LUNG CANCER – Causes, Symptoms, Diagnosis, Treatment

Image Courtesy of Δρ. Χαράλαμπος Γκούβας (Harrygouvas), via Creative Commons license, some rights reserved.

Cancer means excess abnormal and uncontrolled growth of normal body cells. These cells are called malignant cells. Cancer involving lung and its parts is lung cancer. Lung cancer is a common cause of cancer death all over the world.

RISK FACTOR

  • SMOKING – As per research, smoking is the most common risk factor for lung cancer. Higher packs a day and longer duration of smoking are proportional to a higher risk of lung malignancy. All types of tobacco smoking in various forms are predisposed to this cancer. In addition, passive smoking is also risky for developing lung cancer.
  • ASBESTOS EXPOSURE – Another proven risk factor for lung cancer is asbestos exposure. Asbestos exposure is a big occupational hazard for people working at mines, mills or asbestos industry. People exposed to asbestos for a longer duration and large amounts are prone to develop lung cancer. Asbestos exposure leads to a special type of lung cancer known as mesothelioma. Mesothelioma is a lung malignancy that arises from pleura.
  • AIR POLLUTION – Air pollution also increases the risk of CA lung. However in cities due to a large number of vehicles and industrial gas air pollution is very high. This outdoor air pollution causes various lung diseases including cancer.
  • RADIATION EXPOSURE – People working in industries where ionizing radiation exposure is inevitable may develop lung cancer. Sometimes, people taking radiotherapy for cancer of other organs like Hodgkin’s Lymphoma or breast cancer can develop a malignancy.
  • FAMILY HISTORY – A positive family history of lung cancer predisposes to the disease.
  • OTHER DISEASE – Certain diseases like pulmonary fibrosis, COPD, Sarcoidosis increase the risk of pulmonary malignancy.
  • ARSENIC IN DRINKING WATER – People drink water with a high level of arsenic are at increased risk of lung cancer.

SIGNS AND SYMPTOMS

During various stages of the disease, various signs and symptoms are found. Anorexia and weight loss are common presenting symptoms. Recurrent cough or change in cough patters is found in the early stages. Dyspnea and hemoptysis are seen in advanced lung CA. Lung cancer is manifested by chronic chest pain. When lung CA metastases to bones like vertebrae, ribs, and pelvis can cause joint or bone pain. Local spread may lead to endobronchial obstruction and cause respiratory distress. Similarly, voice change and pleural effusion occur due to the local invasion of tumor cells. Brain metastasis can manifest as headache, nausea, vomiting or seizures. Sometimes, lung tumor obstructs the superior vena cava and cause Superior Venacava syndrome. Bronchogenic carcinoma also causes paraneoplastic syndrome(Systemic manifestations due to secretory effects of tumor).

Hypercalcemia developers in squamous cell carcinoma and SIADH ( Syndrome Of Inappropriate Antidiuretic Hormone) developers in small cell carcinoma. Lambert – Eaton Syndrome, hypercoagulability, high ACTH are also seen due to the paraneoplastic syndrome.

INVESTIGATIONS

A primary investigation to diagnose lung cancer is radiographic imaging. A digital chest x-ray and CT scan give a gross idea about the tumor size and location. After that localization of lung mass, pulmonologists go for CT guided FNAC ( Fine Needle Aspiration Cytology) or biopsy to confirm the diagnosis and classification of the malignancy sputum cytology for the malignant cell is also a very specific test but it has low sensitivity. Fiber optic bronchoscopy is another method for diagnosis. It helps to visualize major airways, locate mass and biopsy taking. For metastasis diagnosis PET ( Positron Emission Tomography) is the best modality.

TREATMENT

Lung cancer treatment depends on the type of cancer and TNM staging. In fact, small cell lung carcinoma is responsive to chemotherapy as well as radiotherapy. Etoposide and cisplatin are very much effective for this type of lung cancer. Radiation along with chemotherapy improves the survival rate of the patients. For non-small cell, lung carcinoma surgery is the treatment of choice.

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