What is lung cancer?

The condition in which cancer forms in the tissues of the lungs is known as lung cancer. In this scenario, lymph nodes and other parts of the body can also be affected due to lung cancer. Conversely, cancer may also affect other body parts and damage the lungs. Lung cancer can be fatal if not treated on time. Our lungs help to filter the air we breathe. Cancer in the lungs blocks this functioning resulting in eventual death. Hence, it is advised to identify the abrupt signs our body gives indicating symptoms of lung cancer.

Symptoms Of Lung Cancer

The formation of cancerous cells originating from the lungs is called lung cancer. Usually, lung cancer shows no symptoms at an early stage. Most significant symptoms are found in the advanced stages of lung cancer. Some of the common lung cancer symptoms are-

Chronic cough that worsens over time and fails to go away.
Blood in sputum
Chronic chest pain
Hoarseness (Change in the voice, which sounds breathy and rough).
Difficulty in breathing.
Unexplained weight loss.
Constant feeling of tiredness and weakness.
Body and joint pain accompanied by headache.

Lung Cancer And Smoking

Smoking is considered the highest risk factor to cause lung cancer in 9 out of 10 people. Pipe smoking and cigars are also regarded as dangerous apart from cigarettes. The possibilities of developing lung cancer depend on the frequency and duration of smoking. Most tobacco products consist of more than 7000 chemicals, out of which 70 chemicals are known to cause lung cancer.

Not all lung cancer patients are smokers; however, breathing cigarette or tobacco smoke as passive smokers is even more dangerous. Passive smokers inhale cigarette smoke along with other polluted smoke in the environment, and this damages lung tissues immediately.

Chain smokers can reduce their chances of being affected by lung cancer by 50% if they quit smoking within ten years from when they started.

Causes And Risk Factors

Smoking is linked to about 90% of lung cancer deaths. Even smoking a few cigarettes a day increases the risk of lung cancer. Smoke from other people's cigarettes (passive smoking) can also cause cancer.

However, frequent exposure to smoke causes severe damage to the lungs where self-repair fails to work. It begins to damage lung cells and increase the risk of lung cancer.

The risk can be lowered by giving up on smoking. Other factors like the inhalation of hazardous gases with substances such as cadmium, uranium, a few petroleum gases, nickel, arsenic, and chromium can also cause lung cancer.

Pre-existing lesions like pulmonary fibrosis are associated with a sevenfold increase in the risk of lung cancer.

Although the genetic basis of lung cancer is still being elucidated, there is an established familial risk.

Stages Of Lung Cancer

The treatment entirely depends on the stages of lung cancer. Signs of lung cancer vary at different stages, and the treatment is considered to be more effective when diagnosed at an early stage. Non-small cell lung cancer is considered to be the most common type of lung cancer, and its stages are as follows-

Stage 1: The cancer is at the beginning stage, where a small portion of the lung is infected without spreading outside the lungs.
Stage 2: Cancer has infected the lungs entirely and spread to nearby lymph nodes.
Stage 3: In this stage, cancer spreads in the lungs and lymph nodes present at the centre of the chest.
Stage 3A: Cancer spreads in all lymph nodes present on one side of the chest where it initially started.
Stage 3B: Cancer spreads in lymph nodes on the other side of the chest and gradually moves to the lymph nodes above the collarbone.
Stage 4: Cancer spreads in both lungs and the area around the lungs and gradually moves to other organs.
Small cell lung cancer (SCLC) is another form of lung cancer and has two main stages-
Limited Stage: Cancer is found in a small portion in only one lung and lymph nodes on the same side of the chest.
Extensive Stage: In this stage, cancer begins to spread to the entire lung and gradually moves to the other lung and lymph nodes around it. It also infects lung fluids, bone marrow and other organs. Most often, people suffering from SCLC are diagnosed at an extensive stage.

Diagnosis And Treatment Of Lung Cancer

Diagnosis- Once you show symptoms of lung cancer or if you've been considered at a higher risk for lung cancer, your doctor will recommend you go through several tests to identify the presence of cancerous cells. Lung cancer can often be misdiagnosed and treated as tuberculosis if not adequately investigated; some of the tests to diagnose cancer are-

Imaging Test—During this process, an abnormal mass can be revealed through an X-ray image. If the X-ray scan comes out clean, a CT/PET-CT scan is recommended. A CT scan clearly shows small lesions.

Biopsy- A tissue sample is taken from the lungs through a biopsy to analyse the presence of cancer cells. Different methods can do a biopsy, and they are -

Bronchoscopy- The patient is sedated to pass a lighted tube down the throat to the lungs to get a closer view and to examine the condition of the lungs.
Mediastinoscopy- This procedure is done in the operation theatre with general anaesthesia, where the doctor makes a small cut at the base of the neck to pass a lighted instrument to take a sample of lymph nodes with the help of surgical tools.
Image-guided needle biopsy- A needle is passed through the chest wall and then through the infected lung tissue to obtain a sample of lymph nodes. This procedure is performed by looking at the imaging tests like CT Scan or ultrasound.

A pathologist analyses all samples collected during the biopsy to investigate further. Once cancer cells are found to be present, the patient has to undergo a further test to know the cancer stage. In this process, a radioactive chemical is injected to highlight unusual areas of bone in the MRI-brain, CT, and PET scan images. Depending on the stage of the cancer and pathology report, you may be asked to undergo molecular tests on biopsy samples, which will help decide the treatment plan.

Treatment Options

Treatment- Once you have been diagnosed with lung cancer, a group of doctors coordinate together to discuss treatment methods and keep each other informed about important decisions taken during the treatment. The team includes -

A thoracic surgeon or surgical oncologist who is a specialist in lung and chest surgeries
A pulmonologist
A medical oncologist.
A radiation oncologist.

