Nowadays we are very much familiar with the term cancer. Sometimes it directly knocks into our mind as a disease, which has no answer. Let’s get know about the disease and find out the answer for lung cancer.
Lung cancer in medical term is known as lung carcinoma or ca – lung. Lungs are a pair of cone shaped breathing organ inside our chest wall. It brings oxygen into the body when breathing in and sends carbon dioxide out of the body when breathing out. Lung cancer is one of the most common cancers in the world. It claims more lives each year than do colon, prostate, ovarian and breast cancers combined. Lung cancer and smoking often, but not always, go hand in hand. Cigarette smoking causes most lung cancers.
The two main types of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). These types are based on the way the cells look under a microscope. Non-small cell lung cancer is much more common than small cell lung cancer. The stage of lung cancer refers to the extent to which the cancer has spread in the body.
As it is mentioned earlier that smoking and lung cancer goes hand in hand. Let’s discuss the risk factors that can be avoided to reduce the risk of having lung cancer.
Risk Factors of lung cancer-
- Age: About two out of three lung cancers are diagnosed in people over age 65, and most people are older than 45. The average age at diagnosis is 71.
- Smoking- People who smoke have the greatest risk of lung cancer. The risk of lung cancer increases with the length of time and number of cigarettes you’ve smoked. If you quit smoking, even after smoking for many years, you can significantly reduce your chances of developing lung cancer.
- Exposure to secondhand smoking- Passive exposure to tobacco smoke (passive smoking) also can cause lung cancer. Even if you don’t smoke, your risk of lung cancer increases if you’re exposed to secondhand smoke.
- Exposure to radon gas–Radon is produced by the natural breakdown of uranium in soil, rock and water that eventually becomes part of the air you breathe. Unsafe levels of radon can accumulate in any building, including homes. Radon testing kits, which can be purchased at home improvement stores, can determine whether levels are safe. If unsafe levels are discovered, remedies are available.
- Exposure to asbestos and other carcinogens-Workplace exposure to asbestos and other substances known to cause cancer — such as arsenic, chromium and nickel — also can increase your risk of developing lung cancer, especially if you’re a smoker. High levels of pollution, radiation and asbestos exposure also increases risk.
- Consumption of formalin containing fresh vegetables, fruits, fish for long duration of time.
- Family history of lung cancer- People with a parent, sibling or child with lung cancer has an increased risk of the disease.
If anyone falls in these category of risk factors and feels that they might have a chance of having lung cancer then there are also some physical conditions which can assure you when to see your doctor to get properly diagnosed if you have it or no . About one fourth of all people with lung cancer have no symptoms when the cancer is diagnosed. These cancers are usually identified incidentally when a chest X-ray is performed for another reason. The other three-fourths of people develop some symptoms. There may be no symptoms at the onset of the disease.
When present, common symptoms you might have are given below:
- Coughing: This includes a persistent cough that doesn’t go away or changes to a chronic “smoker’s cough,” such as more coughing or pain.
- Coughing up blood: Coughing up blood or rust-colored sputum (spit or phlegm) should always be discussed with your doctor.
- Breathing difficulties: Shortness of breath, wheezing or noisy breathing (called stridor) may all be signs of lung cancer.
- Loss of appetite: Many cancers cause changes in appetite, which may lead to unintended weight loss.
- Fatigue: It is common to feel weak or excessively tired, headache and bone pain.
- Voice change- Hoarseness.
- Recurring infections: Recurrent infections, like bronchitis or pneumonia, may be one of the signs of lung cancer.
Signs of advanced stages of lung cancer
Advanced stages of lung cancer are often characterized by the spread of the cancer to distant sites in the body. This may affect the bones, liver or brain. As other parts of the body are affected, new lung cancer symptoms may develop, including:
- Bone pain
- Swelling of the face, arms or neck
- Headaches, dizziness or limbs that become weak or numb
- Lumps in the neck or collar bone region
When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms that worry you.If you smoke and have been unable to quit, make an appointment with your doctor. Your doctor can recommend strategies for quitting smoking, such as counseling, medications and nicotine replacement products which are even now available in Bangladesh.
