What is Lung Cancer?
Lung cancer is the deadliest type of cancer. Each year, more people die from breast,. Although smoking has been the leading cause of lung cancer, there have also been cases among non-smokers. Although lung cancer is asymptomatic in its early stages, it can be detected by X-ray.
What are the Symptoms of Lung Cancer?
Some of the common symptoms of lung cancer are:
- Chronic cough for more than a month
- Coughing up blood (hemoptysis)
- shortness of breath
- Wheezing
- chest pain
- fatigue
- Difficulty swallowing
- Progressive weight loss
- loss of appetite
- Joint problems
- Swelling of the arms and face
What are the Causes of Lung Cancer?
Smoking
- Cigarette Smoke Composition: Contains over 60 recognised carcinogens, including radioisotopes from the radon decay sequence, nitrosamine, and benzopyrene.
- Impact of Nicotine: Nicotine in cigarette smoke suppresses the immune response of exposed tissue to cancerous growth.
- Lung Cancer Attribution: Smoking is responsible for 80-90% of lung cancer cases.
- Passive Smoking Definition: Inhalation of smoke from nearby smokers.
- Risk Factors of Passive Smoking: Those living with smokers face a 20-30% higher risk, while individuals in secondhand smoke environments have a 16-19% higher risk compared to non-smokers.
Gas Radon
- Radon Origin: Colorless, odourless gas produced by the decay of radioactive radium.
- Effect on Genetic Material: Decay products of radiation ionize genetic material, leading to mutations, some of which may become cancerous.
- Risk Increase: For every increase in radon concentration by 100 Becquerel per atomic mass, the risk of related health issues rises by 8-16%.
- Measurement Unit: Becquerel (Bq) is used to quantify radioactivity.
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Get A Second OpinionAsbestos
- Asbestos-Related Lung Diseases: Asbestos exposure can lead to various lung diseases, including lung cancer.
- Synergistic Impact of Smoke and Asbestos: Smoking and asbestos exposure together have a synergistic effect on the development of lung cancer.
- Pleural Cancer: Asbestos exposure can also cause pleural cancer, affecting the thin lining between the lung and the chest wall.
- Mesothelioma: An aggressive cancer affecting the pleura caused by asbestos exposure, which can affect the lungs, heart, or abdomen.
Air Pollution
- Outdoor Air Pollution and Lung Cancer: Contrary to common belief, outdoor air pollution has limited effect on increasing lung cancer risk.
Fine particulates (PM2.5) and sulfate aerosols from traffic exhaust gases do increase the risk. - Nitrogen Dioxide's Impact: An increase of 10 parts per billion in nitrogen dioxide elevates lung cancer risk by 14%.
- Contribution of Outdoor Air Pollution: Outdoor air pollution is estimated to contribute to 1-2% of lung cancer cases.
- Indoor Air Pollution Sources: Lung cancer risk is also associated with indoor air pollution, such as burning wood, charcoal, manure, or crop residues for cooking and heating.
- Increased Risk for Women: Women exposed to indoor coal smoke face approximately twice the risk of developing lung cancer.
- Biomass Burning By-Products: Some by-products of biomass burning are known or suspected carcinogens, further increasing lung cancer risk.
Genetics
It is estimated that between 8% and 14% of lung cancer is due to hereditary factors. In relatives of people with lung cancer, the risk increases 2.4 times. This is possibly due to a gene combination.
Other Causes
- Numerous other environmental substances, occupations, and exposures have been linked to lung cancer which are:
- Production and extraction of some metals and arsenic compounds
- By-products of combustion such as carbon monoxide, Sulfur dioxide, nitrogen oxides, and lead.
- Ionizing radiation
- Toxic gases
- Production of rubber and crystalline silica powder.
How many Types of Lung Cancer are there?
Adenocarcinoma Lung Cancer
Bronchioles and Adenocarcinoma: Adenocarcinoma, a type of lung cancer, typically grows in the bronchioles and is commonly found in the outer layers of the lungs.
It originates from glandular cells and is known for its slow growth rate.
- Gender and Risk: Women tend to have a higher risk of developing adenocarcinoma.
- Type of NSCLC: Adenocarcinoma is classified as a type of non-small cell lung cancer (NSCLC), constituting 80-85% of all lung cancers.
- Advanced Stage: When adenocarcinoma spreads extensively, it is termed advanced non-small cell lung cancer.
- Treatment Variability: Treatment approaches for adenocarcinoma depend on factors such as severity and prognosis, leading to varied modalities.
- Advanced Stage (Fourth Stage): At an advanced stage or fourth stage, adenocarcinoma may progress into large-cell lung carcinoma, where cancer cells have spread widely within the lungs from the original site.
- Treatment Variances: The treatment of lung cancer, especially in advanced stages, varies based on the specific circumstances of each case.
Small Cell Lung Cancer
Smoking and Small Cell Lung Cancer (SCLC):
- Smoking is one of the primary causes of small-cell lung cancer.
- Symptoms typically include coughing, shortness of breath, and severe chest pain.
Characteristics of SCLC:
- In small-cell lung cancer, there is the uncontrolled growth of cells forming tumours in the lungs. - SCLC accounts for about 10-15% of all lung cancer cases.
- Oat Cell Cancer: SCLC is also known as oat cell cancer due to the appearance of the cancer cells under a microscope.
- Advanced Stage: When oat cell cancer spreads extensively, it is termed advanced small cell lung cancer.
