Each year, more than 200,000 people in the United States are diagnosed with lung cancer, and more die from this disease than from any other cancer type. That is often because by the time individuals develop symptoms of lung cancer, the disease has already spread and cure is more difficult.
Seattle Cancer Care Alliance (SCCA) is here to help. Learn more about:
- Lung cancer screening
- Lung Cancer Early Detection and Prevention Clinic
- Tobacco-cessation counseling
Lung cancer screening can save your life
If you are at high risk for lung cancer based on your age, smoking history and other factors, you might benefit from a fast and simple computed tomography (CT) scan to check for early signs of lung cancer. Together, SCCA and UW Medicine offer screenings at five convenient locations across Puget Sound.
- Learn whether you qualify for a CT screening.
- Call (206) 606-1434 to request an appointment for screening.
Lung Cancer Early Detection and Prevention Clinic
Who is the clinic for?
- You are worried you might be at risk for lung cancer.
- You have been told recently that you have a pulmonary nodule, a lung mass or enlarged lymph nodes in your lungs, which might be signs of lung cancer.
- You have a chronic cough, blood in your sputum or chest pain.
- You recently lost weight for no known reason or lost your appetite.
What to expect
Before your appointment, we will collect your health records, including X-rays or other scans, if you have been diagnosed with an abnormality that might be a sign of lung cancer.
When you visit, you’ll be evaluated by our clinic team, which includes a pulmonologist and a chest radiologist. As an SCCA patient, you will have immediate access to other experts — such as interventional radiologists, nuclear radiologists, thoracic surgeons, medical oncologists and radiation oncologists — who can help develop a plan to diagnose and treat your condition.
How we diagnose lung problems
To diagnose your condition quickly and safely, we use the latest outpatient-based, minimally invasive technology, such as:
- Navigational bronchoscopy
- Endobronchial ultrasound (EBUS)
- Needle biopsy
Your physican may also recommend screening with a low-dose CT (computed tomography) scan, which has been shown to decrease the risk of dying from lung cancer in current and former heavy smokers. Our researchers are working on clinical studies to find better methods of detecting lung cancers at the earliest possible stages.
If you have lung cancer
If you are diagnosed with lung cancer, we will use EBUS to rapidly determine the type and stage of your disease so you can move on to planning your lung cancer treatment with SCCA’s team of world-class doctors, including specialists in pulmonary medicine, thoracic surgery, medical oncology and radiation oncology. You will have access to the full spectrum of lung cancer treatment options, including innovative therapies available in clinical studies.
If you have a different lung problem
If we make a diagnosis other than lung cancer, we may refer you back to your primary care provider for treatment or to our Lung Cancer Early Detection and Prevention Clinic for help to quit smoking and, if needed, surveillance (ongoing monitoring). You may also have the opportunity to participate in lung cancer early detection studies and help us discover better ways to find lung cancer early.
Request an appointment
- Call (206) 606-6100 to request an appointment.
Learn more about navigational bronchoscopy and endobronchial ultrasound (EBUS)
What is bronchoscopy?
Bronchoscopy is a procedure that allows your doctor to see inside your lower respiratory tract through a bronchoscope (a long, narrow, fiberoptic, lighted tube inserted through your nose or mouth). It can be used to help diagnose lung cancer, as well as other conditions.
With a bronchoscope, your doctor can see your larynx (voice box), trachea (windpipe), bronchi (two main airways that branch off your trachea) and bronchioles (smaller branches of the bronchi).
What’s the difference between flexible and rigid bronchoscopy?
There are two types of bronchoscopes: flexible and rigid. Your doctor can maneuver a flexible bronchoscope to see not only your larger airways (trachea and bronchi) but also your smaller bronchioles. This way the doctor can get more information about your condition than with a rigid bronchoscope.
Also, flexible bronchoscopes have interior channels that your doctor can use in treatment, such as to deliver oxygen, suction secretions, obtain tissue samples (biopsies), give medications and perform laser therapy.
What is navigational bronchoscopy?
Navigational bronchoscopy gives your doctor access to distant parts of your lungs that they cannot reach with conventional bronchoscopy. For this procedure, your doctor uses a computed tomography (CT) scan of your chest to map the airways leading to the outer areas of your lung. Using the bronchoscope and an electromagnetic field around your chest, the doctor directs a catheter through the mapped airways. Then the doctor can pass tools through this catheter to take a sample of a pulmonary nodule or mass.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS TBNA)
What is EBUS TBNA?
