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Lung Cancer

Overview

Lungs are a pair of spongy organs in our bodies that receive oxygen and expel carbon dioxide when we breathe in and out. Like other parts of the body, cancer can develop in the lungs, called Lung cancer which is the most common cancer worldwide.

A significant number of lung cancer cases are caused by long-term tobacco use. Individuals who have never smoked make up only 10–15 percent of all cases. The length of time and the packets of cigarettes you smoke raise your risk of lung cancer. You can dramatically lower your risk of getting lung cancer if you stop smoking, even if you've been smoking for a long time.

The most effective strategy for prevention is to minimize risk factors such as smoking and environmental pollution. The form of cancer, degree of metastasis, and the individual's overall condition are the factors that influence treatment and long-term prognosis. Surgery, medication, and radiation are all common therapies.

Causes

There are various risk factors associated with lung cancer. Some of the common factors are as follows:

Smoking

Tobacco use is by far the leading cause of lung cancer. In tobacco smoke, different carcinogens have been identified. In the year 2000, smoking was responsible for 90% of lung cancer cases in males and 70% of lung cancer deaths among women in rich societies. Non-smokers can get lung cancer by passive smoking, which is when they inhale smoke from someone else who is smoking. It is more hazardous than conventional smoking.

Radon

Radon is the second leading cause of lung cancer in the United States, accounting for over 21,000 fatalities per year.

Asbestos

Smoking tobacco and being exposed to asbestos have synergic effects on lung tumor progression.

Pollution

Lung cancer is increased by outdoor air pollution, particularly chemicals generated from the combustion of fossil fuels. Indoor air pollution poses a greater threat in relation to the burning of wood and charcoal for cooking.

Hereditary

Genetic factors are responsible for around 8% of lung cancer cases. The risk of lung cancer is twice among relatives of those diagnosed, most likely owing to a combination of genes.

Types

Based on the morphology of lung cancer cells under the microscope, physicians divide lung cancer into two primary categories. Your doctor will choose your treatment options depending on the type of lung cancer you possess.

  • Small cell lung cancer is less prevalent than non-small cell lung cancer and occurs virtually exclusively in tobacco users.
  • Non-small cell lung cancer (NSCLC) is an umbrella term for various lung malignancies. Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are examples of non-small cell lung malignancies.

Epidemiology

Lung cancer is the most prevalent cancer in men, both in terms of incidence and mortality, and the third most common cancer in females. In 2020, it had affected 2.2 million people and had caused 1.8 million deaths worldwide. It is the third most common cancer in the USA. In 2018, 218,520 new cases were reported, and the number of deaths recorded was 142,080.  People who have smoked for a long time have the greatest risk of getting cancer, with the harm associated with the length of time they have smoked. One lung cancer death occurs for every 3–4 billion cigarettes consumed.

Signs And Symptoms

]Most of those clinical symptoms of lung malignancy, such as anorexia, loss of weight, temperature, and tiredness, are vague. The early stages of lung cancer do not result in obvious signs or symptoms. These signs and symptoms usually appear when the illness has progressed.

The following are some of the clinical manifestations of lung cancer:

  • Coughing up blood
  • Pain in the chest
  • Hoarseness of voice
  • Weight loss, bone pain, and brain symptoms such as headaches, fainting, and fits all indicate the existence of metastatic illness.

Diagnosis

Your doctor will take a detailed history asking you questions about your symptoms, the number of cigarettes consumed for the number of years, your family history, and your past medical history. He would examine your chest thoroughly and look for signs of other diseases as well. You may undergo the following tests for confirmation of diagnosis.

Imaging:  A chest X-ray scan may indicate an abnormal lump or tumor. A CT scan of your lungs can identify microscopic abnormalities that aren't visible on an X-ray.

Cytology:  If you have a cough with sputum, examining it under a microscope can occasionally detect the presence of cancer.

Tissue sample: A biopsy is a process that removes a sample of aberrant cells from the body. Your surgeon can do a biopsy in a variety of ways, mostly bronchoscopy, which involves passing a lighted catheter down your neck and then into the lungs to check abnormal parts of your lungs.