There are two significant types of lung cancer- Non-small cell lung cancer (NSCLC) and Small Cell lung cancer (SCLC). The treatment depends on the type of lung cancer, its stages, and other health conditions. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, comprising 80% of lung cancer. The treatment depends on the lung cancer stages and other patient-related and disease-related characteristics. Some of the common treatment methods are -

Surgery- Performing surgery on lung cancer patients entirely depends on the stage of cancer and the health condition to withstand surgery. Surgery is reserved for patients who are diagnosed at an early stage. During the surgery, a portion of the infected lung or the entire lung is removed based on the severity of the infection.
Radiation therapy—Radiation treatment is performed with the help of powerful beams emitted from X-rays and protons to kill cancer cells. During the process, the affected area is targeted by radiation from a moving machine while the patient lies down on a table. Radiation can be after surgery during the early stages of NSCLC or to painful sites to provide symptomatic relief. A combined treatment of radiation and chemotherapy is recommended for Stage III patients who are not candidates for surgery.
Chemotherapy- The treatment includes the use of drugs to eradicate cancer cells. These drugs are induced either orally or through veins in your arms. The drugs are combined to provide treatments for a few weeks or months. Chemotherapy is usually performed after surgery to eradicate any cancer cells left behind. Chemotherapy is also combined with the radiation process for the treatment of Stage III cancer and is usually the only treatment option for Stage IV disease.
Targeted Drug Therapy- Patients suffering from Stage IV lung cancer due to a specific type of mutation in cancer cells (EGFR, ALK, ROS, MET, etc) are recommended to undergo targeted drug therapy. The irregularity in the cell is blocked by drugs that kill cancer cells. With advancements in cancer research and medical science, these drugs have drastically improved the survival rate of advanced-stage cancer.
Immunotherapy—Immunotherapy is a new tool in the lung cancer arsenal. These drugs are given through the intravenous route. They help the patient's immune system fight against cancer cells by clearing the proteins covering the immune system. As of now, Immunotherapy drugs are recommended only for patients suffering from advanced lung cancer.
Palliative Care - It is specialised care that improves the quality of life for patients with advanced-stage cancer. Supportive care helps relieve pain and treat vomiting, fatigue, etc. It is given with or without chemotherapy. It is also given to patients who are not fit for directed cancer therapy or to patients where medical therapy fails.

Road To Recovery And Aftercare

Stay positive and have strong mental health to face challenges and pain during treatment and recovery. It is common to feel anxious and doubtful about the future, and recovery is a slow process that takes time to heal.

Recovery time differs from person to person. You must analyse your mental and physical health before performing any regular activity that drains your energy. Below are a few tips that can help you recover sooner with a positive attitude.

Quit smoking- Smoking worsens the condition of cancer and rapidly increases the chances of reoccurrence. Save your energy by not doing everything by yourself, asking for help from your loved ones, and saving your energy on things you want to do.
Follow healthy eating habits and stick to your nutritionist's lung cancer diet chart.
Avoid situations and scenarios that increase your stress level. Take it easy at work, and do not overexert yourself.
Don't get lazy; maintain a healthy balance between resting and being active.
Always talk to your doctor about improvements and difficulties in recovery during follow-ups.
Go on walks. Start with short, slower walks and gradually increase the distance and pace without exhausting yourself.
Stay focused and feel more confident by setting small goals of recovery. Reward yourself with something you love once the goal is achieved.
Socialise with your family, friends and with people who can put a smile on your face.
Go on holidays, arrange parties with friends, indulge in hobbies you love, get back to work, and participate in charity work.
After recovery, you will look at life differently by prioritising things to do. You will realise that a healthy life is more important and will find ways to decrease stress levels.
Stop alcohol consumption.

Steps To Prevent Lung Cancer

Lung cancer cannot be prevented entirely. However, some lung cancer prevention methods can be followed to reduce the risk of being affected.

Stay away from smoke- Avoiding polluted smoke is the best choice. Educate people around you, create awareness in your children, and talk to them about the risks of breathing smoke or contaminated air.

Quit smoking- If you are a chain smoker or smoke casually, consider quitting smoking as soon as possible. If you cannot do it by yourself, consult a lung doctor who can help you quit smoking by providing medication or nicotine replacement products.

Avoid being a passive smoker- Do not accompany your colleagues or friends to smoking zones if you are a non-smoker. Passive smoking is increasingly dangerous when compared to active smokers. Avoid smoking areas in public places like restaurants, bus stands, etc.

Check for radon exposure at home- Radon is a naturally erupted gas from earth and it can enter your house through cracks in the foundation. Follow precautionary methods during construction to avoid radon exposure. It is one of the critical risk factors for the cause of lung cancer in non-smokers.

Stay away from toxic chemicals at work—If you work in a chemical factory, avoid inhaling toxic chemicals by following the instructions provided by your company. Remember to use face masks for protection and have a regular lung check-up done by a doctor to determine the condition of your lungs. If you have signs of lung cancer or are considered to be at risk of being affected by lung cancer, look for an alternative job.

Eat healthy food—A balanced diet with all the nutrients prevents our body from various diseases. By including fresh fruits and vegetables in your daily meal, you can build a stronger immune system to fight dangerous infections. Avoid consuming vitamins and minerals in supplements; instead, consider consuming food with vitamins and minerals in their natural form.

Exercise regularly- By exercising every day, the body strengthens the immune system. Some proven records show that treatments have shown quicker results due to exercise.