Lung Cancer

What is Lung Cancer?

Lungs are spongy organs inside the chest that are responsible to inhale oxygen and exhale carbon dioxide. A lung cancer starts from the lungs and is known to cause the most number of cancer related deaths when compared to any other form of cancer. It may happen in both men and women, especially among those who smoke on a regular basis. The risks of lung cancer can be decreased significantly even if a person stops smoking after years of regular smoking.

Comparison between healthy lung and cancer lung on difference background. lung cancer ( film x-ray of chest pa upright : show pleural effusion at left lung due to lung cancer )

Types of Lung Cancer

Non-Small Cell Lung Cancer (NSCLC):

Characteristics	Carcinoid tumors
It accounts for almost 80-85% Lung Cancer Cases Starts & grows much slowly than SCLC Different kinds of NSCLC (arranged from slowest to fastest to develop) are: Adenocarcinoma (30% cases) Squamous cell carcinoma (30% cases) Large cell carcinoma (9% cases) Large cell neuroendocrine tumors (2% cases)	Lungs but hasn’t spread to other parts of the body Lungs & connected lymph nodes Lungs & lymph nodes at the center of the chest Found within the lymph nodes on the same side of the chest where cancer has developed initially Across lymph nodes on the opposite ends of the chest & the collarbone Across both the lungs & the surrounding areas. It further spreads to other distant organs of the body.

Small Cell Lung Cancer (SCLC):

Mesothelioma	Carcinoid tumors
Accounts for 15-20% cases of Lung Cancer Kind of Neuroendocrine Tumor* that comprises of smaller cells than most of the cancer cells Develops rapidly & spreads across other body parts	Limited: Found inside one of the lungs or lymph nodes on the same side of the chest Extensive: Spread to Across a single lung Both the lungs Lymph Nodes on opposite sides Fluid surrounding the lungs Bone Marrow Distant organs

Other Types of Lung Cancers

Mesothelioma	Carcinoid tumors
Occurs due to over exposure to asbestos A cancer on lining of the organs May also originate from abdomen, chest, and heart.	Another kind of Neuroendocrine Tumor* Divided in two types, typical & atypical Starts from hormone producing cells lining the lungs

*Neuroendocrine Tumor forms within the hormone-releasing cells that are responsible to deliver messages to the organs. This kind of tumor creates overabundance of the hormones and hence causes symptoms that are not often visible in other forms of cancer.

Lung Cancer Symptoms

The symptoms of both Non-Small Cell Lung Cancer & Small Cell Lung Cancer are same, which include:

Local Disease (Restricted to the Lungs)

1. Extended period of coughing (keeps on worsening with every passing day)
2. Coughing up blood or phlegm
3. Chest pain while breathing, coughing or even laughing
4. Feeling short of breath
5. Fatigue & constant weakness
6. Pneumonia

Locally Advanced Disease (Spread to tissues & lymph nodes)

1. Hoarseness inside the throat
2. Dysphagia (Difficulty to swallow food)
3. Wheezing
4. Pleural Effusion (Excess fluid in the lining of lungs)
5. Pericardial Effusion (Excess fluid in the lining of heart)

Distant Metastases (Spread to other body parts)

1. Stomach pain on the right side
2. Vomiting Tendency
3. Seizures
4. Nausea
5. Visual Disturbances
6. Bone Pain
7. Pale skin or eyes (mostly jaundice)

Other Lung Cancer Symptoms (Unrelated to the spread and far from the tumor)

1. Weight Loss & reduced appetite
2. Cancer Cachexia or Wasting Syndrome
3. Clubbing of fingers
4. Excessive calcium in the blood (Hypercalcemia)
5. Low RBC (Red Blood Cells) count or Anemia
6. Tumors might affect facial nerves causing drooping of the eyelids, lack of perspiration, and small pupil known as Horner syndrome.
7. Swelling of face, upper chest, arms or neck due to tumors pressing the a large vein

Causes of Lung Cancers

Smoking is regarded as the primary cause of Lung cancer. The risks are not only high for direct smokers (active smokers), but also among people who are exposed to secondhand smoke or passive smoke. Regular smoking damages the cells that line the lungs as it contains cancer causing substances like carcinogens. The human body is capable of repairing the damage only if the repeated exposers are stopped i.e. smoking (both active & passive). With time, the cells start behaving abnormally and eventually develop into cancer.