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS TBNA) is a relatively new and highly effective outpatient procedure performed at Seattle Cancer Care Alliance (SCCA) to:
- Diagnose and stage lung cancer
- Evaluate pulmonary nodules
- Detect lung infections
- Identify other diseases that can affect the lungs or cause enlarged lymph nodes or masses in the chest
It is a minimally invasive way to get tissue samples for biopsy — without creating too much discomfort for you and without the need for surgery.
How is EBUS TBNA done?
Your doctor inserts a special bronchoscope (a long, narrow, fiberoptic, lighted tube) through your mouth and trachea (windpipe) into your bronchi (the two main airways that branch off your trachea).
The bronchoscope is fitted with an ultrasound processor and a fine-gauge aspiration needle.
- An ultrasound monitor displays real-time images of your airways, blood vessels, lungs and nearby lymph nodes to guide your doctor.
- Your doctor pushes the needle through your bronchial wall from inside to take samples of cells from lymph nodes or other tissues in the area between your lungs (mediastinum).
- The samples can be examined to diagnose lung cancer or other diseases.
What makes EBUS TBNA different?
The conventional surgical way to get samples from your mediastinum is to make a small incision in your neck just above or next to your breastbone. Then your doctor inserts a narrow scope (mediastinoscope) through the incision to see your lungs and surrounding lymph nodes and obtain a tissue sample.
With EBUS TBNA, no incisions are needed. The images from the ultrasound allow your doctor to view difficult-to-reach areas and to access more, and smaller, lymph nodes than they could with a conventional mediastinoscopy.
Living Tobacco-Free Services
SCCA offers Living Tobacco-Free Services to our current patients, their caregivers and their families who want to cut back or quit tobacco use. You do not have to be in Seattle to participate in and benefit from the program. We can meet with you in person or talk on the phone — whichever suits your needs. This service is provided at no charge.
- Call (206) 606-7766 to learn more about our Living Tobacco-Free Services.
Through our Living Tobacco-Free Services session, an SCCA counselor will talk with you about the following to help you achieve your goal to be tobacco-free:
- Nicotine-withdrawal medications. If you are interested in using a medication to manage nicotine-withdrawal symptoms, we can help you determine which one is best for you and help you access it.
- Stress management. If you smoke to manage stress or deal with other emotional issues, we can offer alternate approaches that will preserve and improve your health.
- Creating new habits. We can help you find strategies to break the habit of smoking.
- Educational resources and materials. We can provide written educational materials and information about other resources for quitting smoking.
You are welcome to call us as many times as you like during your journey to becoming tobacco-free. Our goal is to help you become a comfortable, confident non-smoker in a time frame that works for you.
SCCA also has an opportunity for patients who are interested in quitting smoking but do not want to make an appointment with an SCCA Tobacco Cessation counselor. We are partnering with Fred Hutch to develop a smoking cessation smartphone app called Quit2Heal and are currently recruiting study participants. The study is completely online and the app is free.
Participants who join the study will receive:
- Tools to cope with urges to smoke
- A guide to quitting smoking
- Help with staying motivated
- Up to $35 for filling out a two-month follow-up survey
Learn more about Quit2Heal and how you can join the study.
Benefits of quitting
It is never too late to stop using tobacco — quitting at any time will enable you to live a longer and healthier life. It also helps make lung cancer treatment more effective.
If you keep trying, you will succeed. Studies prove it’s worth it.
Benefit #1: Improved health
Your body will experience the following healthful benefits after quitting. In just...
- 20 minutes — Your blood pressure and pulse return to normal.
- 8 hours — Nicotine, carbon monoxide and oxygen levels in your blood begin to return to normal.
- 2 days — Your lungs start to clear, and your sense of taste and smell begin to return.
- 3 days — Breathing is easier, and your energy level increases.
- 2 to 12 weeks — Your circulation improves, and exercise gets easier.
- 3 to 9 months — Breathing problems, coughing, shortness of breath and wheezing improve.
- 5 years — Your risk of having a heart attack falls to about half that of a smoker.
- 10 years — Your risk for lung cancer falls to about half that of a smoker. You have the same risk of a heart attack as someone who has never smoked.
Benefit #2: Thousands of dollars in savings
Smoking is very expensive. Smoking one pack of cigarettes a day for the next 20 years could cost more than $54,000! Write down how much you spend on cigarettes every day for a week. Then work out how much your smoking costs you every year. Think of what else you could do with the money you save.
Benefit #3: Improved health for those around you
If you smoke, you may be exposing those around you to your smoke and endangering their health. People exposed to tobacco smoke have a higher risk of breathing difficulties, and they risk getting lung cancer.
