Lung cancer is a type of cancer that starts in the lungs. Cancer starts when cells in the body begin to grow out of control. It starts in the windpipe (trachea), the main airway (bronchus), or the lung tissue.
Lungs or Airways are part of the breathing system, which is also called the respiratory system.
The breathing system includes:
● the nose and mouth
● windpipe (trachea)
● airways to each lung (left and right bronchus)
There are 2 main types of lung cancer:
Who is at risk for lung cancer?
Lung cancer can affect anyone, but there are certain factors that raise your risk of getting it:
• Smoking. This is the most important risk factor for lung cancer. Tobacco smoking causes about 9 out of 10 cases of lung cancer in men and about 8 out of 10 cases of lung cancer in women. The earlier in life you start smoking, the longer you smoke, and the more cigarettes you smoke per day, the greater your risk of lung cancer. The risk is also greater if you smoke a lot and drink alcohol every day or take beta carotene supplements. If you have quit smoking, your risk will be lower than if you had kept smoking. But you will still have a higher risk than people who never smoked.
• Secondhand smoke, which is the combination of smoke that comes from a cigarette and smoke breathed out by a smoker. When you inhale it, you are exposed to the same cancer-causing agents as smokers, although in smaller amounts.
• Family history of lung cancer
• Being exposed to asbestos, arsenic, chromium, beryllium, nickel, soot, or tar in the workplace
• Being exposed to radiation, such as from
• Radiation therapy to the breast or chest
• Radon in the home or workplace
• Certain imaging tests such as CT scans
• HIV infection
• Air pollution
The most common symptoms of lung cancer are:
● having a cough most of the time
● having a change in a cough you have had for a long time – it may sound different or be painful when you cough
● getting out of breath doing the things you used to do without a problem
● coughing up phlegm (sputum) with blood in it
● having an ache or pain in the chest or shoulder
● chest infections that keep coming back or a chest infection that doesn’t get better
● losing appetite
● feeling tired all the time (fatigue)
If you have an early lung cancer then you might not have any symptoms at all.
The treatment plan will depend upon the results of the various test results carried out to diagnose cancer and how far it has spread beyond the lung.
The test may include an x-ray, CT scan, lung functionality, blood test.
This is mostly seen as the first test to check the tumors more than 1cm wide or larger. Smaller than that tumors do not show up on an x-ray. Additional tests are done to investigate more details confirming if its a lung cancer and its type and spread.
CT scans also called CAT scans (Computed Tomography scans) are carried out by radiographers that use x-ray and computers to create images of the body inside. This can detect smaller tumors than those found in chest Xrays. CT scan provides detailed information like the size, shape, and position of any lung tumors. It can help find enlarged lymph nodes that might contact cancer that has spread. CT scans are used to monitor conditions including checking the size of the tumor during and after the lung cancer treatment.
PET- CT scan
PET – CT scan (Positron emission tomography – computerized tomography) involves the use of the imaging scanner and a tiny amount of radiotracer injected into the patient bloodstream that helps in determining the location of cancer, where cancer has spread in the body, especially the lymph nodes and common sites of spread outside the chest. It helps in determining the best therapy based on results and its evaluation – how cancer is responding to its treatment.
Bronchoscopy and biopsy
Bronchoscopy is a testing procedure used to diagnose lung cancer. It involves looking directly at the airways in the lungs using a long, thin, lighted tube that has a close-focusing telescope on the end of viewing called a bronchoscope. This instrument is put in the mouth or nose and moved down the throat and windpipe (trachea) and into the airways. This procedure is performed to obtain a biopsy to collect several pieces of lung tissues, collection of sputum. A biopsy is when a sample of tissue is taken from the lung and or nearby lymph nodes and examined by a specialist doctor.
Lung function test (spirometry)
This test aims at measuring how much air the lungs can hold, how well the lungs are working. It checks how quickly the lungs can be filled with air then emptied. It uses a machine called a spirometer where you’d be asked to take a full breath in and then blow into the machine.
Kidney and liver function tests would be conducted by taking a sample of the blood to check the number of cells (full blood count).
Treatment of Lung Cancer
The treatment plan depends on the number of factors and the choices you make in terms of overall health, stages of cancer, size, and position of cancer. It’s managed by a team of specialists from different departments. (hyperlink for multi departments).
Its generally used before surgery to destroy cancer cells. It involves drugs that are toxic to cancer cells. The drug is injected into the larger vein through a catheter. After surgery Chemotherapy or radiation aims at targeting cancer cells that may have survived the treatment also to treat locally advanced or metastatic disease.
Radiotherapy aims at delivering high-energy X-rays that destroy rapidly dividing cancer cells. It is used before surgery to shrink the tumor, after surgery to eliminate the cancer cells that remain in the treated area. It helps to relieve some of the symptoms the tumor causes like bleeding.
This therapy aims to treat lung cancer by using certain parts of a person’s immune system to fight and attack cancer cells by using the power of the body’s immunity. Immunotherapies are the drug treatments that are infused into the veins or intravenously in doctors’ offices.
How is lung cancer diagnosed?
To make a diagnosis, your health care provider
• Will ask about your medical history and family history
• Will do a physical exam
• Will probably do imaging tests, such as a chest x-ray or chest CT scan
• May do lab tests, including tests of your blood and sputum
• May do a biopsy of the lung
If you do have lung cancer, your provider will do other tests to find out how far it has spread through the lungs, lymph nodes, and the rest of the body. This is called staging. Knowing the type and stage of lung cancer you have helps your provider decide what kind of treatment you need.