Tests & Diagnosis for Lung Cancer

Annual Computerized Tomography is usually recommended to employees by different organizations to look for any signs of lung cancer. This is considered mandatory at some organizations where there are increased chances of getting effected by lung cancer. An early detection can help in saving lives and studies have already shown the benefits associated with timely checkups.

Tests	Description
Imaging Tests	X-Ray image of the lungs portray abnormal nodule or mass. CT scans are also in cases where X-Ray reports fail to detect small lesions inside the lungs.
Sputum Cytology	Sputum produced during coughing is tested under the microscope revealing the presence of lung cancer cells.
Biopsy	Sample of Abnormal cells are removed and tested. Usually done by any of the following ways: Bronchoscopy: Abnormal areas of the lungs are examined by the use of lighted tubes passing through the throats Mediastinoscopy: Incision is made at the base of the neck followed by insertion of surgical tools behind the breastbone. Tissue samples are extracted from the lymph nodes Needle Biopsy: CT & X-Ray images guiding a needle through the chest wall and inside the lung tissue for collection suspicious cells.

Medical Treatments for Lung Cancer

The treatment plan of any patient is dependent on several factors, these include:

• Health Condition
• Type & Stage of the Cancer
• Preferences of the Patient

Usually when treating medically, doctors often adopt one or more of the following treatments:

• Surgery: Involves removal of the lung cancer along with a margin of healthy tissues. Options include Wedge resection (small part of the lung), Segmental resection (large chunk of the affected lung), Lobectomy (Entire lobe of the affected lung), and Pneumonectomy (Entire Lung).
• Chemotherapy: Doctors use drugs for killing the cancer cells. The drugs are given through the veins in the arms (intravenously) or orally. Different combination of drugs are given over a few weeks or even months with breaks in between. It helps in shirking the cancer and help in easier removal.
• Radiation Therapy: This process involves usage of high-powered energy beams through protons or X-Rays for killing the cancer cells. The therapy is directed towards the cancer from outside the body (External Beam Radiation). Doctors might also put inside the needles, catheters or seeds while pacing them over the cancer affected area (brachytherapy).
• Targeted Drug Therapy: Regarded as the latest form of cancer treatment, doctors target specific abnormalities inside the cancer cells. It is often offered by a combination of different chemotherapy drugs. Among the popular options included under this treatment are:

• 1. Afatinib
  2. Bevacizumab
  3. Ceritinib
  4. Crizotinib
  5. Erlotinib
  6. Nivolumab
  7. Ramucirumab

• • Palliative Care: A specialized area of medicine also known as supportive care involves working with the doctors for minimizing the signs and symptoms of lung cancer. This treatment is often recommended by the doctors after the diagnosis for ensuring that the patient is comfortable both during and post treatment period. It adopts curative treatment procedure instead of an aggressive treatment plan.

There are cases where the potential benefits of a particular treatment might get outweighed by the side-effects. In such cases doctors would often prefer against choosing that particular treatment option.

Prevention & Alternative Medicine

Most people complain about shortness of breath when diagnosed with lung cancer. Shortness of breath may trigger fear or anxiety. In such a scenario it is recommended that they try to adopt the following options:

• • Listen to music, talk to your loved ones, or meditate.
  • Move to a comfortable area
  • Move the muscles responsible to control the diaphragm and try breathing through pursed lips while pacing the breath with the activity
  • Eliminate any non-essential task from your daily routine that consumes a lot of energy

Although alternative medicine cannot cure lung cancer, it acts as a perfect complement to the undergoing medical treatment(s). They include:

• Acupuncture: It helps in relieving pain as well as easing the side effects associated with the cancer treatment. They include vomiting and nausea. It may not be useful for each and every patient and is definitely not recommended to patients having low blood counts.
• Hypnosis: A therapist puts the patient in a trance like state through some relaxation exercises while asking them to think about positive and pleasing things. It can help in reducing nausea, pain, and anxiety.
• Massage: It helps in relieving the anxiety levels among patients suffering from cancer. It is done by a therapist by applying pressure over the skin and muscles using his/her hands.
• Meditate: When a patient meditates, it involves focusing on an idea, sound or image. It helps n reducing stress levels and improving the quality of life of the cancer patients.
• Yoga: Known to combine gentle body movements coupled with deep breathing exercises, it includes a form of meditation. It facilitates better sleep to the patient and is considered pretty safe when a professionally trained instructor assists.

Cancer Statistics & Summary

Cancer signs, symptoms and management.