Updated 3 August 2023 | Approved By Dr. Umberto Russo
What is Lung Cancer?Lung cancer is a serious disease that begins when abnormal cells grow uncontrollably in the lungs . These abnormal cells can form tumours and interfere with the lung's ability to function properly. There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Early detection and lifestyle changes can play a crucial role in preventing and treating this condition.
What is Non-Small Cell Lung Cancer?Non-small cell lung cancer (NSCLC) is a type of lung cancer that originates from abnormal cell growth in the lungs. Unlike small-cell lung cancer, NSCLC tends to grow and spread at a slower rate. It is the most common form of lung cancer, accounting for about 85% of all cases .
What is Small Cell Lung Cancer?Small-cell lung cancer (SCLC) is another type of lung cancer that develops from abnormal cells in the lungs. It is less common than non-small-cell lung cancer but tends to grow and spread at a faster rate. SCLC is strongly associated with smoking, and it is rare among non-smokers . This aggressive form of lung cancer is characterised by the rapid formation of tumours that can quickly spread to other parts of the body, making early detection critical for better treatment outcomes.
Signs and Symptoms Lung CancerIt's essential to note that the following symptoms can be caused by various conditions, and having one or more of them does not necessarily mean a person has lung cancer. Common signs and symptoms of lung cancer may include:
- Persistent cough that doesn't go away or worsens over time.
- Shortness of breath or a feeling of breathlessness, even with mild physical activity.
- Chest pain that is often worsened by deep breathing, coughing, or laughing.
- Coughing up blood
- A sudden and unexplained loss of weight.
- A general feeling of tiredness and weakness that doesn't improve with rest.
- A persistent hoarse or raspy voice that doesn't resolve within a few weeks
- Frequent infections like bronchitis or pneumonia, especially if they don't respond to treatment as expected.
Lung Cancer CausesThe most common cause of lung cancer is smoking tobacco, like cigarettes and cigars . When people smoke, the harmful substances can change the cells in the lungs and cause abnormal growth. Lung cancer can also occur in people who have never smoked. Other causes of lung cancer include:
- Being around secondhand smoke
- Working with dangerous materials like asbestos or other chemicals.
- Living in places with high air pollution or exposure to a gas called radon.
- Having a family history of lung cancer
- A side effect of radiotherapy.
Lung Cancer Diagnosis and AssessmentWhen it comes to diagnosing various health conditions, including lung cancer, doctors use different assessments or tests to gather important information . These assessments help them understand a person's symptoms and determine the underlying cause of their health problems. For diagnosing lung cancer, some common assessments include:
General Practitioner (GP) ConsultationThe process often begins with a visit to a GP if someone experiences symptoms such as a persistent cough, chest pain, or difficulty breathing. GPs play a crucial role in conducting initial assessments, discussing medical histories, and conducting physical examinations.
Referral to a SpecialistIf the GP suspects a potential issue related to the lungs, they may refer the patient to a respiratory specialist or an oncologist for further evaluation and testing.
Imaging TestsDoctors may order imaging tests such as X-rays, CT scans, or PET scans to examine the lungs and nearby areas for any abnormalities or signs of cancer.
Biopsy and Tissue AnalysisIf imaging tests reveal suspicious findings, a biopsy is performed by collecting a tissue sample for laboratory analysis. Pathologists examine the tissue under a microscope to confirm the presence of cancer and identify its type.
Molecular Testing and Biomarker AnalysisBiomarkers are specific substances or molecules present in the body that can indicate the presence of a disease, predict its behaviour, or indicate how the body responds to treatment. Tests can be performed to determine the presence of these molecules and biomarkers, including EGPR, ALK, PD-L1, and ROS-1 .
Lung Cancer TreatmentLung cancer treatments aim to target and remove cancer cells from the lungs to improve respiratory and overall health. There are several types of treatments available , and often a combination of treatments may be necessary. Examples of common lung cancer treatments include:
SurgerySurgery involves removing the tumour and, in some cases, nearby lymph nodes to eliminate cancer cells from the lungs. It is often an option for early-stage non-small cell lung cancer if the tumour is confined to the lungs and has not spread extensively.
Radiation TherapyRadiation therapy uses high-energy beams to target and destroy cancer cells. It can be used as the main treatment for early-stage lung cancer or alongside surgery to shrink tumours before the operation. For advanced cases, radiation therapy can help alleviate symptoms and improve quality of life.
ChemotherapyChemotherapy involves the use of powerful drugs to kill cancer cells or stop their growth. It is often administered through an intravenous infusion or oral medication. Chemotherapy is used for both small cell lung cancer (SCLC) and advanced NSCLC. In some cases, it can be combined with other treatments.
Targeted TherapyTargeted therapies are drugs designed to specifically target certain genetic mutations or biomarkers present in cancer cells. They are effective against certain types of NSCLC with specific genetic alterations, and they have fewer side effects compared to traditional chemotherapy.
ImmunotherapyImmunotherapy drugs help the body's immune system recognise and attack cancer cells. They can be beneficial in treating some cases of advanced NSCLC.
Combination TherapyFor advanced lung cancer, doctors often use a combination of treatments, such as chemotherapy with immunotherapy or targeted therapy with radiation, to maximise the chances of success and improve patient health.
Lung Cancer ComplicationsLung cancer can lead to various complications that affect your health and wellbeing. These complications can arise due to the tumour's growth, its spread to other parts of the body, or the side effects of cancer treatments. Here's a brief overview of some common lung cancer complications :
- Breathing problems such as shortness of breath and wheezing.
- Cancer-related pain can occur in the chest, back, or other parts of the body where the cancer has spread.
- Coughing and coughing up blood due to bleeding within the airways.
- Infections like pneumonia or bronchitis due to having a weakened immune system.
- Unintended weight loss and persistent fatigue.
- If lung cancer spreads to the bones, it can cause bone pain and increase the risk of fractures.
- Headaches, seizures, or neurological deficits, especially in advanced lung cancers that spread to the brain.
- Blood clots, which can be dangerous if they travel to the lungs (pulmonary embolism) or other parts of the body.
- Side effects of treatments chemotherapy and radiation therapy can cause side effects such as nausea, hair loss, and fatigue.
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