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Lung Cancer

Lung cancer occurs when cells in the lung grow and multiply uncontrollably, damaging surrounding tissue and interfering with the normal function of the lung. The cells can spread to other parts of the body. When the disease spreads, it is still called lung cancer.Basics

LUNG CANCER TYPES

Non-small cell lung cancer (NSCLC) accounts for 80% of all lung cancers. Non-small cell lung cancers include adenocarcinoma, squamous cell carcinoma and large cell carcinoma. They generally spread very slowly to other organs in the body, and can be hard to detect in the early stages.

Small cell lung cancer is responsible for about 20% of all lung cancers. Also known as “oat cell” cancer, it spreads very quickly through the lungs to other parts of the body.

LUNG CANCER SYMPTOMS

Lung Cancer symptoms vary from person to person and may include:

  • A cough that will not go away and gets worse over time
  • Constant chest pain, or arm and shoulder pain
  • Coughing up blood
  • Shortness of breath, wheezing or hoarseness
  • Repeated episodes of pneumonia or bronchitis
  • Swelling of the neck and face
  • Loss of appetite and/or weight loss
  • Fatigue
  • Clubbing of fingers

Many of these symptoms are not cancer, but if you notice one or more of them for more than two weeks, see your doctor.

RISK FACTORS

Many factors may influence the development of lung cancer, including:

Smoking - This is by far the most important risk factor. Smoking is responsible for 87% of all lung cancer cases in the United States. Also at higher risk are individuals who smoke cigars and pipes.

Family history - Research is beginning to show that a family history of lung cancer may be a risk factor.

Personal history - A person with a previous lung cancer diagnosis is more likely to develop a second lung cancer.

Occupational or environmental exposure – People who are routinely exposed to radon or asbestos are at increased risk for developing lung cancer — particularly if they are smokers.

Radiation exposure - People who are routinely exposed to radiation from occupational, medical and environmental sources are at increased risk.

Industrial exposure - People who are exposed to certain industrial substances like arsenic could be at high risk.

Air pollution - The byproducts from the combustion of fossil fuels can put people at risk.

Environmental tobacco smoke - People who live with or who are routinely around smokers are at higher risk.

Lung diseases - People with lung diseases such as tuberculosis (TB) are at higher risk.

Reducing Your Risk

You can take action to reduce your risk of developing lung cancer. MD Anderson suggests:

  • eliminating tobacco use
  • using protective equipment when exposed to dangerous substances and pollutants
  • avoiding secondhand smoke

Take time to discuss your own risks with your health care provider who can best advise you on the screening exams and risk-reduction strategies that are right for you.

SCREENING

Cancer screenings are medical tests that are performed when a person has no symptoms. There presently are no effective screening tests to find lung cancer early. X-rays and/or laboratory analysis of the cells in phlegm and fiber optic screening are limited in detecting lung cancer before it spreads. CT scans may be able to detect lung cancer earlier, but their ability to improve long-term survival has not been proven.

DIAGNOSING LUNG CANCER

Although there are currently no screening tests for lung cancer, there are many procedures that can be used to diagnose lung cancer. Some of these tests may be used in combination to obtain the most accurate diagnosis possible.

  • Chest X-rays: A common method that photographs the lungs. Specialists can spot abnormal areas that may indicate the presence of cancer.
  • CAT scans: A specialized X-ray machine which uses radiographic beams to create precise computerized pictures of the lung
  • Bronchoscope: A thin flexible tube with a tiny camera, which is inserted through the nose or mouth and down into the lungs. A bronchoscope can also take a small tissue sample for biopsy.
  • Fine Needle Aspiration (FNA): A thin needle attached to a syringe is inserted through the chest into the lung tissue and cells are drawn out for examination under a microscope
  • Positron Emission Tomography (PET) uses a special type of scanner and a form of sugar that contains a radioactive atom. This sugar is injected into a vein, and the scanner rotates around the patient's body and records the sugar as it moves through the body and collects in organs. Cancer cells show up brighter in the pictures because they absorb more sugar than normal cells.
  • Sputum cytology: Cells taken from mucus expelled by coughing are analyzed for the presence of cancer.
  • Thoracentesis: Fluid from around the lungs is drawn out with a needle for examination.
  • Video Assisted Thoracoscopic Surgery (VATS): VATS can be used to aid in the diagnosis of thoracic cancers. Using a limited number of tiny incisions, small diameter video-thoracoscopes can allow examination of the entire thoracic cavity. Biopsies of the lining of the chest cavity (pleura), lung nodules, mediastinal masses and pleural fluid can easily be obtained for diagnosis.

