HCA Virginia Physicians
November 25, 2015

Graham Bundy, MD, FACS

Lung cancer, the most common and most deadly type of cancer originates in the thoracic (chest) cavity, often starting in cells lining the air passages. There are two primary types of lung cancer, and they each grow differently and require different treatments. Non-small cell lung cancer, the most common form, generally grows and spreads slowly. Small cell lung cancer grows more quickly and is more likely to metastasize to other parts of the body. Primary symptoms such as coughing, wheezing, shortness of breath and bloody mucus may not be apparent until advanced stages, making early detection of paramount importance.

Tobacco smoking remains the primary cause of lung cancer, although anyone, including non-smokers, can develop the disease from some combination of genetics, radon or asbestos exposure, air pollution or secondhand smoke. Treatments include surgery, chemotherapy and radiation or a combination of options.

Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues and then spread to other parts of the body.

Factors that may increase your chance of developing lung cancer include:

  • Smoking
  • Using chewing tobacco
  • Being exposed to second-hand smoke
  • Being exposed to asbestos or radon
  • Having a lung disease, such as tuberculosis
  • Having a family or personal history of lung cancer
  • Being exposed to certain air pollutants
  • Being exposed to coal dust
  • Radiation therapy that was used to treat other cancers

Symptoms of developing lung cancer may include:

  • A persistent cough, shortness of breath, wheezing, or hoarseness
  • Constant chest pain
  • Coughing up blood
  • Repeated problems with pneumonia or bronchitis
  • Swelling of the neck and face
  • Loss of appetite or unexplained weight loss
  • Excessive fatigue

In order to properly diagnose lung diseases up to and including cancer, your doctor will ask about your symptoms and medical history as well as complete a full physical exam. Some tests that may be performed include:

  • Sputum Cytology: a test that examines of a sample of mucus from the lungs
  • Biopsy: removal of a sample of lung tissue to be tested for cancer cells
  • Imaging tests evaluate the lungs and other structures such as chest x-rays, spiral CT, PET scan, , and bone scans

The physical exam, combined with all of your test results, will help to determine the progression of your disease, and cancer stage if necessary. Staging is used to guide your treatment plan. Like other cancers, lung cancer is staged from I-IV. Stage I is a localized cancer, while stage IV indicates a spread to other parts of the body.

There are several treatment options available for lung cancer, with the goal being to eliminate the cancer and/or control the presenting symptoms.


Surgery involves removing the tumor and nearby tissue. Lymph nodes may also need to be removed. The type of surgery depends on the location of the tumor, such as:

  • Segmental or wedge resection: removal of only a small part of the lung
  • Lobectomy: removal of an entire lobe of the lung
  • Pneumonectomy: removal of an entire lung
  • Radiation Therapy: the use of radiation to kill cancer cells and shrink tumors. This may also be used to relieve symptoms, such as shortness of breath. External radiation is usually used to treat lung cancer. With this treatment, radiation is directed at the tumor from a source outside of the body.


Chemotherapy is the use of drugs to kill cancer cells. This may be given in many forms, including pill, injection, and administration via catheter. Chemotherapy is often used to kill lung cancer cells that have spread to other parts of the body.

The American Lung Association and American Cancer Society both suggest that screening for lung cancer with a low radiation dose type of CT scan may be considered if you are a smoker (or former smoker), aged 55-74 years, and have a history of heavy smoking (such as one pack a day for 30 years).

If you're concerned about your risk, take advantage of the low-dose CT screening program at HCA Virginia. You will benefit from a phone consultation, a low-radiation-dose chest CT scan at one of our convenient centers and a follow-up appointment with one of our lung specialists, if needed. Call 804-HCA-CARE (804-422-2273) to reach our Nurse Navigator, who works with you to make all your arrangements and schedule your appointment at anyone of our ten locations. When you contact our lung screening program at any HCA facility, a nurse navigator will guide you through the process.

Lung cancer remains the #1 cause of cancer deaths in men and women. It claims more lives than colon, breast, and prostate cancers combined. Early detection can lead to better outcomes, but it is particularly hard to find because most patients don’t experience symptoms.

Dr. Graham Bundy collaborates with a multi-disciplinary group of specialists who can help you navigate detection, diagnosis, and treatment for lung cancer. For more information, call Cardiothoracic Surgical Associates at (804) 282-8777.