  • N stands for lymph node – has the cancer spread to the lymph nodes in and near the lungs?
  • M stands for metastasis – has the cancer metastasized to other body parts?

(Source)

Treatment

The best treatment for lung cancer depends on the nature of the disease and how far it has spread. The treatment options that are most widely used include: surgery, chemotherapy, radiation, radiosurgery, immunotherapy, and targeted drug therapy22https://www.mayoclinic.org/diseases-conditions/lung-cancer/diagnosis-treatment/drc-20374627.

Please consult with a physician on treatment options as necessary.

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