Lung Cancer: Types, Symptoms, & Treatment

Lung cancer has been plaguing our society for a really long time. However, due to the advancements in medical science, it has become manageable if caught early. Heightened awareness can lead to early detection, when interventions are most effective, potentially saving lives and improving treatment outcomes. Moreover, increasing public knowledge about lung cancer helps dispel misconceptions and reduce stigma, encouraging those at risk to seek medical advice without hesitation.

Q. What is lung cancer and what are its types?

A) Lung cancer is a malignant tumour that originates in the tissues of the lungs. It is a type of cancer characterized by the uncontrolled growth of abnormal cells within the lung tissues, often leading to a range of symptoms and health complications. The condition is primarily caused by exposure to carcinogens, with smoking being the most significant risk factor.

There are two main categories of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). These categories are based on the type of cells that are affected and the growth patterns of the cancer.

  • Non-Small Cell Lung Cancer (NSCLC): NSCLC is further divided into several subtypes, including:
  • Adenocarcinoma: This is the most common type of NSCLC and tends to start in the peripheral areas of the lungs. It is often associated with non-smokers and is more common in women.
  • Squamous Cell Carcinoma: This type typically arises in the central airways and is often linked to a history of smoking. It can cause symptoms like coughing and breathing difficulties.
  • Large Cell Carcinoma: This subtype is less common and is characterized by large, abnormal-looking cells. It can occur anywhere in the lungs and tends to grow and spread quickly.
  • Small Cell Lung Cancer (SCLC): SCLC is known for its rapid growth and early spread to other parts of the body. This type is strongly associated with smoking. SCLC is often divided into two stages: the limited stage (confined to one lung) and the extensive stage (spread to other lungs or distant parts of the body).

Q. What are the symptoms of lung cancer?

A) Lung cancer often presents a wide range of symptoms, which can vary depending on the type of lung cancer, the stage of the disease, and individual factors. Recognizing these symptoms is crucial for early detection and improved treatment outcomes. The common symptoms of lung cancer are:

  • Respiratory Symptoms: Respiratory symptoms are among the most common early signs of lung cancer. These can include persistent coughing, especially if it changes in intensity, becomes more frequent, or produces blood-tinged sputum. A chronic cough that doesn’t improve with time or treatment should raise suspicion and prompt further evaluation.
  • Breathlessness and Wheezing: As lung cancer tumours grow and interfere with the normal functioning of the lungs, they can cause breathlessness and wheezing. These symptoms are often mistaken for asthma or other respiratory conditions, leading to delayed diagnosis. Shortness of breath during routine activities, such as walking or climbing stairs, can be indicative of lung cancer.
  • Chest Pain: Chest pain is a common symptom of lung cancer. The pain may be dull, aching, or sharp in nature. It can be localized to the chest area or radiate to the shoulders, back, or arms. Persistent chest pain should be evaluated by a healthcare professional to rule out any serious underlying conditions.
  • Unexplained Weight Loss and Fatigue: Unintended weight loss and persistent fatigue can be signs of advanced lung cancer. The body’s energy reserves may be redirected to support the rapid growth of cancer cells, leading to weight loss. Additionally, the immune response against cancer cells can contribute to fatigue.
  • Hoarseness and Vocal Changes: Lung cancer can affect the nerves and structures in the chest, leading to vocal changes and hoarseness. If hoarseness persists for more than two weeks without an apparent cause (such as a cold or excessive voice use), it should be investigated.
  • Recurrent Respiratory Infections: Frequent respiratory infections, such as bronchitis or pneumonia, could be indicative of lung cancer. Tumours can block airways, making it difficult for the body to clear infections effectively.
  • Bone Pain and Headaches: If lung cancer metastasizes (spreads) to other parts of the body, it can cause symptoms in those areas. Bone pain, particularly in the spine, hips, or ribs, can occur. Additionally, lung cancer metastases to the brain can lead to headaches, seizures, and neurological symptoms.
  • General Symptoms: Lung cancer can also cause general symptoms that are not directly related to the lungs. These can include loss of appetite, changes in the sense of taste, muscle wasting, and overall weakness.

