Lung cancer specialists recommend patients check for symptoms like trouble breathing, excess coughing, coughing blood, chest pain, constant fatigue, repeated lung infections, & weight loss.
Lung Cancer
Lung Cancer
Overview
Lung cancer is a major public health concern worldwide, accounting for a significant proportion of cancer-related deaths. In India, lung cancer is the 4th in incidence and number of deaths. Approximately 80,000 new cases of lung cancer are diagnosed by a lung cancer specialist with an equal number of lung cancer–related deaths every year. Cigarette smoking is the most common cause of lung cancer, but other risk factors include exposure to secondhand tobacco smoke, exposure to radiation or other toxic materials like asbestos and arsenic, having close family members who have had cancer, old age, and having other types of lung problems like chronic obstructive pulmonary disease (COPD) or pulmonary fibrosis.
Clinical Presentation
When lung cancers are small in size and in early stages, a person is usually asymptomatic. But with increasing size and advancing stages, one or more symptoms may develop. Some of the common symptoms of lung cancer lung cancer specialists warn of are:
- Cough, which is new, persistent, worsening, and sometimes blood-tinged
- Chest pain
- Shortness of breath with exertion and, in advanced stages, at rest too
- Wheezing (a whistling sound during each breath)
- Hoarseness of voice
- Headache with swelling of face, arms, and neck
- When the tumor is located in the top part of the lungs, then symptoms may include arm, shoulder, and neck pain, with weakening of the hand muscles, droopy eyelid, and blurred vision.
- Unexplained weight loss
- Tiredness or fatigue
- Bone pains, which are worse at night
Diagnosis
When a lung cancer specialist suspects lung cancer from the history and physical examination, he may advise numerous check-ups like CECT (contrast-enhanced CT) or PET-CT scans to see the size and spread of a tumor and a biopsy for confirmation and for the subtype of the cancer. Biopsy may be done via bronchoscopy (flexible tube with a camera and other small instruments inserted through the mouth or nose and then into the windpipe), CT-guided fine needle biopsy, or via removal of fluid collected in the chest (if any). Sometimes, surgical procedures like mediastinoscopy (used to biopsy lymph nodes in the center of the chest); video-assisted thoracoscopic surgery (VATS) (a less invasive way to biopsy lung tissue); and thoracotomy (a larger surgery to remove larger portions of lung tissue or tumors) may be required if biopsies obtained by conventional means are inconclusive.
The tissue obtained is then sent to an experienced oncopathologist for confirmation of the cancer, its subtype (whether non-small cell or small cell), and for molecular characterization. With the advent of next-generation sequencing methods (NGS), some common biomarkers like programmed cell death ligand 1 (PD-L1) expression, epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) translocations, c-ROS oncogene 1 (ROS1) translocations, etc., are tested to determine which targeted therapy or lung cancer immunotherapy is best suited for the patient.
Treatment From a Lung Cancer Specialist
The management of lung cancer depends on the stage, histology, and molecular profile of the tumor. Therapy options include:
- Surgery – for early-stage, localized cancers lung cancer specialists remove the mass and lymph nodes.
- Radiation therapy – it uses high-energy X-rays or other types of radiation like protons to kill cancer cells. It can be post-surgery or for pain relief in stage 4 cancers with painful bone metastasis.
- Chemotherapy – medicines that kill cancer cells. It can be given before surgery to shrink the cancer and make it easier to remove. It can be given after surgery, depending on the stage, to prevent the growth or spread of the cancer. It is also given in stage 4 cancers where surgery and radiation are not considered.
- Targeted therapy – As the name suggests, targeted medicines attack only specific types of cancer cells, like EGFR positive (afatinib, osimertinib, etc.), ALK translocation positive (crizotinib, ceritinib, alectinib, etc.), and ROS1 inhibitors like crizotinib.
- Lung cancer immunotherapy – aids the immune system in recognizing and attacking cancer cells. Choosing the right therapy offered by a lung cancer specialist is crucial for improving the response rates and overall survival of the patient. However, there is no one therapy that fits in all cases. Precision medicine is the way forward, where evidence-based, personalized therapy or lung cancer immunotherapy can be given for the best outcomes.
Choosing the right therapy offered by a lung cancer specialist is crucial for improving the response rates and overall survival of the patient. However, there is no one therapy that fits in all cases. Precision medicine is the way forward, where evidence-based, personalized therapy or lung cancer immunotherapy can be given for the best outcomes.
Follow Up Care With a Lung Cancer Specialist
After completion of therapy like lung cancer immunotherapy in early-stage cancers, long-term follow-up is required to detect recurrences and second primary cancers and to look for late toxicities of chemotherapy and radiation. It is important to watch for symptoms that could signal the return of cancer—headaches, convulsions, shortness of breath, chronic cough, body pains, abdominal pain or distension, jaundice, weight loss despite adequate food intake, etc.
Lung Cancer Screening
Cigarette smoking is responsible for almost 90 percent of cases of lung cancer, so the best way to prevent lung cancer is to avoid smoking: don't start smoking, or if one already does, then. Studies show that smokers who quit for more than 15 years have an 80 to 90 percent reduction in their risk of lung cancer compared with people who continue to smoke. Yearly screening with a low-dose CT scan is now recommended for persons aged 50 to 80 years who are current or former smokers (who quit within the past 15 years) with a moderate or long smoking history. A large, randomized trial (the National Lung Screening Trial [NLST]) in the United States showed that low-dose CT scans reduced the risk of death from lung cancer by 20 percent and the overall risk of death by about 7 percent. For stage 1 lung cancer detected via early CT screening, the 10-year survival rate can be 88% or higher, especially with timely surgical treatment and treatments like lung cancer immunotherapy.
Frequently Asked Questions
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Q1Common Lung Cancer Symptoms Patients Should Know.
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Q2What Are The Major Contributors Of Lung Cancer?
Lung cancer specialists have pointed out that patients with a history of inhaling excess smoke or dust through smoking or dusty environments, family history of lung issues, & contact with asbestos & toxic substances were at a higher risk of developing lung cancer.
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Q3Tests A Lung Cancer Specialist Uses To Diagnose Lung Cancer
If you notice any symptoms, a lung cancer specialist in Surat will carry out some tests to identify the presence of cancer-
- X-ray
- CT Scan
- Biopsy
- PET Scans
- Molecular Testing
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Q4How Many Stages Does Lung Cancer Progress In?
Lung cancer specialists have categorized the cancer into 4 stages that progress-
- Stage I- Cancer cells are found only in your lungs.
- Stage II & Stage III- Cancer cells have progressed & reached the lymph nodes close by & the chest wall.
- Stage IV- Cancer has reached surrounding organs & bones.
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Q5What Are The Treatment Options For Lung Cancer In Surat?
Depending on the condition of the disease & the patient, lung cancer specialists offer the following treatment options-
- Surgery.
- Chemotherapy.
- Radiation Therapy.
- Targeted Therapy.
- Lung cancer immunotherapy.
- Palliative care.