Health Desk- Lung cancer is the third most common cancer in the US. It is caused by uncontrolled growth of harmful cells in your lungs. Treatments include surgery, chemotherapy, immunotherapy, radiation, and targeted drugs. Screening is recommended if you are at high risk. Advances in treatment have led to a significant decline in lung cancer deaths in recent years.

Table of Contents

Lung Cancer- Causes, Symptoms and Treatment

What is lung cancer?

Lung cancer is a disease caused by uncontrolled cell division in your lungs. Your cells divide as part of their normal function and make more copies of themselves. But sometimes, they get mutations that cause them to keep making more of themselves than they should. Damaged cells that divide uncontrollably form masses of tissue, or tumors, that eventually prevent your organs from working properly.

Lung cancer is the name for cancers that start in your lungs – usually in the airways (bronchi or bronchioles) or small air sacs (alveoli). Cancers that start in other places and move to your lungs are usually named after where they start (your healthcare provider may refer to this as cancer that is metastatic to your lungs). Is).

How many types of lung cancer are there?

There are many cancers that affect the lungs, but we usually use the term “lung cancer” to refer to the two main types: non-small cell lung cancer and small cell lung cancer.

Non-small cell lung cancer (NSCLC)
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. It is responsible for more than 80% of lung cancer cases. Common types include adenocarcinoma and squamous cell carcinoma. Adenosquamous carcinoma and sarcomatoid carcinoma are two less common types of NSCLC.
Small cell lung cancer (SCLC)
Small cell lung cancer (SCLC) tends to grow more quickly and is more difficult to treat than NSCLC. It is often found as a relatively small lung tumor that has already spread to other parts of your body. Specific types of SCLC include small cell carcinoma (also called oat cell carcinoma) and combined small cell carcinoma.

Other types of lung cancer-

Other types of cancer can start in or around your lungs, including lymphomas (cancer in your lymph nodes), sarcomas (cancer in your bones or soft tissue) and pleural mesothelioma (cancer in the lining of your lungs). These are treated differently and are not usually called lung cancer.

What are the stages of lung cancer?

Cancer is usually staged based on the size of the initial tumor, how far or deep it has spread into surrounding tissue, and whether it has spread to lymph nodes or other organs. Each type of cancer has its own guidelines for staging.

Lung cancer staging-

Each stage has many combinations of size and spread that can fall into that category. For example, the primary tumor in stage III cancer may be smaller than in stage II cancer, but other factors place it at a more advanced stage. The general staging for lung cancer is:

Stage 0 (in-situ): The cancer is in the upper lining of the lung or bronchus. It has not spread to other parts of the lung or outside the lung.

Stage I: The cancer has not spread outside the lungs.

Stage II: Cancer is larger than stage I, has spread to lymph nodes inside the lung, or there are more than one tumor in the same part of the lung.

Stage III: The cancer is larger than Stage II, has spread to nearby lymph nodes or structures, or there is more than one tumor in a different lobe of the same lung.

Stage IV: Cancer has spread to the other lung, the fluid around the lung, the fluid around the heart, or distant organs.

Limited vs Comprehensive Phase-

While providers now use stages I to IV for small cell lung cancer, you may also hear it described as limited or extensive stage. This is based on whether the area can be treated with a single radiation field.

Limited-stage SCLC is confined to one lung and may sometimes occur in lymph nodes in the middle of the chest or above the collar bone on the same side.

Extensive stage SCLC has spread throughout one lung or has spread to the other lung, lymph nodes on the opposite side of the lung, or other parts of the body.

What is metastatic lung cancer?

Metastatic lung cancer is cancer that starts in one lung but has spread to the other lung or other organs. Metastatic lung cancer is more difficult to treat than cancer that has not spread beyond its original site.

How common is lung cancer?

Lung cancer is the third most common cancer in the US health system, reporting more than 200,000 new cases of lung cancer each year.

Symptoms of lung cancer-

Most lung cancer symptoms look similar to those of other less serious diseases. Many people do not have symptoms until the disease is advanced, but some people have symptoms in the early stages. For those who do experience symptoms, it may be only one or a few of these:

A cough that does not go away or gets worse over time.
Shortness of breath or trouble breathing (dyspnoea).
Chest pain or discomfort.
Wheezing.
Coughing up blood (hemoptysis).
Hoarseness.
Hoss of appetite.
Unexplained weight loss.
Unexplained tiredness (fatigue).
Shoulder pain.
Swelling in the face, neck, arms or upper chest (superior vena cava syndrome).
Little or no sweating on that side of your face with a small pupil and drooping eyelid in one eye (Horner’s syndrome).