If any of these symptoms persist or are of concern, it is important to consult a healthcare professional lung specialist for a thorough evaluation. Early detection of lung cancer can significantly improve treatment options and outcomes.

Q. What tests are done to diagnose lung cancer?

A) Diagnosing lung cancer involves a series of tests and procedures to accurately identify the presence of cancer, and determine its type, stage, and extent of spread. Early and accurate diagnosis is crucial for developing an effective treatment plan. The essential tests and procedures used in the diagnosis of lung cancer:

  • Imaging Tests: Imaging plays a central role in diagnosing lung cancer. Various imaging techniques provide detailed visualizations of the lungs and surrounding tissues:
  • Chest X-ray: A basic tool that may reveal abnormal masses or shadows in the lungs.
  • Computed Tomography (CT) Scan: A more detailed imaging technique that provides cross-sectional images of the lungs, helping to locate tumours and assess their size and spread.
  • Positron Emission Tomography (PET) Scan: Combined with a CT scan, PET can show areas of increased metabolic activity, helping to determine if cancer has spread to other parts of the body.
  • Biopsy: A biopsy involves obtaining a tissue sample for laboratory analysis to confirm the presence of cancer and determine its type. There are different biopsy methods:
  • Needle Biopsy: A thin, hollow needle is inserted into the lung through the skin to extract a tissue sample.
  • Bronchoscopy: A flexible tube with a camera is passed through the airways to collect samples from suspicious areas.
  • Endobronchial Ultrasound (EBUS): Combines bronchoscopy with ultrasound to guide biopsy needle placement in lymph nodes.
  • Thoracentesis: If there’s fluid around the lungs (pleural effusion), a sample of the fluid can be removed and analyzed.
  • Sputum Cytology: For some cases, examining a sample of sputum (mucus coughed up from the lungs) under a microscope can reveal cancer cells. However, this method is less commonly used due to its lower sensitivity compared to other diagnostic techniques.
  • Blood Tests: Blood tests are used to assess general health and organ function. While there’s no blood test that can definitively diagnose lung cancer, certain biomarkers, like carcinoembryonic antigen (CEA) or certain genetic markers, can provide additional information about the disease.
  • Mediastinoscopy: This surgical procedure involves making a small incision at the base of the neck to access the area between the lungs (mediastinum) and collect lymph node samples for staging.
  • Thoracoscopy: Also known as video-assisted thoracoscopic surgery (VATS), this procedure involves making small incisions in the chest and using a tiny camera to guide the removal of tissue samples or perform certain surgeries.
  • Brain Imaging: Since lung cancer can spread to the brain, brain imaging, such as MRI or CT scans, may be conducted to evaluate if cancer has metastasized to the brain.

A thorough and accurate diagnosis lays the foundation for creating a personalized treatment plan that offers the best chance for successful outcomes.

Q. Who are at risk of developing lung cancer?

A) Lung cancer risk is influenced by a combination of factors. Identifying those at risk is essential for prevention, early detection, and tailored interventions. The key risk factors for developing lung cancer are:

