LUNG CANCER
Overview
Lung cancer is a cancer that involves the lung. Your lungs are two spongy organs in your chest that take in oxygen and release carbon dioxide when you breathe in and out.
Lung cancer is the most common cancer that kills people around the world. Lung cancer is most common in smokers, but it can also affect people who have never smoked. You can significantly reduce your chances of developing lung cancer if you quit smoking, even if you've been smoking for a long time.
Signs and Symptoms
In the early stages of lung cancer, there are usually no signs or symptoms. Lung cancer signs and symptoms usually appear when the disease has progressed.
The following are some of the signs and symptoms of lung cancer:
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A new cough cough that produces blood, even if it's only a small amount. Lung cancer can cause bleeding in the airway, resulting in blood in your cough (haemoptysis). Bleeding can become severe at times.
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Shortness of breath is one of the complications of lung cancer-Shortness of breath can occur in people with lung cancer if the cancer has progressed to the point where it has blocked the major airways. Fluid can build up around the lungs as a result of lung cancer(pleural effusion), making it difficult for the affected lung to fully expand when you inhale.
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Pain due to metastasis- Pain can be caused by advanced lung cancer that has spread to the lining of the lung leading to chest pain or to another part of the body, such as a bone. Depending on which organ is affected, cancer spread can cause pain, nausea, headaches, or other signs and symptoms. Lung cancer that has spread beyond the lungs is usually incurable. Treatments are available to help you live longer by reducing signs and symptoms.
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Hoarseness
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Weight loss without effort
When should you see a doctor?
If you have persistent signs or symptoms that are concerning you should schedule an appointment with your doctor.
Make an appointment with your doctor if you have been unable to quit smoking. Counselling, medications, and nicotine replacement products are all options that your doctor can suggest to help you quit smoking.
Reasons for this :
The majority of lung cancers are caused by smoking, which affects both smokers and those who are exposed to passive smoke. Lung cancer can also attack people who have never smoked. There may be no obvious cause of lung cancer in these cases.
Lung cancer is caused by smoking:
Smoking, according to doctors, causes lung cancer by harming the cells that line the lungs. When you inhale cigarette smoke, which is high in carcinogens, changes in lung tissue occur almost instantly.
Your body may be able to repair the damage at first. However, the normal cells that line your lungs become increasingly damaged with each exposure. The damage causes cells to behave abnormally over time, and cancer may develop as a result.
Types of lung cancer:
On the basis of the appearance of lung cancer cells under the microscope, lung cancer is divided. Your doctor will determine your treatment options based on the type of lung cancer you have. Lung cancer can be divided into two types:
a) Small cell lung cancer is less common than non-small cell lung cancer and occurs almost exclusively in heavy smokers.
b) Non-small cell lung cancer (NSCLC) is a catch-all term for a variety of lung cancers. Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are examples of non-small cell lung cancer.
Risk Factors:
Lung cancer can occur and be caused by a number of factors, including:
1)Smoking -The number of cigarettes you smoke per day and the number of years you've smoked increase your risk of lung cancer. Quitting smoking at any age reduces your chances of developing lung cancer significantly.
2)Inhalation of passive smoke. Even if you don't smoke, being exposed to passive smoke increases your risk of lung cancer.
3)Radiation therapy has been used in the past. You may be at a higher risk of developing lung cancer if you've had chest radiation therapy for another type of cancer.
4)Asbestos and other carcinogens exposure Workplace exposure to asbestos and other cancer-causing substances, such as arsenic, chromium, and nickel, can raise your risk of lung cancer, especially if you smoke.
5)Lung cancer runs in the family. Lung cancer is more likely in people who have a parent, sibling, or child who has the disease.
Preventive Measures
Quit smoking. Now is the time to quit smoking. Even if you've smoked for years, quitting reduces your risk of lung cancer. Consult your doctor about strategies and quit-smoking aids that can assist you in quitting smoking. Nicotine replacement products, medications, and support groups are all options.
Avoid passive smoking - You live or work with someone who smokes, encouraging them to quit. Request that such a person should smoke outside at the very least. Avoid places where people smoke, such as bars and restaurants, and look for places that are smoke-free.