What are the first symptoms of lung cancer?

A cough or pneumonia that keeps coming back after treatment can sometimes be an early sign of lung cancer (although it can also be a sign of a less serious condition). The most common symptoms of lung cancer include a persistent or worsening cough, shortness of breath, chest pain, hoarseness or unexplained weight loss.

Depending on where the cancer starts in your lungs, some of these symptoms may occur early (in stages I or II), but they often don’t occur until the cancer has progressed to later stages. go. That’s why it’s important to get screened for lung cancer if you’re at high risk.

How long can you have lung cancer without knowing it?

Cancer can grow in your body for a long time – years – before you even know it’s there. Lung cancer often does not cause symptoms in the early stages.

Causes of lung cancer-

Lung cancer is caused by cells that do not divide, even though they should. While cell division is a normal process, all cells have a built-in off switch that prevents them from dividing into more cells (senescence) or causes them to die (apoptosis) when necessary. The off switch is triggered when the cell divides too many times or undergoes too many mutations.

Cancer cells are normal cells in your body that have acquired a mutation that removes the off switch. The cells keep growing, get out of control and interfere with your normal cells. Cancer cells can enter your bloodstream or lymph nodes and travel to other places in your body, causing damage.

We’re not sure what causes these changes that lead to cancer in some people and not others, but certain factors, including smoking tobacco products, can put you at a higher risk of damaging the cells that line your lungs. Can cause cancer.

Risk factors for lung cancer-

While there are many factors that can increase your risk of lung cancer, the biggest single risk factor is smoking any type of tobacco products, including cigarettes, cigars or pipes. Experts estimate that 80% of lung cancer deaths are related to smoking.

Other risk factors include:

Exposure to secondhand tobacco smoke.
Exposure to harmful substances such as air pollution, radon, asbestos, uranium, diesel exhaust, silica, coal products, and others.
Previous radiation treatment to your chest (for example, for breast cancer or lymphoma).
Having a family history of lung cancer.

Does Vaping Cause Lung Cancer?

You can inhale a number of substances when you vape (use a device to inhale nicotine and flavoring mist), including some that are known to cause cancer. Vaping is too new to know all of its long-term effects, but experts agree that it has the potential to damage the lungs.

Can you get lung cancer if you don’t smoke?

While smoking is the major risk factor for lung cancer, 20% of people diagnosed have never smoked. That’s why it’s important to talk with your provider about any concerning symptoms.

Diagnostics and Testing-

How is lung cancer diagnosed?

Diagnosing lung cancer can be a multi-step process. Your first visit to a healthcare provider usually involves listening to your symptoms, asking you about your health history, and doing a physical exam (such as listening to your heart and lungs). Since the symptoms of lung cancer are similar to those of many other, more common diseases, you provider may start by having blood tests and a chest X-ray.
If your provider suspects that you may have lung cancer, your next steps in diagnosis will usually involve more imaging tests, such as a CT scan, and then a biopsy. Other tests include using a PET/CT scan to see if the cancer has spread, and testing cancer tissue from a biopsy to help determine the best type of treatment.
Can a chest X-ray show lung cancer?
X-rays are not as good as CT scans for showing tumors in your lungs.
Especially in the early stages—the tumor may be too small to see on an X-ray or may be blocked from view by other structures in your body (such as your ribs). X-rays can’t diagnose lung cancer — they can only show your provider if there’s something suspicious that they should look into further.

What tests are done to diagnose lung cancer?

Tests your healthcare provider may order or perform include blood tests, imaging, and biopsy of fluid or tissue.

1. Blood test-

Blood tests cannot diagnose cancer on their own, but can help your provider check how your organs and other parts of your body are working.

2. Imaging-

Chest X-rays and CT scans give your provider images that can show changes in your lungs. PET/CT scan is usually done on a CT scan or after a diagnosis of cancer to determine if the cancer has spread.

3. Biopsy-

There are several procedures your provider may use to get a more close look at what’s going on inside your chest. During the same procedures, your provider may take samples of tissue or fluid (biopsies), which can be studied under a microscope to look for cancer cells and determine what type of cancer it is. The samples may also be tested for genetic changes (mutations) that may affect your treatment.

Procedures used to initially diagnose lung cancer or learn more about its spread include:

1.Needle biopsy- During this procedure, your provider will use a needle to collect a sample of fluid or tissue for testing.

2. Bronchoscopy- Thoracoscopy or Video-Assisted Thoracic Surgery (VATS). A provider uses these procedures to view parts of your lungs and take tissue samples.