  • Tobacco Smoke Exposure: Tobacco smoke, including both active smoking and exposure to secondhand smoke, is the most significant risk factor for lung cancer. Cigarette smoke contains numerous carcinogens that can damage lung tissue and lead to the development of cancerous cells. Smokers are at the highest risk, but even exposure to secondhand smoke can increase the likelihood of lung cancer. The risk decreases after quitting smoking, but it may take years for the threat to drop significantly.
  • Radon Gas Exposure: Radon is a colourless, odourless radioactive gas that is naturally produced by the breakdown of uranium in soil and rocks. Prolonged exposure to elevated levels of radon indoors, especially in poorly ventilated spaces, can increase the risk of lung cancer.
  • Occupational and Environmental Exposures: Exposure to carcinogens and toxins in the workplace and environment can contribute to lung cancer risk. Asbestos, arsenic, diesel exhaust, certain chemicals, and other hazardous substances have been linked to lung cancer. Workers in industries like construction, mining, and manufacturing are particularly vulnerable to such exposures.
  • Prior History of Lung Disease: Individuals with a history of certain lung diseases, such as chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, or tuberculosis, are at an increased risk of developing lung cancer. Chronic inflammation and damage to lung tissue contribute to the heightened risk.
  • Personal History of Cancer: People who have had lung cancer in the past are at an elevated risk of developing a second primary lung cancer. It’s essential for survivors to be vigilant about follow-up screenings and adopt healthy behaviours to reduce the risk.
  • Age and Gender: Lung cancer risk increases with age, and it is more commonly diagnosed in older adults. Men historically had higher rates of lung cancer due to higher smoking rates, but the gap has been narrowing as smoking rates among women have increased.
  • Radiation Exposure: Exposure to high levels of ionizing radiation, such as during certain medical procedures or radiation therapy for other cancers, can increase the risk of lung cancer.
  • Air Pollution: Long-term exposure to outdoor air pollutants, including fine particulate matter and hazardous gases, has been associated with a slightly increased risk of lung cancer. However, the contribution of air pollution to individual risk is generally lower compared to factors like smoking.
  • Lifestyle Factors: Certain lifestyle choices can also influence lung cancer risk. These include a poor diet lacking in fruits and vegetables, lack of physical activity, and heavy alcohol consumption.

Understanding these risk factors empowers individuals and healthcare professionals to work together to reduce the incidence of lung cancer and improve overall public health.

Q. What is the treatment plan for lung cancer?

A) The treatment plan for lung cancer is determined by various factors, including the type of lung cancer, its stage, the patient’s overall health, and individual preferences. A multidisciplinary approach involving oncologists, surgeons, radiation therapists, and other specialists is often employed to develop a personalized treatment strategy.

  • Surgery: Surgery is a common treatment for early-stage non-small cell lung cancer (NSCLC) and sometimes for limited-stage small cell lung cancer (SCLC). The goal is to remove the tumour and any nearby affected tissues. Surgical options include:
  • Lobectomy: Removal of the entire lobe of the lung containing the tumour.
  • Segmentectomy or Wedge Resection: Removal of a smaller portion of the lung.
  • Pneumonectomy: Removal of the entire lung (rarely done). Surgery is most effective when the cancer is confined to a specific area of the lung and has not spread to lymph nodes or distant sites.
  • Chemotherapy: Chemotherapy involves the use of drugs to kill or inhibit the growth of cancer cells. It is commonly used to treat both small cell and non-small cell lung cancer. Chemotherapy can be administered before surgery (neoadjuvant), after surgery (adjuvant), or as the primary treatment for advanced stages. It may also be combined with radiation therapy.
  • Radiation Therapy: Radiation therapy uses high-energy rays to target and kill cancer cells. It is often used in combination with surgery or chemotherapy. External beam radiation therapy delivers radiation from outside the body, while internal radiation therapy (brachytherapy) places radioactive material directly inside or near the tumour. Radiation therapy can be used to shrink tumours before surgery or to relieve symptoms in advanced cases.
  • Targeted Therapy: Targeted therapies are medications that specifically target genetic mutations or alterations in cancer cells that allow them to grow uncontrollably. These therapies are primarily used for patients with certain types of advanced NSCLC.
  • Immunotherapy: Immunotherapy harnesses the body’s own immune system to combat cancer. In some cases, cancer cells employ proteins to evade detection by the immune system. Immunotherapy disrupts this mechanism, enabling the immune system to target and counteract cancer cells effectively.
  • Combination Therapies: Combination therapies involve using multiple treatment modalities together to improve outcomes. For instance, some patients with advanced lung cancer might receive a combination of chemotherapy and immunotherapy, known as chemoimmunotherapy. These combinations can enhance treatment effectiveness while managing potential side effects.
  • Palliative Care: Palliative care focuses on improving the quality of life for patients with advanced lung cancer. It addresses symptoms, pain management, emotional support, and overall comfort. Palliative care can be integrated alongside curative treatments or as the primary approach for patients for whom curative treatments are not feasible.
  • Clinical Trials: Clinical trials play a critical role in advancing lung cancer treatment options. New therapies, techniques, and approaches are tested in clinical trials to determine their safety and effectiveness. Patients with lung cancer are encouraged to explore clinical trial opportunities, as they may have access to innovative treatments that are not yet widely available.