Mediastinoscopy: Another option is mediastinoscopy, which involves making a slit at the base of the neck and inserting surgical equipment under your ribcage to obtain samples from lymph glands.

Another alternative is a needle biopsy, in which your surgeon guides a syringe through your rib cage and into your lung cells to collect abnormal cells using X-ray or CT pictures.

Lung cancer staging: Lung cancer staging determines the extent to which cancer has spread from its initial source. Your doctor will seek to identify the lung cancer stage once it has been discovered. The stage of your cancer aids you, and the physician determines the best treatment option. CT scans, MRI scans, PET scans, and bone scans are among the tests available. Lung cancer stages are denominated by Roman numerals that range from 0 to IV. Stage 0 indicates that the cancer is limited to the lung, while stage IV means that cancer has spread to other body parts.

Management

Surgical resection of the tumor

Your surgeon will remove the lung cancer as well as a border of normal tissue during the operation. There are different types of resection, such as:

Wedge resection involves removing a tiny piece of the lung that includes the tumour as well as a normal border.

Segmental resection is used to remove a larger area of the lung but not the whole lobe.

Lobectomy is a procedure that removes the entire lobe of one lung.

Pneumonectomy is a procedure that removes the whole lung.

Your doctor may also extract lymph nodes from your neck to look for cancerous indications. If your disease is limited to your lungs, resection may be a possibility. If you have more advanced lung cancer, the doctor may advise medication or radiation treatment before surgery to help the tumor reduce in size.

Radiotherapy: Radiation pulses are used in radiotherapy to kill cancer cells. It is used to manage lung cancer in a variety of ways. When you're not fit enough for surgery, an extensive course of radiation called radical radiotherapy may be used to manage non-small-cell lung cancer.

Chemotherapy: Chemotherapy uses medications to destroy cells that are quickly developing into cancer cells. One or even more chemotherapeutic medications may be administered intravenously or orally. Chemotherapy is frequently administered in cycles. A cycle entails taking chemotherapy drugs for a few days and then taking a break for several weeks to allow the therapy to function and your body to heal from the treatment's side effects. The number of cycles you'll require is usually determined by the type and stage of lung cancer you have. Most patients require four to six treatment cycles spread out over three to six months.

Prognosis

Your prognosis is determined by the nature of the lung cancer you have and the stage of the disease at the time of diagnosis. Your overall health and fitness may also have an impact on your ability to survive. This is what physicians refer to as your performance status. A value of 0 indicates that you are entirely self-sufficient. A value of 1 means that you can perform most things independently but require assistance. Your score will continue to rise based on how much help you need. An individual with higher scores may have a worse prognosis.

Lifestyle Modifications

  • Don't start smoking if you've never smoked before. Talk to your children about the dangers of smoking to learn how to prevent this leading cause of lung cancer.
  • Quit smoking. Even if you've been smoking for years, quitting lessens your chance of lung cancer. Consult your doctor about techniques and quit-smoking aids that might assist you in quitting smoking. Nicotine replacement treatments, medicines, and support networks are all options.
  • If you work or live with someone who smokes, encourage them to quit. Smoke-filled environments, such as pubs and restaurants, should be avoided. Have your home's radon levels examined, especially if you reside in a region where radon is a recognized issue.
  • Protect yourself from harmful substances at work by taking measures. Obey workplace safety rules. If you smoke, your chance of lung injury from occupational toxins increases.
  • Consume a healthy diet rich in fruits and vegetables. Choose a nutritious diet that includes a wide variety of healthy foods.
  • Exercise regularly to live a healthy life.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 24, 2023.

 

References

What Is Lung Cancer? | CDC

https://www.cdc.gov/cancer/lung/basic_info/what-is-lung-cancer.htm#:~:text=When%20cancer%20starts%20in%20the,another%2C%20they%20are%20called%20metastases.

What Is Lung Cancer? | CDC (theclinics.com)

https://www.chestmed.theclinics.com/article/S0272-5231(19)30080-2/fulltext

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