Lung cancer symptoms, early diagnosis and treatment
ಶ್ವಾಸಕೋಶ ಕ್ಯಾನ್ಸರ್ ಬಗ್ಗೆ ತಿಳಿಯಲೇ ಬೇಕಾದ ವಿಷಯಗಳು

What is Lung Cancer?

Lung cancer is characterized by uncontrolled growth of the cells of the lungs. It is the leading cause of death in men in India and the second most common cancer occurring in women in India. It is also the leading form of cancer worldwide.

Identifying lung cancer in the initial stages can be difficult as it presents symptoms similar to any respiratory infection.

There are different types of lung cancer. Knowing which type you have is important because it affects the treatment options and outlook. If you aren’t sure which type of lung cancer you have, please ask your doctor to get the correct information.

Symptoms of Lung Cancer

Common symptoms of lung cancer can include:

  • Coughing
  • Trouble breathing or wheezing
  • Spitting or coughing up blood
  • Chest pain which can be dull, sharp, or stabbing
  • Hoarseness of voice
  • Headache and swelling of the arms, face or neck

If the cancer is present in the top of lungs, then the patients may experience

  • Pain in the arm, shoulder, or neck
  • Droopy eyelid or blurred vision
  • Weakness of the hand muscles

These conditions may be caused by conditions other than cancer. It is always better to let your doctor know about that.

lung-cancer

Causes of Lung Cancer

Smoking is one of the main reasons of developing cancer of lungs. But lung cancer has also been detected in patients who never smoked or were exposed to secondary smoke.

Smoking damages the cell lining around lungs and with repeated exposure causes cells to act abnormally which ultimately develops into cancer.

Stages of Lung Cancer

The most common system used for staging lung cancer is the TNM system.

T stands for Tumour. It is used to describe the size of the tumour. It also helps to determine whether tumour has grown into other parts of the organ or tissues around the organ. It is represented by a range of 1 to 4. The higher the number means the larger the tumour.

N stands for Lymph Nodes. It helps determine if the cancer has spread to the lymph nodes around the organ. NX means the impact on lymph nodes cannot be determined. N0 means cancer hasn’t spread to nearby lymph nodes while N1, N2 and N3 means cancer has spread to lymph nodes. N1 to N3 also shows the range that how many lymph nodes are affected.

M stands for Metastasis. It is used to determine if the cancer has spread to other parts of body through blood or lymphatic system. MX means the metastasis cannot be determined; M0 means cancer has not spread to other body parts while M1 indicates that it has spread to other body parts.

Sometimes lowercase letters like a, b and c is used to divide the tumour, lymph nodes and metastasis into sub categories. Also lowercase “is” is used to denote carcinoma in situ. For e.g. Tis

For the convenience of grading the extent of spread of cancer, the cancer is classified into 5 broad stages.

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Stage 0

In this stage the tumor is found only in the top layers of cells lining the air passages, but it has not invaded deeper into other lung tissues (Tis). The cancer did not spread to nearby lymph nodes (N0) or to distant parts of the body (M0).

Stage I

In this stage the tumour is in a single lung and the tumour is no bigger than 4cm. It has not spread outside the lung or to any lymph nodes. This is called early or localised lung cancer.

Stage II

This is the second stage of the cancer, in this stage the cancer can be of different sizes. It may have spread to the nearby lymph nodes, other parts of the lung, or to areas just outside the lung. Stage 2 lung cancers are usually known as locally advanced lung cancer.

Stage III

Stage III is an advanced stage of cancer. The cancer can be any size and has usually spread to nearby lymph nodes. It may also be seen growing into other parts of the lung, or the airway, or to surrounding areas just outside the lung. It may also have spread to tissues and structures further away from the lung. But it has not spread to other any parts of the body.

Stage IV

It is the most advanced form of cancer. In this stage the cancer can be any size and may or may not have grown into nearby structures (any T). It may or may not have reached any nearby lymph nodes (any N).

In addition to the above conditions following also can be seen:

  • The cancer has spread to the lung on the other side of lung.
  • The cancer has spread to the lung on the other side of lung.
  • There is presence of cancer cells in fluid in the pleura or around the heart.
  • The cancer has spread to other parts of the body, which includes the liver, bones or brain.

Stage 4 lung cancer is also known as metastatic or secondary lung cancer.

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Lung Cancer

Risk Factors

A number of factors can contribute to increasing the chances of getting lung cancer. These are called risk factors. Some of the most significant risk factors are discussed here :

Smoking

The chance of getting lung cancer increases with smoking.

Second-hand Smoke

The risks of developing lung cancer increases if someone is exposed to second-hand smoke for a long period.

Radon Gas

Radon gas is a known agent for causing lung cancer. It is produced by breakdown of uranium

Asbestos and heavy Metals

Exposure to asbestos or metals like arsenic, nickel and chromium also increases the chances of lung cancer.

Family history of lung cancer

People with family history of lung cancer have an increased risk of the developing the disease.

Types of Lung Cancer

Lung cancer is divided into two broad categories based on their appearance under microscope.

  • Small Cell Lung Cancer: This form of cancer is most common among heavy smokers. It is the most aggressively growing lung cancer.
  • Non-Small Cell Lung Cancer: Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are the different types of non-small cell lung cancer.

Adenocarcinomas are the most common type of NSCLC. It occurs in the outer or peripheral areas of the lungs.

Squamous cell carcinomas account for 30% of the NSCLC. It forms most frequently in the chest area in the bronchi.

Large cell carcinoma also known as undifferentiated carcinomas are the least common type of NSCLC.

Diagnosis of Lung Cancer

If your doctor suspects lung cancer, then following types of tests can be performed.

  • Chest X-Ray: If the chest X-ray shows a spot that looks like it could be cancer, then it will probably be followed up with other tests.
  • CT (computerized tomography) scans are performed on the chest, abdomen, and/or brain to examine for presence of both metastatic and lung tumours. In addition to CT Scans, PET scans can also be done; this test creates a 3D image of the radioactive drugs presence in the tissues.
  • Biopsy: A small sample of tissue collected from the affected site and checked under microscope for detecting cancer.

Treatment of Lung Cancer

Lung cancer is detected very late, generally in the third or fourth stage and hence, treatment for lung cancer primarily involves one or combinations of these treatments.

  • Surgical removal of the area affected by cancer
  • Chemotherapy
  • Radiation therapy
  • Targeted therapies
  • Immunotherapy

The decision about appropriate treatment for a given individual must take into account the location and extent of the tumor in the individual, as well as the overall health status of the patient.

Prevention of Lung Cancer

Most lung cancers could be prevented, by reducing or stopping smoking or exposure to second-hand smoke, preventing exposure to radon gas or other environmental factors. But some lung cancers occur in people without having the presence of risk factors known for the disease. Such type of cancers cannot be prevented.