The treatment plan for lung cancer is highly individualized and depends on factors such as cancer type, stage, and the patient’s health.  

Q. What can you do to prevent lung cancer?

A) Preventing lung cancer involves a combination of lifestyle changes, environmental awareness, and early detection efforts. Here’s a list of strategies to prevent lung cancer:

  • Quit Smoking and Avoid Secondhand Smoke: The most effective way to prevent lung cancer is to quit smoking and avoid exposure to secondhand smoke. The harmful substances in tobacco smoke are known carcinogens that significantly increase the risk of lung cancer. If you’re a smoker, seek support to quit, and if you’re not a smoker, steer clear of environments where you might be exposed to secondhand smoke.
  • Radon Testing and Mitigation: Radon, a naturally occurring radioactive gas, is a leading cause of lung cancer among non-smokers. Testing your home for radon levels and taking steps to mitigate exposure, such as sealing cracks and improving ventilation, can reduce this risk.
  • Reduce Occupational and Environmental Exposures: Limiting exposure to harmful substances in the workplace and environment can lower the risk of lung cancer. If you work in industries associated with lung cancer risk (such as construction or mining), follow safety protocols, wear protective gear, and adhere to occupational health guidelines. Minimizing exposure to asbestos, diesel exhaust, and other toxins is crucial.
  • Eat a Healthy Diet: A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats provides essential nutrients that support overall health, including lung health. Antioxidant-rich foods, like berries, citrus fruits, and leafy greens, may offer protective benefits against lung cancer. Limiting processed foods, sugary drinks, and excessive red meat consumption is advised.
  • Maintain a Healthy Weight: Being overweight or obese can contribute to inflammation and other factors that increase cancer risk, including lung cancer. Aim to maintain a healthy weight through regular physical activity and a well-balanced diet. Engaging in regular exercise can also enhance lung function and overall well-being.
  • Limit Alcohol Consumption: Excessive alcohol consumption is associated with an increased risk of several cancers, including lung cancer. If you choose to drink alcohol, do so in moderation. For men, moderation typically means up to two drinks per day, and for women, up to one drink per day.
  • Avoid Carcinogens at Home: Exposure to certain household pollutants, such as radon, asbestos, and pollutants from cleaning products or cooking fumes, can contribute to lung cancer risk. Ensure proper ventilation and use of exhaust fans when cooking. Choose eco-friendly cleaning products and reduce indoor air pollutants.
  • Exercise Regularly: Engaging in regular physical activity not only helps maintain a healthy weight but also supports overall lung function and cardiovascular health. Aim for at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, cycling, or swimming.
  • Get Vaccinated: Infections like the human papillomavirus (HPV) and influenza can increase the risk of lung cancer. Getting vaccinated against these infections can help lower that risk. The HPV vaccine is recommended for both males and females, and an annual flu vaccine is advised, especially for those at higher risk.
  • Regular Health Check-ups and Screenings: Early detection is crucial for successful treatment. If you are at high risk of developing lung cancer due to factors like smoking history, family history, or occupational exposures, discuss the possibility of lung cancer screenings with your healthcare provider. Regular check-ups and screenings can detect any abnormalities early on.

Preventing lung cancer requires a proactive approach that encompasses healthy lifestyle choices, awareness of environmental factors, and early detection efforts.

Getting the appropriate medical treatment and care is crucial to avoid any associated medical complications.

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