Lung cancer, Respiratory disorder, Smoking, Lungs

Description :   Lung cancer is a cancer that affects your lungs. The lungs are responsible for gaseous exchange-

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What is lung cancer?

Lung cancer is a cancer that affects your lungs.  The lungs are responsible for gaseous exchange- when you breathe in you take in oxygen and when you breathe out you take out carbon dioxide. 

85% of lung cancer is due to non-small cell lung cancer.  In the United States, lung cancer is the second most common cancer and the most common cause of cancer deaths.  By 2020, the American Cancer Society projects that around 228, 000 people will be affected by lung cancer.  In addition, the lung cancer death rate is higher in men than women.  Furthermore, it most commonly occurs in people aged between 50 to 70 years.

What are the risk factors for lung cancer?

The risk factors for lung cancer include:

• Smoking: your risk of developing lung cancer increases with the number of cigarettes you smoked per day and the number of years you have been smoking.  Smoking cessation at any age significantly reduces your risk of developing lung cancer.
• Passive smoking: being exposed to second-hand smoke, even if you do not smoke cigarettes yourself, can increase your risk of developing lung cancer.
• Family history of lung cancer: having a parent or sibling with lung cancer increases your risk of developing lung cancer.
• Previous radiation therapy: if you have done radiation therapy to the chest previously, you are at an increased risk of developing lung cancer.
• Asbestos exposure: being exposed to asbestos, which can found at some workplace, can increase your risk of developing lung cancer.
• Radon gas exposure: radon gas is a naturally existing radioactive gas and being exposed to an elevated level of the gas can increase your risk of developing lung cancer.  Radon gas is produced during the breakdown of uranium in soil, rocks and water that eventually evaporates into the air.
• Other carcinogenic substances: arsenic, cadmium, nickel, chromium and uranium amongst others can increase your risk of developing lung cancer.

What are the signs and symptoms of lung cancer?

Early stages of lung cancer does not result in any symptoms.  However, as the cancer continues to grow, the following signs and symptoms may ensue:

• A persistent cough that remains after 2-3 weeks and worsens progressively.
• Coughing up blood (haemoptysis).
• Recurrent chest infections.
• Pain during deep breathing and coughing.
• Persistent shortness of breath.
• Lack of energy.
• Unintentional weight loss.
• Loss of appetite.
• Hoarseness of voice.
• Finger clubbing- your finger nails become more curved.

Making a diagnosis

After taking a detailed history from you to know more about your symptoms, your doctor will perform a physical examination to look for signs of lung cancer.  In addition, several tests can be used to confirm the diagnosis and these include:

• Chest x-ray: this is usually the first test that is used to confirm the diagnosis of lung cancer.  The cancer may be seen as a white-grey opaque mass.  However, this test cannot be used to get a definitive diagnosis as it cannot differentiate between lung cancer and lung abscess- a collection of pus within the lungs.
• Contrast-enhanced computed tomography (CT) scan: before the CT scan is taken, your doctor will give you an injection containing a dye which will improve the quality of the image.  The CT scan provides a detailed image of your lungs and will detect with precision any mass within your lungs.
• Positron Emission Tomography- CT scan (PET-CT scan): if the previous CT scan shows early stage lung cancer, the PET-CT scan can localise the active cancer cells. A radioactive substance is injected for better imaging.  The PET-CT scan will be used to confirm the diagnosis and guide the treatment strategy.
• Bronchoscopy and biopsy: if after the CT scan a mass is seen in the central part of your lungs, endoscopy might be an option.  This technique allows your doctor to directly visualize the mass and take a few samples to be sent for laboratory investigations.  The samples are analysed using a microscope to confirm the diagnosis of lung cancer and stage it.
• Percutaneous needle biopsy: before introducing a needle to reach the lung mass, local anaesthesia is used to numb your skin.  A CT scanner is used as a guide to reach the mass.

What are the treatments for lung cancer?

There are several treatment strategies available for lung cancer.  To decide which type of treatment will be used, your doctor will assess the type, size, position, and stage of the lung cancer plus your overall health. The treatment strategies of lung cancer include:

• Surgery: there are different types of surgeries which can be performed such as wedge resection, segmental resection, lobectomy and pneumonectomy.  Wedge resection is the removal of a small section of your lung along with some healthy tissues at the margins.  Segmental resection    Read more