How to Diagnose Lung Cancer?
- Chest X-ray is an initial step in evaluating symptoms that may indicate lung cancer.
- This procedure helps identify abnormalities like masses, mediastinal widening, atelectasis, consolidation, or pleural effusion.
- CT scans provide more detailed information about the nature and extent of the disease.
- CT-guided biopsies or bronchoscopies are commonly performed to obtain tissue samples for analysis.
- Lung cancer often appears as a solitary pulmonary nodule on a chest X-ray, but the differential diagnosis includes conditions like tuberculosis, fungal infections, and pneumonia.
- Other causes of solitary pulmonary nodules include hamartomas, bronchogenic cysts, adenomas, arteriovenous malformations, pulmonary sequestration, rheumatoid nodules, Wegener syndrome, or lymphoma, each requiring specific treatment approaches.
- Lung cancer can also be incidentally discovered during routine chest X-rays or CT scans performed for unrelated reasons.
- The clinical diagnosis of lung cancer relies on a comprehensive evaluation of clinical, radiological, and histological findings from suspicious tissue samples.
- A precise diagnosis is crucial for optimizing the effectiveness of lung cancer management.
How to Treat Lung Cancer?
To effectively treat lung cancer, it's crucial to know the type of cells involved, how far the cancer has spread, and the general health of the patient. Treatment options vary depending on the stage of the cancer and may include palliative care, surgery, chemotherapy, or radiation therapy.
Surgery For Lung Cancer:
- NSCLC Diagnosis and Staging: NSCLC diagnosis prompts staging evaluation to determine surgical eligibility or metastasis, termed metastatic NSCLC.
Computed tomography and positron emission tomography are standard staging tools. - Mediastinal Lymph Node Assessment: Mediastinoscopy aids in sampling lymph nodes to assess involvement, crucial for staging and treatment planning.
Blood and lung function tests assess surgical candidacy; poor lung function may preclude surgery. - Surgical Options for NSCLC:Lobectomy is standard for early-stage NSCLC, with sub-lobar excisions considered for inoperable cases.
Video-assisted thoracoscopic surgery (VATS) offers minimally invasive alternatives, with comparable efficacy to open surgery and less postoperative morbidity. - SCLC Treatment Approach: SCLC management primarily involves chemotherapy and/or radiation, with evolving roles for surgery.
Surgery may enhance outcomes when combined with chemotherapy and radiation in early-stage SCLC. - Metastatic SCLC Management: It includes chemotherapy and radiation, focusing on symptom control and quality of life.
- Consultation Importance: Timely medical consultation enhances diagnostic accuracy and facilitates appropriate cancer care, optimizing outcomes, especially in the early stages.
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Book an AppointmentRadiotherapy for Lung Cancer:
- Radiation Therapy in Lung Cancer Treatment: Often combined with chemotherapy, especially in NSCLC cases where surgery is not an option.
Radical radiation therapy delivers high-intensity radiation with curative intent. - Continuous Hyperfractionated Accelerated Radiation Therapy (CHART): administers high radiation doses over a short period, refining treatment efficacy.
- Brachytherapy for Bronchial Obstruction: Directs localized radiation into blocked bronchi, restoring airway patency.
Reduces treatment duration and radiation exposure compared to external beam therapy. - Advancements in Stereotactic Radiation: Targeted imaging advancements enhance stereotactic radiation's efficacy, particularly in early-stage lung cancer.
High doses are precisely delivered over a few sessions via stereotaxic targeting. - Patient Eligibility: Stereotactic radiation is preferred for patients unsuitable for surgery due to medical complexities.
Cyber Treatment for Lung Cancer:
- CyberKnife Advancements in Lung Cancer Treatment: Enhances Stereotactic Body Radiation Therapy (SBRT) precision and efficiency.
Allows for real-time adjustment of radiation beams to account for patient and tumour movements during treatment. - SBRT for Targeted Radiation Delivery: Delivers precise radiation to effectively treat lung cancer tumours.
- Precision Delivery with CyberKnife: Adjusts beams to accommodate patient and tumour movements, ensuring accurate radiation dosage.
- Palliative Radiation Therapy for Symptom Control: Utilizes lower doses of radiation to alleviate symptoms in NSCLC and SCLC patients, improving quality of life.
Chemotherapy for Lung Cancer:
- Chemotherapy in Lung Cancer: Chemotherapy regimen depends on tumour type, applicable to both SCLC and NSCLC, often in conjunction with radiation.
- Role in Advanced NSCLC: Chemotherapy is the first-line treatment against radiation in advanced NSCLC, improving survival rates.
- Fitness Assessment in Metastatic SCLC: Patient fitness determines eligibility for metastatic SCLC treatment, crucial for survival outcomes.
- Adjuvant Chemotherapy after Surgery: Enhances outcomes post-curative surgery, known as adjuvant chemotherapy, particularly in NSCLC.
Improves five-year survival rates by 5% in stage II or III NSCLC. - Debate on Stage IV Adjuvant Chemotherapy: Controversial in stage IV lung cancer, with clinical trials lacking evidence of survival benefits.
- Inconclusive Evidence on Neoadjuvant Chemotherapy: Trials on preoperative chemotherapy (neoadjuvant chemotherapy) outcomes remain inconclusive.
- Side Effects of Chemotherapy: Patients may experience various side effects including hair loss, mouth pain, loss of appetite, nausea, and vomiting during lung cancer treatment.
