Diagnosis and Treatment of Lung Cancer

Causes and Risk Factors

There are two main types of lung cancer: small cell lung cancer and non-small cell lung cancer. The main causes of these are as follows:

• Smoking is the single largest risk factor for developing lung cancer. The greater the amount and duration of smoking, the higher is your risk.

• Exposure to harmful environmental and industrial factors such as radon, uranium, arsenic, asbestos, coal products and tactical chemicals

• Previous exposure to radiation therapy in the chest/lungs

• Tuberculosis leads to scarring of the lung tissue which may thus make you more susceptible to lung cancer

• Genetics/Family History of lung cancer

• The older you get, the larger your chances of getting lung cancer

Symptoms

If the cancer is confined to the lungs, the symptoms are as follows:

• Persistent coughing, coughing up blood or mucus with blood

• Shortness of breath or wheezing

• Hoarseness of voice

• Chest pain

• Persistent and/recurring lung illnesses such as pneumonia

If the cancer has metastasized to the lymph nodes, liver, bones or brain, accompanying symptoms may include: bone pain, jaundice, nausea, weight loss, cognitive changes, balance problems, inflammation of lymph nodes among others.

Diagnosis and Treatment

Diagnosis and Screening

• Sputum cytology, where the mucus from your cough is examined under a microscope to look for signs of cancerous cells.

• Imaging tests such as CT, MRI, X-ray and PET

• A biopsy is carried out if imaging results show a possibility of cancer. In this procedure, a small sample of tissues is taken from your lungs and examined under a microscope.

• Genetic testing, or molecular profiling to get a deeper insight into the mutations that are causing the cancer. This aids your oncologist in preparing your treatment plan.

• There is also the possibility of looking for biomarkers or biological markers, which simply put are signs which can be accurately measured/quantified to make a conclusion about a medical state. These may be specific proteins, receptors or molecules. Some biomarkers of lung cancer are: Epidermal growth factor receptor (EGFR), Anaplastic lymphoma kinase (ALK) and K-ras mutations (KRAS 1). These aid your oncologist in deciding the best course of action against the cancer.

How Is Lung Cancer Treated?

Lung cancer can be treated with surgery, radiation therapy, chemotherapy, targeted therapy or immunotherapy. A single treatment, or a combination of treatments are usually used.

Surgery

Surgery is an option for certain patients diagnosed with earlier stages of non-small cell lung cancer, and has high chances of success. Before removing parts of the lung there is always a patient’s eligibility (whether they have enough lung capacity) for the operation is determined. The different types of surgeries include:

• Pneumonectomy: This surgery involves removing a full lung with the tumor.

• Lobectomy: Our lungs are divided in lobes, with right one having 3 and the left with 2 lobes. Depending on the location of the tumor, an entire lobe is removed.

• Segmentectomy: In this surgery, only a section of a lobe and some surrounding tissue is removed.

• Sleeve resection: If the cancer is located on a bronchus, then the surgeon removes that particular section of the bronchus and stitches back the remaining healthy ends.

For small cell lung cancer, surgery is rarely carried out.

Radiation Therapy

Radiation therapy works by aiming high energy waves at the cancerous cells. This causes the cancer cells to die and though the healthy cells sustain some damage, they can repair themselves. The treatment takes place over the course of a few weeks, in short sessions of 5 days per week. Depending on the stage of your cancer and how far it has spread, a radiation therapy course is planned.

Radiation can be given before or after a surgery, as a main treatment in individuals who cannot have surgery, in combination with chemotherapy or as palliative care in late stage small cell and non-small cell lung cancer. Additionally, in patients with small cell lung cancer, radiotherapy to the brain is often given to reduce the risk of the cancer metastasizing there. This is also known as prophylactic cranial irradiation. Radiation can be given externally or internally which is known as Brachytherapy.

Chemotherapy

Uses anti-cancer drugs to kill or shrink the cancer causing cells and to prevent the spread of cancer to other areas of the body. Chemotherapy can be used before and after surgeries, in combination with radiation for patients that cannot undergo surgery and is also sometimes the central treatment for advanced stages. In small cell lung cancer, chemotherapy is a vital part of the treatment plan regardless of stage.

Immunotherapy

Immunotherapy works by helping/boosting your immune system to fight against cancer cells. This treatment can be used for both non-small and small cell lung cancer, and is also prescribed based on other factors of your illness.

Targeted Therapy

Targeted therapy drugs, are as the name suggested more specific, i.e, they harm cancer cells and do not have any adverse effects on surrounding or other cells of our body. As of now, targeted therapy drugs are used in tandem with chemotherapy drugs.

What Should I Expect From This Procedure?

Please bear in mind, that your medical history, your environment which includes family and friends, your lifestyle habits, genetics, the type and intensity of cancer you have, all play a role in deciding the course of your treatment. Many times a combination of treatments is recommended, and this may change through the duration of your illness. This is done so the doctor can ensure that you are getting the best possible treatment for your individual case.

How Do I Find the Right Doctor?

We understand that before going through a major treatment like surgery or radiotherapy, you may be feeling unsure and want a second opinion, or you would like to look for the top oncologist specializing in lung cancer, or for a clinical trial doing cutting edge research. For support with any of these queries and question, Qunomedical is here for you 24/7.