3.Thoracentesis – A provider uses this procedure to take a sample of the fluid around your lungs for testing.

4.Endobronchial ultrasound or endoscopic esophageal ultrasound—A provider uses these procedures to view and biopsy lymph nodes.

5. Mediastinoscopy or mediastinotomy – A provider uses these procedures to view the area between your lungs (the mediastinum) and take samples.

6.Molecular test-

As part of the biopsy, your provider may have your tissue sample tested for gene changes (mutations), which special drugs can target as part of your treatment plan. Genes that may have alterations that can be targeted in NSCLC include:

KRAS
EGFR.
Alak.
ROS1.
BRF.
RET.
Met up with.
HER2.
NTRK.

Lung cancer treatment-

Lung cancer treatments are designed to get rid of cancer or slow its growth in your body. Treatments can remove cancer cells, help destroy or prevent them from multiplying, or teach your immune system to fight them. Some treatments are also used to reduce symptoms and relieve pain. Your treatment will depend on the type of lung cancer you have, where it is, how far it has spread, and many other factors.

Which drugs/treatments are used for lung cancer?

Lung cancer treatments include surgery, radiofrequency ablation, radiation therapy, chemotherapy, targeted drug therapy, and immunotherapy.

1. Operation-

NSCLC that has not spread and SCLC that is confined to a single tumor may be eligible for surgery. Your surgeon may remove the tumor and a small amount of healthy tissue around it to make sure they don’t leave any cancer cells behind. Sometimes they have to remove all or part of your lung (resection) to have the best chance of the cancer not coming back.

2.Radio frequency separation-

NSCLC tumors near the outer edges of your lungs are sometimes treated with radiofrequency ablation (RFA). RFA uses high-energy radio waves to heat and destroy cancer cells.

3. Radiation therapy-

Radiation uses high energy beams to kill cancer cells. It can be used on its own or to help make surgery more effective. Radiation may also be used as part of palliative care to shrink tumors and relieve pain. It is used in both NSCLC and SCLC.

4. Chemotherapy-

Chemotherapy is often a combination of several drugs designed to stop cancer cells from growing. It may be given before or after surgery, or in combination with other types of drugs such as immunotherapy. Chemotherapy for lung cancer is usually given through an IV.

5.Targeted drug therapy-

In some people with NSCLC, lung cancer cells have specific changes (mutations) that help the cancer grow. Special drugs target these mutations to try to slow down or destroy cancer cells. Other drugs, called angiogenesis inhibitors, can stop tumors from making new blood vessels, which cancer cells need to grow.

6.Immunotherapy-

Our bodies usually recognize and destroy damaged or harmful cells. Cancer has ways of hiding from the immune system to avoid being destroyed. Immunotherapy exposes cancer cells to your immune system so that your own body can fight the cancer.

Treatment to reduce the symptoms of lung cancer-

Some lung cancer treatments are used to relieve symptoms such as pain and difficulty in breathing. These include treatments to shrink or remove tumors that are blocking the airways, and procedures to drain fluid around your lungs and prevent it from coming back.

Side effects of treatment-

The side effects of lung cancer treatment depend on the type of treatment. Your provider can tell you what side effects to expect for your specific treatment, and what complications to watch for.

Chemotherapy immunotherapy radiation surgery

Nausea vomiting.
Diarrhea.
Hair loss
Tiredness.
Mouth sores.

Loss of feeling, weakness or tingling (neuropathy).

Tiredness.
Itchy rash.
Diarrhea.
Nausea vomiting.
Joint pain

Complications (such as pneumonitis, colitis, hepatitis, and others) may result in additional side effects.

Breathing difficulty.
Cough.
Pain.
Tiredness.
Difficulty swallowing.
Dry, itchy or red skin.
Nausea vomiting.
Breathing difficulty.
Pain in chest wall.
Tiredness.

How do I manage the symptoms and side effects?

Your provider may prescribe medicines to help manage your symptoms or side effects of treatment. A palliative care specialist or dietitian can help you manage pain or other symptoms and improve your quality of life during treatment.

Prevention of Long Cancer-

How can I prevent lung cancer?

Since we don’t know for sure what causes most cancers, the only preventive measures are focused on reducing your risk. Some ways to reduce your risk include:

1. Don’t smoke or quit smoking if you do. Your risk of lung cancer begins to decline within five years of quitting.

2 .Avoid secondhand smoke and other substances that can harm your lungs.

3. Eat a healthy diet and maintain a weight that is healthy for you. Some studies suggest that eating more fruits and vegetables (two to six and a half cups per day) may help reduce the risk of cancer.

