What is Lung Cancer
Lung cancer is an uncontrolled growth of abnormal cells in one or both the lungs. These abnormal cells disrupt the normal functioning of the lungs. As they grow these abnormal cells forms a tumor.
Tumors are of two types :
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Benign tumors: They have localized growth. That is they can only cause problems if they put pressure on their nearby tissues.
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Malignant tumors: Are the ones which invade the surrounding body tissues. These are the dangerous tumors & are formed when :
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Invasion : In this the cancerous cell manages to move throughout the body via the blood or lymphatic systems, destroying healthy tissue
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Angiogenesis: In this, the cell manages to divide and grow, making new blood vessels to feed itself.
Lung cancer is the most common cancer found worldwide. It is most common in men above the age of 60 years as compared to females
LUNG ANATOMY
Lungs are a pair of large spongy, air-filled organs located on both side of the chest (thorax). The main function of the chest is the exchange of oxygen and carbon dioxide between the blood and air. Oxygen is very important for survival, so the lungs provide oxygen to the body and remove carbon dioxide.
Lung cancer is classified as follows:
Risk Factors of Lung Cancer
There are many conditions that may lead to lung cancer,however, the top known causes are
SYMPTOMS AND SIGNS
In the early stages, lung cancer usually has no signs and symptoms. Signs and symptoms of lung cancer is mostly seen when the diseases has reached an advanced stage.The symptoms and signs include:
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Cough that does not goes away.
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Change in cough-pay attention to any chronic cough or blood or more mucus than usual.
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Breathing changes-shortness of breath during work or rest.
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Pain in the chest area which can be sharp dull and constant or comes and goes.
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Pain can also go to the shoulders or back.
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A hoarse voice which persists for more than two weeks.
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Wheezing or whistling sound when you breathe.
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Drop in weight.
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Bone pain –an indicator of metastasis. Worsens at night while resting at the back.
DIAGNOSIS
Diagnosis is based on
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Detailed history
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Physical examination
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Laboratory investigations
Detailed history-it includes signs, symptoms and any associated risk factors
Physical examination-It includes complete clinical respiratory examination along with an examination of other systems.
Investigations-It includes:
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Chest x-ray
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Ct-scan
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Sputum cytology
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Biopsy
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STAGING
Staging is the process of finding the location &extent of cancer, such as how large it is, if or where it has spread & whether it is affecting the other parts of the body. Knowing the stage of the cancer is important as this will help the doctor by:
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Understand the severity of cancer and survival chances.
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Plan the best treatment option accordingly.
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Identify clinical trials that may be treated the options for the patients.
STAGING SYSTEM
TNM (Tumor, Nodes, and Metastasized) staging system is the most preferred cancer staging system in use. Others systems are more specific to a particular type of cancer. Staging systems include information about:
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Location of the tumor
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Cell type (such as adenocarcinoma or squamous cell carcinoma)
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Tumor size
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Spread to nearby lymph nodes
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Spread to different parts of the body
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Tumor grade, which refers as to how abnormal the cancer cells look and how likely the tumor is to grow and spread
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In situ: Presence of abnormal cells, which have not spread.
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Localized: Cancer is limited to its origin place.
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Regional: Cancer has spread to nearby lymph nodes, tissues, or organs.
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Distant: Cancer has spread to distant parts of the body.
METASTASIS
Is a process in which a tumor is able to successfully spread to the other parts of the body and grow there, invading and destroying the other healthy tissues. The resulting condition is a serious one & it is very difficult to treat.
The most common site of spread of cancer is:-
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Regional lymph node
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Liver
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Bone
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Brain
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Adrenal
TREATMENT
The treatment options for lung cancer depend on the type of lung cancer you have.
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Small cell lung cancer: treated with chemotherapy because surgery cannot be done as the cancer is diagnosed when it has already spread
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Non-small cell lung cancer: treated with surgery radiotherapy as well as chemotherapy or combination according to the stage of cancer
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Surgery: if the cancer is in stage 1 and 2 and has not metastasized it is possible to cure by surgically removing the tumor and the lymph nodes. Surgery is carried by a thoracic margin and a negative margin of tissue is created around the tumor. Surgery can be curative or palliative. Surgery has side effects like pain and infection.
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Chemotherapy: utilizes strong chemicals that interfere with cell divisions process damaging protein or DNA so that cancer cells will commit suicide. It is considered systemic because its medicine travels throughout the entire body killing the original tumor cells as well as cancer cells that have spread.
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Also given as adjuvant therapy.
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Several side effects-nausea and vomiting appetite loss, diarrhea, hair loss, infection bleeding, and mouth sores.
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Radiation-high energy rays are focused on the tumor so that the tumor shrinks or destroys, the tumor high energy gamma rays are emitted from metals such as radium or special machine
Side effects:
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Fatigue
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Nausea
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Loss of appetite
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Hairless
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Causes dry skin & irritation
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Sensitivity on the skin surface
| STAGE | DESCRIPTION | TREATMENT OPTIONS |
| Stage Ia-Ib | Tumor localized in the lung | Surgical resection |
| Stage IIa IIb | Tumor spread to local lymph nodes | Surgical resection |
| Stage IIIa | Tumor spread to regional lymph nodes in trachea, chest | Chemotherapy followed by surgery or radiation |
| Stage IIIb | Tumor spread to contralateral lymph nodes | Combination of chemotherapy & radiation |
| Stage IV | Tumor metastasis to organs outside the chest | Chemotherapy & or palliative care |
PROGRESS IN LUNG CANCER TREATMENT
PREVENTION
The most important prevention for lung cancer is to quit smoking
FREQUENTLY asked questions
IS LUNG CANCER FATAL?
Yes, lung cancer is fatal and the majority of the people die of lung cancer every year around the globe.
CAN NON-SMOKERS ALSO SUFFER FROM LUNG CANCER?
Lung cancer death is caused by tobacco mostly (80%). Even if it is a small number but it’s true that some people who don’t smoke can also develop lung cancer.
CAN A LUNG CANCER BE DETECTED FROM X-RAY?
The x-ray can be used to detect cancer, but for confirmatory diagnosis, other investigations are also done.
WHAT IS THE SURVIVAL RATE OF LUNG CANCER
If diagnosed at an early stage then the survival rate is -5 years If diagnosed in the late stage then the 5-year survival rate is 4%.
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