Lung Cancer
Introduction : Lung cancer is a disease caused by uncontrolled cell division in your lungs. Your cells divide and make more copies of themselves as a part of their normal function. But sometimes, they get changes (mutations) that cause them to keep making more of themselves when they shouldn’t. Damaged cells dividing uncontrollably create masses, or tumors, of tissue that eventually keep your organs from working properly.
Lung cancer is the name for cancers that start in your lungs — usually in the airways (bronchi or bronchioles) or small air sacs (alveoli).
Most lung cancer symptoms look similar to other, less serious illnesses. Many people don’t have symptoms until the disease is advanced, but some people have symptoms in the early stages. For those who do experience symptoms, it may only be one or a few of these:
- A cough that doesn’t go away or gets worse over time.
- Trouble breathing or shortness of breath (dyspnea).
- Chest pain or discomfort.
- Wheezing.
- Coughing up blood (hemoptysis).
- Hoarseness.
- Loss of appetite.
- Unexplained weight loss.
- Unexplained fatigue (tiredness).
- Shoulder pain.
- Swelling in the face, neck, arms or upper chest (superior vena cava syndrome).
- Small pupil and drooping eyelid in one eye with little or no sweating on that side of your face (Horner’s syndrome).
While there are many factors that can increase your risk of lung cancer, smoking any kind of tobacco products, including cigarettes, cigars or pipes is the biggest single risk factor. Experts estimate that 80% of lung cancer deaths are smoking-related.
Other risk factors include:
- Being exposed to secondhand tobacco smoke.
- Being exposed to harmful substances, like air pollution, radon, asbestos, uranium, diesel exhaust, silica, coal products and others.
- Having previous radiation treatments to your chest (for instance, for breast cancer or lymphoma).
- Having a family history of lung cancer.
Diagnosing lung cancer can be a multi-step process. Your first visit to a healthcare provider will usually involve them listening to your symptoms, asking you about your health history and performing a physical exam (like listening to your heart and lungs). Since lung cancer symptoms are similar to many other, more common illnesses, you provider may start by getting blood tests and a chest X-ray.
If your provider suspects you could have lung cancer, your next steps in diagnosis would usually involve more imaging tests, like a CT scan, and then a biopsy. Other tests include using a PET/CT scan to see if cancer has spread, and tests of cancerous tissue from a biopsy to help determine the best kind of treatment.
As part of a biopsy, your provider might have your tissue sample tested for gene changes (mutations) that special drugs can target as part of your treatment plan.
Surgery
NSCLC that hasn’t spread and SCLC that’s limited to a single tumor can be eligible for surgery. Your surgeon might remove the tumor and a small amount of healthy tissue around it to make sure they don’t leave any cancer cells behind. Sometimes they have to remove all or part of your lung (resection) for the best chance that the cancer won’t come back.
Radiofrequency ablation
NSCLC tumors near the outer edges of your lungs are sometimes treated with radiofrequency ablation (RFA). RFA uses high-energy radio waves to heat and destroy cancer cells.
Radiation therapy
Radiation uses high energy beams to kill cancer cells. It can be used by itself or to help make surgery more effective. Radiation can also be used as palliative care, to shrink tumors and relieve pain. It’s used in both NSCLC and SCLC.
Chemotherapy
Chemotherapy is often a combination of multiple medications designed to stop cancer cells from growing. It can be given before or after surgery or in combination with other types of medication, like immunotherapy. Chemotherapy for lung cancer is usually given through an IV.
Targeted drug therapy
In some people with NSCLC, lung cancer cells have specific changes (mutations) that help the cancer grow. Special drugs target these mutations to try to slow down or destroy cancer cells. Other drugs, called angiogenesis inhibitors, can keep the tumor from creating new blood vessels, which the cancer cells need to grow.
Immunotherapy
Our bodies usually recognize cells that are damaged or harmful and destroy them. Cancer has ways to hide from the immune system to keep from being destroyed. Immunotherapy reveals cancer cells to your immune system so your own body can fight cancer.
The stage wise 5-year survival percentages
Non-Small Cell Lung Cancer
- Stage 1: ~57%
- Stage 2: ~31%
- Stage 3: ~10–15%
- Stage 4: ~5–10%
Small Cell Lung Cancer
- Limited Stage:~10-30%
- Extensive Stage: ~2–5%
Since we don’t know what causes most cancers for sure, the only preventative measures are focused on reducing your risk. Some ways to reduce your risk include:
- Don’t smoke or quit smoking if you do. Your risk of lung cancer starts coming down within five years of quitting.
- Avoid second hand smoke and other substances that can harm your lungs.
- Eat a healthy diet and maintain a weight that’s healthy for you. Some studies suggest that eating fruits and vegetables (two to six-and-a-half cups per day) can help reduce your risk of cancer.
- Get screened for lung cancer if you’re at high risk.
Lung cancer screening
You can increase your chances of catching cancer in its earliest stages with screening tests. You’re eligible for lung cancer screening if you meet all of these requirements:
- You’re between the ages of 50 and 80.
- You either currently smoke or have quit smoking within the last 15 years.
- You have a 20 pack-year smoking history (number of packs of cigarettes per day times the number of years you smoked).