4. Get screened for lung cancer if you are at high risk.

Lung cancer screening-

You can increase your chances of catching cancer in its early stages with screening tests. You are eligible for lung cancer screening if you meet all of these requirements:

Your age is between 50 to 80.
You are either a current smoker or have quit smoking in the last 15 years.
You have a 20 pack-year smoking history (the number of years you smoked times the number of packs of cigarettes per day).
Ask your provider about the benefits and risks of annual screening.

Long Cancer Prognosis-

What can I expect if I have lung cancer?

What to expect after a diagnosis of lung cancer depends on several factors. For some people with early-stage cancer, your provider will remove the cancer and you will need follow-up checks for several years. For many others, it is a process that develops over time. This may mean trying one type of treatment until it stops being effective, then moving on to another type.

Does lung cancer spread fast?

How fast lung cancer spreads depends on its type. Among the main types, small cell lung cancer tends to spread more quickly than non-small cell lung cancer. By the time lung cancer is diagnosed, it may have started to spread to lymph nodes or other organs.

Can lung cancer be cured?

Some types of lung cancer may be considered curable if they are diagnosed before they have spread, although experts often do not use the term “curable” to describe the cancer. More common terms are “remission” or “no evidence of disease” (NED). If you have been in remission or NED for five years or more, you can be considered cured. There is always a small chance that the cancer cells may return.

What is the survival rate for lung cancer?

Lung cancer survival rates depend largely on how far the cancer has spread when it is diagnosed, how it responds to treatment, your overall health, and other factors. For example, for small tumors that have not spread to the lymph nodes, the survival rate is 90% for tumors that are smaller than 1 cm, 85% for tumors between 1 and 2 cm, and 2 and 3. 80% for intermediate tumours. cm.

The relative five-year survival rate for lung cancer diagnosed at any stage is 22.9%. How much cancer has spread is the five-year relative survival rate:

61.2% for cancer (64% for NSCLC, 29% for SCLC) that is confined to one lung (localized).

33.5% for cancer spread to the lymph nodes (regional) (37% for NSCLC, 18% for SCLC).

7% for cancer spread to other organs (distant) (26% for NSCLC, 3% for SCLC).

Remember that these numbers don’t take into account the specific details of your diagnosis and treatment. Thanks to improvements in detection and treatment, the death rate from lung cancer has decreased rapidly in recent years.

What is meant by relative survival rate?

Your healthcare provider may share five-year survival rates as a way to explain how your lung cancer may affect your health five years after diagnosis. These numbers compare the survival rate of someone with lung cancer to someone of the same age in the general population.

Living with lung cancer-

How do I take care of myself?

Self-care is an important part of cancer care. Some ways you can take care of yourself while you are receiving treatment or recovering from it include:

1. Bring a friend or family member with you to appointments if you can. They can help you keep track of the information and choices your provider gives you.

2. Plan in advance for how you will feel in the days following your treatment. This may include asking for extra help, preparing meals ahead of time, or making sure your schedule is light.

3. Asking your provider about getting proper nutrition, even if you don’t feel well. Drink plenty of fluids to stay hydrated. Exercise if you can and as recommended by your provider.

4. Having important phone numbers at hand. There are many providers you can look at and it is useful to know who to contact when problems arise.

5. Consider joining a local or online support group. Being around other people who you are can help you gain perspective and know what to expect.

6. If you have completed treatment, support and self-care can still play an important role in moving forward. Don’t hesitate to reach out for help or guidance. Make sure you follow up with your provider as recommended.

When should I see my doctor?

Contact your provider if you have any symptoms that worry you. If you smoke or used to smoke, ask your provider about lung cancer screening.

What questions should I ask my doctor?

1. What are my treatment options?

2. What is the best way to take care of yourself at home?

3. How will be the treatment?

4. What are my next steps?

5. What are the important numbers for emergencies?

6.Which side effects should I call you about?

7. When should I go to the ER?

A diagnosis of lung cancer can bring with it a flood of different emotions. Sometimes the amount of new information can be overwhelming. An important thing to remember is that statistics cannot tell you what your treatment will be like or what decisions are right for your specific situation.

The help of trusted loved ones or a support group can help you consider your options and voice your preferences. Cancer treatment is often a process, and taking care of yourself is one of the most important parts of it.

Disclaimer – This article has been written for educational purpose. There is no alternative to cure any disease, so if you have any symptoms related to lung cancer, consult a doctor.

Lung Cancer- Causes, Symptoms and Treatment