At work, stay away from carcinogens. Protect yourself from toxic chemicals. Observe your employer's safety precautions. Inquire with your doctor about additional steps you can take to protect yourself at work. If you smoke, your risk of lung damage from workplace carcinogens increases.
Consuming a healthy diet which is rich in fruits and vegetables. Choose a nutritious diet that includes a wide variety of fruits and vegetables. Vitamin and nutrient sources from food are the best. Large doses of vitamins in pill form should be avoided because they can be harmful. For example, to reduce the risk of lung cancer in heavy smokers, researchers gave them beta carotene supplements. The supplements actually increased the risk of cancer in smokers, according to the findings.
Most days of the week, exercise. Start slowly if you haven't been exercising regularly.
Lungs Cancer Screening :
People who are at a higher risk of lung cancer should consider getting a low-dose CT scan every year. Lung cancer screening is usually offered to older adults who have smoked heavily for a long time or who have quit smoking within the last 15 years.
Consult your doctor about your lung cancer risk. Your doctor can decide if lung cancer screening is right for you.
Lung cancer diagnostic tests :
If your doctor suspects you have lung cancer, he or she can order a series of tests to look for cancerous cells and rule out other possibilities.
The following tests may be performed:
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Imaging examinations. An abnormal mass or nodule in your lungs may be revealed by an X-ray image. A CT scan of your lungs can reveal small lesions that aren't visible on an X-ray.
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Cytology of sputum - Looking at sputum under a microscope can sometimes reveal the presence of lung cancer cells if you have a cough and are producing sputum.
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A sample of tissue (biopsy). A biopsy is a procedure that removes a sample of abnormal cells. Your doctor can perform a biopsy in a variety of ways, including bronchoscopy, which involves passing a lighted tube down your throat and into your lungs to examine abnormal areas of your lungs.
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Another option is mediastinoscopy, which involves making an incision at the base of your neck and inserting surgical tools behind your breastbone to take tissue samples from lymph nodes.
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Another option is a needle biopsy, in which your doctor guides a needle through your chest wall and into lung tissue to collect suspicious cells using CT images.
A biopsy sample from lymph nodes or other areas where cancer has spread, such as your liver, may also be taken.
The type of lung cancer you have will be determined by a careful analysis of your cancer cells in a lab. The results of advanced testing can tell your doctor about the specific characteristics of your cells, which can help your doctor determine your prognosis and treatment plan.
Tests to determine the cancer's extent
Your doctor will work to determine the extent (stage) of your lung cancer once it has been diagnosed. The stage of your cancer aids you and your doctor in determining the best treatment option.
Imaging procedures may be used as part of your staging tests to look for signs that your cancer has spread beyond your lungs. CT scans, MRI scans, PET scans, and bone scans are among the tests available. Because not every test is right for everyone, talk to your doctor about which procedures are right for you.
Lung cancer stages are designated by Roman numerals ranging from 0 to IV, with the lowest stages indicating cancer that is limited to the lungs. By stage IV, the cancer has spread to other parts of the body and is considered advanced.
Medications:
Your doctor and you will decide on a cancer treatment plan based on a variety of factors, including your overall health, the type and stage of your cancer, and your personal preferences.
1) Surgery -Your surgeon will remove the lung cancer as well as a margin of healthy tissue during surgery. The following procedures can be used to remove lung cancer:
- Wedge resection - removes a small section of lung with the tumour and a margin of healthy tissue;
- Segmental resection - removes a larger portion of lung but not an entire lobe;
- Lobectomy- removes an entire lobe of one lung; and
- Pneumonectomy- removes an entire lung.
If you have surgery, your surgeon may remove lymph nodes from your chest to examine them for cancer signs.
If your cancer is limited to your lungs, surgery may be an option. If you have a more advanced lung cancer, your doctor may suggest chemotherapy or radiation therapy before surgery to help the cancer shrink. Your doctor may recommend chemotherapy or radiation therapy after surgery if there's a chance cancer cells were left behind after surgery or if your cancer may recur.
2) Radiation therapy- is a type of treatment that uses high-powered energy beams from sources such as X-rays and protons.
Radiation may be used before or after surgery for people with locally advanced lung cancer. It's frequently used in conjunction with chemotherapy. If surgery isn't an option, your primary treatment may be a combination of chemotherapy and radiation therapy.
