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Lung Cancer

Lung cancer is a type of cancer that begins in the lungs, often originating in the cells that line the air passages. It’s one of the most common and serious types of cancer, with two main types:

  1. Non-Small Cell Lung Cancer (NSCLC): The most common type, making up around 85% of lung cancers. It tends to grow and spread more slowly than small cell lung cancer.
  2. Small Cell Lung Cancer (SCLC): A rarer and more aggressive form that tends to spread rapidly to other parts of the body.

Symptoms of Lung Cancer:

Lung cancer can sometimes be asymptomatic in the early stages, but common signs and symptoms include:

  • Persistent cough (that doesn’t go away or worsens)
  • Coughing up blood or rust-colored sputum
  • Shortness of breath or wheezing
  • Chest pain or discomfort
  • Unexplained weight loss
  • Fatigue or feeling weak
  • Hoarseness
  • Recurring respiratory infections like pneumonia or bronchitis

Diagnosis of Lung Cancer:

Diagnosing lung cancer typically involves a series of tests to confirm the presence of cancer, its type, and its stage:

  1. Physical Exam and Medical History: Your doctor will review your medical history and perform a physical exam to check for signs of lung cancer.
  2. Imaging Tests:
    • Chest X-ray: Often the first step if lung cancer is suspected. It can detect abnormal growths or masses in the lungs.
    • CT Scan (Computed Tomography): Provides more detailed images of the lungs and helps to assess the size and location of tumors.
    • PET Scan (Positron Emission Tomography): Helps determine whether cancer has spread to other parts of the body.
  3. Biopsy: A tissue sample is taken from the lung tumor to confirm the diagnosis. This may be done through:
    • Bronchoscopy: A flexible tube is passed through the airways to collect tissue samples.
    • Needle Biopsy: A needle is inserted through the chest wall to take a sample from the tumor.
    • Surgical Biopsy: In some cases, surgery is necessary to remove a portion of the tumor for examination.
  4. Molecular Testing: If cancer is confirmed, molecular tests may be done on the tumor to identify specific mutations or genetic changes. This helps in deciding targeted therapies if appropriate.

Stages of Lung Cancer:

Lung cancer is staged based on its size, location, and whether it has spread to other parts of the body. The stages are:

  • Stage 0 (Carcinoma in situ): Very early stage where the cancer is confined to the lung lining.
  • Stage I: The tumor is small and localized to the lung.
  • Stage II and III: The tumor has spread to nearby lymph nodes or tissues but not to distant organs.
  • Stage IV: The cancer has spread to other parts of the body, like the brain, liver, or bones.

Treatment Options for Lung Cancer:

Treatment varies depending on the type, stage, and overall health of the patient. Common treatments include:

  1. Surgery: Surgery may be an option for early-stage lung cancer (usually NSCLC). The surgeon may remove a portion of the lung (lobectomy) or, in some cases, the entire lung (pneumonectomy).
  2. Radiation Therapy: High-energy radiation is used to kill cancer cells or shrink tumors. This may be used in combination with surgery or as a treatment for inoperable tumors.
  3. Chemotherapy: Chemotherapy uses drugs to kill cancer cells throughout the body. It’s often used for advanced stages of lung cancer or when surgery is not an option.
  4. Targeted Therapy: Targeted drugs are designed to attack specific cancer cell mutations or markers without harming normal cells. This is more common for NSCLC, particularly if certain mutations (like EGFR, ALK) are present.
  5. Immunotherapy: Immunotherapy works by stimulating the body’s immune system to fight cancer. It’s often used in advanced stages of lung cancer or when other treatments have not worked. Drugs like pembrolizumab and nivolumab are examples of immunotherapies used for lung cancer.
  6. Palliative Care: In cases of advanced or inoperable lung cancer, palliative care focuses on relieving symptoms and improving quality of life. This may include treatments for pain, shortness of breath, or other symptoms caused by the cancer.

Prevention and Risk Factors:

The major risk factor for lung cancer is tobacco smoking, which is responsible for approximately 85% of cases. Other factors include:

  • Exposure to secondhand smoke
  • Radon exposure (a naturally occurring gas)
  • Asbestos exposure
  • Family history of lung cancer
  • Environmental pollution

Prognosis:

The prognosis for lung cancer depends heavily on the stage at diagnosis. Early-stage lung cancer, especially NSCLC, has a better chance of successful treatment, while advanced-stage cancer (especially SCLC) may be more difficult to treat.

The 5-year survival rate for lung cancer varies:

  • For early-stage lung cancer, the survival rate is significantly higher.
  • For late-stage, particularly stage IV, the prognosis can be less favorable, though treatments like immunotherapy and targeted therapy have been improving outcomes.

Prevention:

Quitting smoking is the most important step in preventing lung cancer.

Regular screenings (especially for high-risk individuals) may help catch cancer early. A low-dose CT scan is recommended for current or former smokers aged 50–80 years.