Once you see your doctor still it’s a very hard decision and many steps to go through to decide whether you have lung cancer or not. There are many diagnostic tools available .
Tests to diagnose lung cancer
If there’s reason to think that you may have lung cancer, your doctor can order a number of tests to look for cancerous cells and to rule out other conditions. It’s not as simple to diagnose lung cancer as you may think. In order to diagnose lung cancer, your doctor may recommend:
- Imaging tests-An X-ray image of your lungs may reveal an abnormal mass or nodule. A CT scan can reveal small lesions in your lungs that might not be detected on an X-ray.
- Sputum cytology- if you have a cough and are producing sputum, looking at the sputum under the microscope can sometimes reveal the presence of lung cancer cells.
- Tissue sample (biopsy)- A sample of abnormal cells may be removed in a procedure called a biopsy.
- Your doctor can perform a biopsy in a number of ways, including bronchoscopy, in which your doctor examines abnormal areas of your lungs using a lighted tube that’s passed down your throat and into your lungs; mediastinoscopy, in which an incision is made at the base of your neck and surgical tools are inserted behind your breastbone to take tissue samples from lymph nodes; and needle biopsy, in which your doctor uses X-ray or CT images to guide a needle through your chest wall and into the lung tissue to collect suspicious cells.
- A biopsy sample may also be taken from lymph nodes or other areas where cancer has spread, such as your liver.
Lung cancer staging
Once your lung cancer has been diagnosed, your doctor will work to determine the extent (stage) of your cancer. Your cancer’s stage helps you and your doctor decide what treatment is most appropriate.
Staging tests may include imaging procedures that allow your doctor to look for evidence that cancer has spread beyond your lungs. These tests include CT scans, magnetic resonance imaging (MRI), positron emission tomography (PET) and bone scans. Not every test is appropriate for every person, so talk with your doctor about which procedures are right for you.
Stages of lung cancer
- Stage I- Cancer is limited to the lung and hasn’t spread to the lymph nodes. The tumor is generally smaller than 2 inches (5 centimeters) across.
- Stage II- The tumor at this stage may have grown larger than 2 inches, or it may be a smaller tumor that involves nearby structures, such as the chest wall, the diaphragm or the lining around the lungs (pleura). Cancer may also have spread to the nearby lymph nodes.
- Stage III- The tumor at this stage may have grown very large and invaded other organs near the lungs. Or this stage may indicate a smaller tumor accompanied by cancer cells in lymph nodes farther away from the lungs.
- Stage IV-Cancer has spread beyond the affected lung to the other lung or to distant areas of the body.
Small cell lung cancer is sometimes described as being limited or extensive. Limited indicates cancer is limited to one lung. Extensive indicates cancer has spread beyond the one lung.The saying Cancer has no answer is not true in our life anymore. Passion of medical science and hard work our researches have found variety of treatment options for lung cancer.
Treatments and Drugs
You and your doctor choose a cancer treatment plan based on a number of factors, such as your overall health, the type and stage of your cancer, and your preferences. Options typically include one or more treatments, including surgery, chemotherapy, radiation therapy or targeted drug therapy.
During surgery your surgeon works to remove the lung cancer and a margin of healthy tissue. Procedures to remove lung cancer include:
- Wedge resection to remove a small section of lung that contains the tumor along with a margin of healthy tissue
- Segmental resection to remove a larger portion of lung, but not an entire lobe
- Lobectomy to remove the entire lobe of one lung
- Pneumonectomy to remove an entire lung
If you undergo surgery, your surgeon may also remove lymph nodes from your chest in order to check them for signs of cancer.
Lung cancer surgery carries risks, including bleeding and infection. Expect to feel short of breath after lung surgery. If a portion of your lung is removed, your remaining lung tissue will expand over time and make it easier to breathe. Your doctor may recommend a respiratory therapist who can guide you through breathing exercises to aid in your recovery.