Radiation therapy may help relieve symptoms such as pain in advanced lung cancers and those that have spread to other parts of the body.
Stereotactic body radiotherapy(SBRT), also known as radiosurgery, is a high-intensity radiation treatment that targets the cancer with multiple beams of radiation from various angles. Treatment with stereotactic body radiotherapy is usually completed in one or a few sessions.
For people with small lung cancers who are unable to undergo surgery, stereotactic body radiotherapy may be an option. It could also be used to treat lung cancer that has spread to other organs, such as the brain.
3) Chemotherapy - treatment that uses drugs to kill cancer cells. Chemotherapy drugs can be given intravenously (through a vein in your arm) or taken orally. A combination of drugs is usually administered in a series of treatments over weeks or months, with breaks in between to allow you to recover.
Chemotherapy can also be used to shrink cancers and make them easier to remove before surgery.
Chemotherapy can be used to relieve pain and other symptoms in people with advanced lung cancer.
Drug therapy with a specific goal
4) Targeted drug treatments - These are designed to target specific abnormalities found in cancer cells. Targeted drug treatments can kill cancer cells by blocking these abnormalities.
Lung cancer is treated with a variety of targeted therapy drugs, the majority of which are reserved for people with advanced or recurrent cancer.
Some targeted therapies are only effective in patients with cancer cells that have specific genetic mutations.
5) Immunotherapy - is a type of cancer treatment that makes use of your immune system. Because cancer cells produce proteins that help them hide from immune system cells, your body's disease-fighting immune system may not attack your cancer. Immunotherapy works by interfering with the immune system's natural processes.
Immunotherapy is typically reserved for people who have locally advanced lung cancer or cancer that has spread to other parts of the body.
Afatinib (Gilotrif), dacomitinib (Vizimpro), erlotinib (Tarceva), necitumumab (Portrazza), and osimertinib (Tagrisso), as well as bevacizumab (Avastin) and ramucirumab (Cyramza), which target the tumour blood supply, have shown significant activity in helping to control advanced lung cancer. Gefitinib (Iressa), a targeted therapy for tumours with specific EGFR mutations, has been approved to treat metastatic NSCLC.
Immunotherapy drugs such as atezolizumab (Tecentriq), durvalumab (Imfinzi), nivolumab (Opdivo), and pembrolizumab (Keytruda) block a protein that prevents the body from fighting cancer. Every 2-3 weeks, these drugs are administered via IV infusion.
Alectinib (Alecensa), brigatinib (Alunbrig), ceritinib (Zykadia), crizotinib (Xalkori), and lorlatinib (Lorbrena) have been discovered to target a specific molecule, an ALK gene rearrangement, which is seen in some lung cancers. In tumours with changes in the BRAF gene, dabrafenib (Tafinlar) and trametinib (Mekinist) target specific proteins.
Palliative care is a type of hospice care.
Lung cancer patients frequently experience signs and symptoms of the disease, as well as treatment side effects. Supportive care, also known as palliative care, is a medical specialty that entails collaborating with a doctor to reduce your signs and symptoms.
Your doctor may provide his opinion and recommendation that you should meet with a palliative care team soon after your diagnosis to ensure that you're comfortable during and after your cancer treatment.
Lifestyle and Home Remedies
Many people with lung cancer experience shortness of breath at some point in the course of the disease. Treatments such as supplemental oxygen and medications are available to help you feel more comfortable, but they aren't always enough.
● Try to relax. Feeling short of breath can be scary. But fear and anxiety only make it harder to breathe. When you feel short of breath, try to manage the fear by choosing an activity that helps you relax. Listen to music, imagine your favourite vacation spot, meditate or say a prayer.
● Find a comfortable position which may help you lean forward when you feel short of breath.
● Focus on your breath. When you feel short of breath, focus your mind on your breathing. Instead of trying to fill your lungs with air, concentrate on moving the muscles that control your diaphragm. Try breathing through pursed lips and pacing your breaths with your activity.
● Save your energy for what's important. If you're short of breath, you may become tired easily. Cut out the nonessential tasks from your day so that you can save your energy for what needs to be done.
Tell your doctor if you experience shortness of breath or if your symptoms worsen, as there are many other treatments available to relieve shortness of breath.