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Lung Cancer Causes Symptoms Diagnosis Treatment

Lung Cancer Causes Symptoms Diagnosis Treatment

Posted By HealthcareOnTime Team Posted on 2022-01-26

Cancer has emerged as the most dreaded ailment in recent times and is one of the major causative factors for mortality worldover. In spite of developments and continuous research for determining the causative factor, efficient treatment strategies and classification of cancer, the death toll still remains high. There are more than 200 types of cancers which have been known to affect more than 60 different sites in the human body. Few of these like cancer of the breast cancer, lung cancer, colon, colorectal, blood, etc. have been documented to have a higher prevalence. Lung cancer is the third most prevalent type in men and women and the most common cause of cancer deaths worldwide.

Lung Cancer Causes Symptoms Diagnosis Treatment

Let us understand lung cancer in more detail including its types, symptoms, diagnosis and current treatment modalities available.

Lung cancer Overview
Cancer or neoplasm is defined as an uncontrolled cellular growth. They can be broadly classified depending on the site of growth as lung cancer, oral cancer breast cancer, cervical cancer, etc. They can also be classified on the basis of cell of origin as squamous cell carcinoma or adenocarcinoma. There are two types of lung cancers or carcinomas (cancer that begins in the skin or in any tissue that line or cover the internal organs) viz. Small cell lung cancer and non- small cell lung cancer. If not treated immediately these cancer cells can metastasise i.e. migrate to the nearby tissues and start multiplying

Small cell lung cancer (SCLC) About 10-15% of the lung cancers belong to this type and it usually occurs in or around the bronchi, hence is centrally located. It is an aggressive tumour that can spread to other parts of the body. These cells look small and have oval nuclei with characteristic salt and pepper chromatin, when observed under microscope. Small cell lung cancer may be solely composed of the typical small neuroendocrine cells or may be combined with some other non-small cell component (combined small cell cancer).

Non-small cell lung cancer (NSCLC) These are more common than SCLC and account for about 85-95% of all lung cancers. These are further subclassified on the basis of predominant cell type in the tumour tissue, identified by microscopic examination. There are three types of non-small cell lung cancer viz. squamous cell carcinoma, large cell carcinoma and adenocarcinoma.

Squamous cell carcinoma About 25-30% of NSCLC are squamous cell carcinomas. This type of cancer originates due to metaplasia in the epithelial lining of the airways and is connected to the history of Smoking.

Adenocarcinoma About 40% of NSCLC are adenocarcinomas which begin in the mucous secreting cells lining the air sacs and hence are usually peripherally located. Men seem to be more affected than women and the incidence is higher among the younger age groups. This type of cancer grows very slowly than any other type. They are more commonly found in non-smokers and are the most which ultimately leads to the development of cancer. common subtype of primary tumours in women.

Large cell carcinoma This subtype forms 10-15% of all primary tumours in lung and it can occur in any part of the organ. It has the ability to grow at a faster rate and hence it may become difficult to treat. It is an aggressive, undifferentiated tumour which has lost all resemblance to the cell of origin.

Causes / risk factors for lung cancer
Smoking is considered to be one of the most important causes of lung cancer. It is considered to be the most important etiological factor for the development of squamous cell carcinoma. However, because of changes in smoking patterns due to awareness created by electronic media, adenocarcinoma has replaced squamous cell carcinoma as the most common primary lung tumour in recent years. To understand further about the pathogenesis of lung cancer, let's understand some of the risk factors for development of lung cancer

Smoking is the 1st cause of cancer
Cigarette smoke is composed of many hazardous substances which have the ability to bind to DNA of the cells, thereby hampering their normal functioning ultimately leading to cancer. The four main causative agents include benzene, polonium-210 (absorbed in tobacco leaves from soil), benzo-(a)-Pyrene and nitrosamines. Apart from these, cigarette smoke also contains certain heavy metals like chromium which enhances the binding ability of benzo-(a)-pyrene, arsenic and nickel interfere in the DNA repair pathway on immune system which encourages the growth of cancer cells. It takes many years or even decades of smoking to cause cancer as the body's immune system tries its best to cope up with the effects of toxic chemicals entering your body each time you smoke . But continuous smoking for many years may eventually lead to developments of lung cancer

Passive smokers Researchers have shown that passive smokers also have 24% increased chances of developing lung cancer as compared to non-smokers.

