Normally, your body's cells die when they are old or damaged. But there are times when they overgrow and multiply inappropriately, which leads to tumors and other complications. This condition is known as cancer. In lung cancer, cells in the lungs divide abnormally, leading to tumors and lumps. Typically, this cancer presents with a persistent cough, blood in the cough, and shortness of breath. The risk of lung cancer increases if you smoke or are exposed to a gas called radon and toxic substances such as asbestos or diesel.
The worldwide prevalence of lung cancer is quite alarming. In 2018 alone, approximately 2.1 million new cases of this cancer were diagnosed worldwide, representing 11.6 percent of the total global cancer burden. Globally, death rates are highest in North America and Europe. In India, one in 68 men will get lung cancer. Lung cancer is one of the five most common cancers in India. More than 40% of patients are diagnosed with advanced lung cancer, where the cancer has spread.
Types
There are two types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).
Small cell lung cancer (SCLC)
In this type of lung cancer, the malignant cells appear small and round under the microscope. Although it affects a smaller number of people, while compared to NSCLS, SCLC is more aggressive in terms of development. A significant reason is smoking. However, this form of lung cancer responds well to chemotherapy and radiation therapy.
Non-small cell lung cancer (NSLC)
The cells of this form of lung cancer are larger than SCLC cells. NSLC, which is more common than SCLC, takes time to develop. So you may not experience symptoms in the initial stage. In fact, it may not even invade nearby tissues or need immediate treatment. In this type of lung cancer, smoking is also one of the main culprits among others.
Stages
The stage of the cancer tells us about the spread of the condition. This is crucial for deciding on the treatment method. While the NSLC has four main grades, the SCLC has two grades.
Stages of non-small cell lung cancer:
Stage 1: Cancer cells have not spread outside the lungs.
Stage 2: Cancer cells are present in the lungs and nearby lymph nodes.
Stage 3: In addition to the lungs, the cancer cells have spread to the lymph nodes located in the middle of the chest.
Stage 3A: Malignant cells are only present in the lymph nodes in the chest area where the cancer originated.
Stage 3B: Cancer cells are present in lymph nodes in the chest area opposite the site or above the collarbone.
Stage 4: Malignant cells are found both in the lungs and in distant organs.
Stages of Small cell lung cancer:
Limited stage: In this stage, malignant cells are found in only one lung or in nearby lymph nodes.
Extensive stage: Cancer cells are found both in the lungs, the surrounding fluid, in the bone marrow and in distant organs.
Symptoms
Whatever the form, the manifestations of lung cancer usually remain the same. In most cases, symptoms begin to appear at a much later stage. Here are the red flags to look out for:
Persistent cough
Blood in the cough
Chest pain that gets worse when you laugh, cough or breathe deeply
Hoarseness of voice
Stuffiness
Wheezing
Weakness and fatigue
Loss of appetite
Unexplained weight loss
Respiratory infections such as pneumonia or bronchitis.
Lymph nodes in the neck or collarbone
Severe bone pain, especially in the back, ribs and neck
Numbness in the legs or arms
Dizziness
Problems with body balance
Drooping eyelid (caused by pressure exerted by the tumor on the facial nerves)
Muscle fatigue
Nausea
Fluid retention
High blood pressure
High blood sugar
Seizures
Causes And Risk Factors
Almost anyone can get this condition. However, certain factors make you more vulnerable to lung cancer.
Active and passive smoking is the main cause of developing lung cancer. Very long or long cigarettes may put you at greater risk of lung cancer.
Heavy exposure to metals such as asbestos, uranium, arsenic, radon, cadmium, chromium, nickel, carbon black and tar can increase your risk of developing lung cancer.
Lung cancer can also run in families. People with the genetic mutation have a higher chance of getting lung cancer than heavy smokers with or without the inherited mutation.
There is an increased risk of lung cancer if you have previously had any lung disease or suffered an organ injury.
Exposure to chest or breast radiation therapy or certain imaging tests, such as a CT scan, can increase your risk of lung cancer.
The male population is highly susceptible to lung cancer.
Prevention
No form of cancer, including lung cancer, can be prevented. However, you can reduce your chances of falling victim to this condition.
Say no to smoking. If necessary, join smoking cessation programs.
Avoid passive smoking. Avoid places where people smoke, such as bars and restaurants, and look for non-smoking options.
Reduce your exposure to environmental toxins such as radon, uranium, arsenic, nickel, etc. If your job requires you to come into close contact with them, wear a face mask.
Include lots of fruits and vegetables in your diet.
Exercise regularly. Also, practicing breathing techniques will improve your overall lung health.
Diagnosis
After reviewing your symptoms, if your doctor suspects lung cancer, he may recommend the following tests to confirm the diagnosis.
Imaging tests: Computed tomography (CT) and positron emission tomography (PET) are imaging studies that help your doctor detect lung tissue with cancer. He may also suggest a bone scan to identify cancerous growths. These tests are also necessary to see how your body is responding to treatment.
Tissue sampling: If an imaging study reveals a suspicious lesion, a sample of your lung tissue must be taken to identify cancer cells. Tissue samples can be taken with needles or using minimally invasive procedures such as bronchoscopy.
Lab tests: Your doctor may also recommend sputum or blood tests to identify the type of lung cancer you have. These tests will also tell your doctor about the stage of the cancer.
Therapy
Treatment for this condition can vary depending on the location, stage, and overall health of the individual. Here are the treatment modalities your oncologist may resort to:
Surgery
The goal of surgical intervention is to remove cancerous tissues in the lungs and surrounding areas. Your doctor may need to remove all or part of one lung, depending on your condition.
Chemotherapy
This is a potent intervention in which drugs are used to shrink or obliterate rapidly dividing cancerous cells. It works well for people with an advanced stage of this cancer. However, chemotherapy comes with its own set of side effects.
Radiation therapy
In this method, high-energy rays kill cancer cells and reduce the size of malignant tumors prior to surgical removal. It works best when the cancer cells or tumors are confined to one location.
Targeted therapy
This therapy targets a particular action of cancer cells and tries to fix it. For example, one targeted therapy may aim to stop cancer cells from multiplying.
Immunotherapy
Immunotherapy is a group of medications that use the body’s defense system to fight lung cancer. This therapy can be used alone or in combination with chemotherapy.
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