Benefit #4: Improved treatment effects
Many studies have shown the benefits of stopping smoking on treatments for many diseases, including cancer, like treatment effectiveness, the toxicity of cancer treatments, quality of life, return of the cancer, development of a second tumor and survival. Tobacco use can complicate a wide variety of cancer treatments, including radiation therapy, chemotherapy and surgery.
Benefits of quitting smoking during cancer treatment
Surgical patients may experience these benefits of quitting smoking:
- Faster recovery and healing after surgery
- Fewer pulmonary, circulatory and infectious complications
- Reduced risk of being admitted to the intensive care unit after surgery
Radiation therapy or chemotherapy patients may experience these benefits of quitting smoking:
- Better response to treatment with fewer side effects
- Reduced risk for developing more tumors
- Reduced risk of long-term toxicity or damage to the lungs
- Improved immune function
Reduce your risk
Tobacco is the cause of nearly 90 percent of lung cancers, and smoking increases the risk of more than a dozen other cancers, including cancers of the mouth, larynx (voice box), pharynx (upper throat), nose, sinuses, esophagus, liver, pancreas, stomach, kidney, bladder, cervix and bowel; one type of ovarian cancer; and some types of leukemia. There is also some evidence that smoking could increase the risk of breast cancer.
Other resources to help you quit
In addition to SCCA’s program, there are numerous websites and online forums to support you. Most of these are free, but some programs charge a fee. The secret of quitting is to not give up trying. You can do it.
All states have quitlines in place with trained counselors available
American Cancer Society: Quit for Life
American Legacy Foundation: Become an EX
American Lung Association: Lung HelpLine
National Cancer Institute (NCI)
- Smokefree — www.smokefree.gov
- Smokefree Women — women.smokefree.gov
- Smokefree Teen — teen.smokefree.gov
- LiveHelp (live online assistance) — 8 am to 11 pm ET, Monday through Friday (English only)
Information on pulmonary nodules
Pulmonary nodules may be a sign of lung cancer or another lung condition that isn’t cancerous. These growths are among the abnormalities our doctors evaluate in the Lung Cancer Early Detection and Prevention Clinic, and they sometimes lead to a lung cancer diagnosis.
What is a pulmonary nodule?
A pulmonary nodule is a small, roundish growth on the lung that measures three centimeters in diameter or less. Most pulmonary nodules are extremely small, less than one centimeter across.
If the growth is larger than three centimeters, it is called a pulmonary mass.
Though pulmonary nodules may grow to become a pulmonary mass, some nodules may not grow at all.
What causes pulmonary nodules?
There are many causes of pulmonary nodules, including:
- Infections, such as fungal or bacterial infections
- Noncancerous processes, such as sarcoidosis
- Cancerous processes, such as lung cancer, lymphoma or cancer that has spread from other organs
The likelihood that a pulmonary nodule is lung cancer depends on:
- Your age
- Your smoking history
- Your history of exposure to environmental risk factors
Generally, less than 1 in 10 pulmonary nodules turns out to be lung cancer.
Symptoms of pulmonary nodules
Because pulmonary nodules are small, they rarely cause any symptoms. Some people might experience symptoms of a respiratory infection, such as a chest cold or mild flu.
Most pulmonary nodules are discovered by accident, when a patient gets a chest X-ray or a computed tomography (CT) scan for some other reason.
Evaluating a pulmonary nodule
The immediate goal of evaluating a pulmonary nodule is to determine its potential to be cancerous. Your doctor will ask about your personal and medical history and your environmental-exposure history, and you may have a chest CT scan.
If your doctor thinks you have a nodule with significant cancer potential and the nodule is one centimeter across or larger, they will use diagnostic procedures to determine the cause of the nodule.
There are many noninvasive or minimally invasive methods, such as:
- Positron emission tomography (PET) scans
- Endobronchial ultrasound
- CT-guided needle biopsy
- Biopsy guided by fluoroscopy (moving X-ray)
If your pulmonary nodule cannot be diagnosed using one of these approaches, you may need surgery, such as:
- Video-assisted thoracic surgery, done through a series of small incisions using a scope with a camera to see inside your chest
- Open-chest surgery (thoracotomy)
- Mini-thoracotomy (open-chest surgery with a smaller incision)
Once your doctor knows the cause of your pulmonary nodule, they can recommend a treatment plan tailored to you. If you are diagnosed with lung cancer, learn more about lung cancer treatment.
Following a pulmonary nodule
Most pulmonary nodules are too small (less than one centimeter across) to be diagnosed safely and accurately using any of the procedures or tests currently available. Because these very small pulmonary nodules can represent early lung cancer, they need to be followed closely using CT scans to evaluate whether they grow over time. If the size of these nodules doesn’t change for two years, the chance that they represent lung cancer is very small.