Asbestos fibers Asbestos fibers are silicate fibers which have the ability of persisting in the lung tissue for lifetime and generally enter through inhalation. Asbestos is generally used in thermal and acoustic insulation material and exposure is associated mainly with occupational hazard. BANI (Ban Asbestos Network of India) is a network which includes a group of scientists, public health researchers, doctors, trade union activists and many more who have succeeded in drawing attention of people towards the hazardous affects of asbestos on the environment as well as human health.

Others Apart from the above mentioned causes or risk factors, radon gas (that is released when uranium decays) and air pollution (due to carcinogenic fumes released from vehicles) also increase the chances of lung cancer.

Symptoms of lung cancer
- Persistent cough for 2-3 weeks
- Blood in sputum
- Persistent chest infection
- Persistent breathlessness
- Pain when breathing or coughing
- Shortness of breath

Diagnosis of lung cancer
On visit to a clinic with the above symptoms, a detailed chest examination is done by the physician to identify the site of the lesion and detect the presence of concomitant pleural effusion. Blood tests is also suggested if infection in the chest is suspected as a differential diagnosis.

- X-ray is done as a preliminary test followed by CT scan (Computerised Tomography) for confirmation.

- In case of a positive CT scan, a biopsy is also done using a bronchoscope. Bronchoscopy is a technique which involves use of a tube inserted in the lungs either through mouth or nose and the tumour cells or fluid is taken for further examination.

- In addition to the above tests, tumour markers like CEA, CYFRA 21-1, NSE can also be used for diagnosis and follow-up of lung cancers.

PET-CT (Positron Emission Tomography) scan is done for initial staging in patients with NSCLC and selected patients with SCLC or for characterisation of an indeterminate pulmonary nodule which is at least 8-10 mm in diameter. In PET-CT scan, a radioactive material is injected in the body which binds to the cancer cells and helps to determine a detailed information on the type of tumour i.e benign or malignant, stage of the cancer, etc.

There are different types of treatment modalities available for lung cancer which include surgery, radiation, chemotherapy, etc. The type of treatment depends upon the stage of cancer.

Surgery It is used in the initial stages of the cancer when the tumour mass is restricted to a particular lobe of lung and has not spread to neighbouring regions or to distant sites. The entire tumour is surgically removed from the site along with the surrounding lymph nodes. There are different types of surgeries

- Lobectomy: Lungs are composed of 3 lobes on the right side and 2 on the left. In this surgery, the entire tumour containing lobe is removed.
- Wedge resection: If removal of lobe is not possible then the tumour surrounded by the margin of normal lung is removed.
- Segmentectomy: Lung is further subdivided into broncho pulmonary segments based on the branching of bronchus and the vascular supply. Segmentectomy involves removal of the involved segment of the lung. However, this minimal resection surgery can only be done if the tumour size is very small.
- Pneumonectomy: The entire lung is removed wherein the cancer has developed.

Radiation therapy Radiation therapy is a highly targeted and effective way of cancer treatment. The commonly used method is external beam radiation therapy where radiation is given from outside of the body. This therapy is also effective in the initial stages. Sometimes CT scan is used to identify the exact location of cancer cells in order to minimise damage to the normal cells.

Chemotherapy Chemotherapy is a treatment mode involving use of drugs. Medication is given either intravenously or orally depending on the stage of cancer. The only draw back of chemotherapy is, it has many side effects like hairloss, fever, bone marrow suppression, etc.

Targeted therapy Proteins or specific genes of the DNA of cancerous cells are targeted in this therapy. Nanotechnology is playing a key role nowadays wherein the anti-cancer drugs are loaded in nano particles and injected into the body. These bind to the targeted site and release the drug, thus causing targeted destruction of cancerous cells.

Prognosis and prevention of lung cancer
Whenever a person is diagnosed with lung cancer, the 1" question that comes in mind is prognosis of cancer and whether its curable. However, prognosis depends upon the stage of cancer at the time of presentation. If lung cancer is diagnosed in the early stage then the chances of survival increases. And with the availability and use of multimodality therapies as explained above, the chances of survival may further increase. But if the cancer is diagnosed at a later stage, when it has metastasised to other part of the body, then the 5 year survival rate drops down to just 4%.

As prevention is always better than cure, it is always better to know the risk factors that can lead to lung cancer and take preventive steps which include:
Stop smoking
Ban smoking in public spaces to reduce exposure to second hand smoke.
Healthy diet (low fat, high fiber, fresh fruits, vegetables, whole grain)
Exercise: Daily moderate-intensity aerobic activity reduces lung cancer risk.
Finally, the most important, try to keep your environment free from pollution.


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