Chemotherapy uses drugs to kill cancer cells. One or more chemotherapy drugs may be given through a vein in your arm (intravenously) or taken orally. A combination of drugs usually is given in a series of treatments over a period of weeks or months, with breaks in between so that you can recover.
Radiation therapy uses high-powered energy beams from sources such as X-rays and protons to kill cancer cells. Radiation therapy can be directed at your lung cancer from outside your body (external beam radiation) or it can be put inside needles, seeds or catheters and placed inside your body near the cancer (brachytherapy).Radiation therapy can be used after surgery to kill any cancer cells that may remain. It may also be used as the first treatment for lung cancers that can’t be removed during surgery. For people with advanced lung cancer, radiation therapy may be used to relieve pain and other symptoms.
Targeted drug therapy
Targeted therapies are newer cancer treatments that work by targeting specific abnormalities in cancer cells. Targeted therapy drugs are often used in combination with chemotherapy drugs.
People with lung cancer often experience signs and symptoms of the cancer, as well as side effects of treatment. Supportive care, also known as palliative care, is a specialty area of medicine that involves working with a doctor to minimize your signs and symptoms.Your doctor may recommend that you meet with a palliative care team soon after your diagnosis to ensure that you’re comfortable during and after your cancer treatment.
Lung cancer can cause complications such as:
- Shortness of breath- People with lung cancer can experience shortness of breath if cancer grows to block the major airways. Lung cancer can also cause fluid to accumulate around the lungs, making it harder for the affected lung to expand fully when you inhale.
- Coughing up blood- Lung cancer can cause bleeding in the airway, which can cause you to cough up blood (hemoptysis). Sometimes bleeding can become severe. Treatments are available to control bleeding.
- Pain-Advanced lung cancer that spreads to the lining of a lung or to another area of the body, such as a bone, can cause pain.
- Fluid in the chest (pleural effusion). Lung cancer can cause fluid to accumulate in the space that surrounds the affected lung in the chest cavity (pleural space).
- Cancer that spreads to other parts of the body (metastasis)-Lung cancer often spreads (metastasizes) to other parts of the body, such as the brain and the bones.Cancer that spreads can cause pain, nausea, headaches, or other signs and symptoms depending on what organ is affected. Once lung cancer has spread to other organs, it’s generally not curable. Treatments are available to decrease signs and symptoms and to help you live longer.
Coping with shortness of breath
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.
To cope with shortness of breath, it may help to:
- Try to relax- Feeling short of breath can be scary. But fear and anxiety only make it harder to breathe. When you begin to feel short of breath, try to manage the fear by choosing an activity that helps you relax. Listen to music, imagine your favorite vacation spot, meditate or say a prayer.
- Find a comfortable position- It may help to 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.Hospitals where you can go in Dhaka for a reliable diagnosis and less expensive treatment :
Ahsania Mission Cancer Detection & Treatment Centre
Plot No – M-1/C, Section -14,
Mirpur, Dhaka -1206
Phone : 9008919, 8051618
Delta Hospital Ltd.
26/2, Principal Abul Kashem
(Former Darussalam) Road, Mirpur-1,
Tel: 9029151-2, 8031378-9,9022410
Plot No.-21, Sector-08,
Abdullahpur, Uttara, Dhaka-1230
National Institute of Cancer Research & Hospital
Phone No. +88028111169
Five years survival (NSCLC): Stage 1 – >75%; stage 2 – 55% ; stage 4 – about 1 year. In general 80% die in 1 year, 5 years overall survival now around 15%. Best prognosis if well differentiated squamous cell carcinoma, if localized and treated by surgery.This means that if diagnosed early and properly treated then longevity can be more than expected. According to the latest WHO data published in may 2016 Lung Cancers Deaths in Bangladesh reached 9,660 or 1.33% of total deaths. The age adjusted Death Rate is 9.61 per 100,000 of population ranks Bangladesh #94 in the world.
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