Lung Cancer Not exclusively a smoker’s disease

Lung cancer is the leading cause of cancer death among both men and women. World Health Organization (WHO) estimates that there were 1.59 million deaths caused by lung cancer in 2012. It is more common in men and mainly occurs in older people.  

Getting to know lung cancer

Lung cancer is the uncontrolled growth of abnormal cells in one or both lungs. The abnormal cells divide rapidly and form tumors. There are two kinds of risk factors: external and internal. The external factors are smoking and pollution. These induce changes in the cell in the smokers themselves and people exposed to second-hand smoke. In addition, radon and asbestos are non-tobacco carcinogens strongly associated with lung cancer. The internal factors are caused due to genetics and cell degeneration.

Symptoms of lung cancer

Patients who often experience chronic cough or is coughing up blood needs to get themselves checked. Patients with metastatic disease have symptoms related to the organ that the cancer has spread to. The symptoms might include:
  • Symptoms of Horner syndrome – a tumor compress the sympathetic nerve. The symptoms include shoulder pain radiating to arms, a drooping eyelid, and decreased sweating on one side of your face.
  • Symptoms of SVC obstruction – caused by a tumor compressing superior vena cava. The symptoms include facial swelling, neck swelling, and shortness of breath when lying flat.
  • Symptoms caused by cancer spreading to the brain – headache and forceful vomiting
  • Symptoms caused by cancer spreading to the spine – back pain, cannot control bowel and bladder, numbness, weakness, and significant weight loss

Diagnosis of lung cancer

  1. History taking and physical examination
  2. Investigations – chest x-ray, CT-scan chest, or MRI chest
If imaging tests reveal abnormal lesions in your lung, a sample of abnormal cells may be removed for further investigations. This can be done in a number of ways including bronchoscopy and using an imaging test to guide a needle through your chest wall and into lung tissue to collect a sample. A pathological result will give information about the cancer cell type such as small cell lung cancer and non-small cell lung cancer. Once the diagnosis has been made, the doctor will work to determine the stage of lung cancer. This helps deciding what treatment is most appropriate. The staging tests may include bone scan, PET/CT-scan, and MRI brain.

Treatment of lung cancer

The treatment depends on the type of lung cancer.
  • Small cell lung cancer
This cell type spreads quickly to other organs but response well to chemotherapy and radiotherapy. The main treatment is chemotherapy to destroy cancer cells and prevent the metastasis. Radiotherapy might be also considered and be given at the same time. This is called chemoradiotherapy.
  • Non-small cell lung cancer
If non-small cell lung cancer not spread to other organs, the main treatment is a surgery. Chemotherapy, targeted therapy, or immunotherapy might also be considered. If the cancer has spread to other organs, the treatment is chemoradiotherapy with or without targeted therapy or immunotherapy. Also, If the cancer is very advanced and the patient’s condition is not appropriate for aggressive treatment, the treatment will be palliative care or supportive care. Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care. A diagnosis of cancer can be overwhelming. With time you will find ways to cope with the distress and uncertainty of cancer. A team of experts in diagnosing, treating, and caring for patients with cancer are here to help you physically and emotionally. Most importantly, the best way to reduce your risk of lung cancer is to not smoke and to avoid secondhand smoke. Yearly physical to detect early signs of this disease.

Reference: Dr. Chanawat Tesavibul, Intervention radiologist, Wattanosoth hospital For more information: Wattanosoth hospital Call 1719