STAGES OF NON-SMALL CELL LUNG CANCER

Doctors describe non-small cell lung cancer based on the size of the lung tumor and whether cancer has spread to the lymph nodes or other tissues. A staging system, below, is used to characterize the tumors. Staging is very important when deciding the best form of treatment for each patient.

Early stage lung cancer is considered to be any tumor classified as stage 0 through stage IB, in which the cancer is still localized and hasn't spread to nearby lymph nodes.

Occult stage: Lung cancer cells are found in sputum or in a sample of water collected during bronchoscopy, but a tumor cannot be seen in the lung.

Stage 0: Cancer cells are found only in the innermost lining of the lung. The tumor has not grown through this lining. A stage 0 tumor is also called carcinoma in situ. The tumor is not an invasive cancer.

Stage IA: The lung tumor is an invasive cancer. It has grown through the innermost lining of the lung into deeper lung tissue. The tumor is no more than three centimeters across (less than 1 ¼ inches). It is surrounded by normal tissue and the tumor does not invade the bronchus. Cancer cells are not found in nearby lymph nodes.

Stage IB: The tumor is larger or has grown deeper, but cancer cells are not found in nearby lymph nodes. The lung tumor is one of the following:

  • The tumor is more than three centimeters across
  • It has grown into the main bronchus
  • It has grown through the lung into the pleura

Stage IIA: The lung tumor is no more than three centimeters across. Cancer cells are found in nearby lymph nodes.

Stage IIB: The tumor is one of the following:

  • Cancer cells are not found in nearby lymph nodes, but the tumor has invaded the chest wall, diaphragm, pleura, main bronchus or tissue that surrounds the heart
  • Cancer cells are found in nearby lymph nodes, and one of the following:
  • The tumor is more than three centimeters across
  • It has grown into the main bronchus
  • It has grown through the lung into the pleura

Stage IIIA: The tumor may be any size. Cancer cells are found in the lymph nodes near the lungs and bronchi, and in the lymph nodes between the lungs but on the same side of the chest as the lung tumor.

Stage IIIB: The tumor may be any size. Cancer cells are found on the opposite side of the chest from the lung tumor or in the neck. The tumor may have invaded nearby organs, such as the heart, esophagus or trachea. More than one malignant growth may be found within the same lobe of the lung. The doctor may find cancer cells in the pleural fluid.

Stage IV: Malignant growths may be found in more than one lobe of the same lung or in the other lung. Cancer cells may be found in other parts of the body, such as the brain, adrenal gland, liver or bone.

TREATMENTS

Surgery

The standard operation for lung cancer includes removal of the lobe of the lung in which the tumor resides (lobectomy) and dissection and removal of the mediastinal lymph nodes (MLND). This procedure is usually performed through an incision on the back and requires the ribs to be spread apart (right).

Advances in minimally invasive surgery are improving treatment outcomes for many lung cancer patients. Video Assisted Thoracoscopic Surgery (VATS), a minimally invasive technique, is resulting in better outcomes and decreased recovery times. VATS lobectomy can accomplish the same cancer operation as the traditional open procedure, but requires only three or four small incisions and does not involve spreading of the ribs. VATS is an option for selected lung cancer patients, particularly those have a small tumor in the outer regions of the lung .

Radiation Therapy

External beam radiation treatment is most often used in conjunction with surgery, but it can also be combined with chemotherapy as an alternative to surgery.

Proton therapy is an innovative treatment at MD Anderson, which delivers high radiation doses directly to the tumor site, with no damage to nearby healthy tissue. Proton therapy results in better cancer control with fewer side effects. Many lung cancer patients may be candidates for proton therapy.

Chemotherapy

Chemotherapy, the use of drugs to destroy tumors, is usually used along with surgery in lung cancer patients. Chemotherapy can make the tumor more manageable before surgery, or to destroy lingering cancer cells at the tumor site after surgery.

Photodynamic Therapy (PDT)

Photodynamic therapy involves a light-sensitive chemical injected into the body, where it remains longer in cancer cells than it does in normal cells. The chemical is activated with a laser that initiates the destruction of cancer cells. PDT is best used on very small tumors, or to reduce some symptoms of lung cancer.

SUPPORT

Cancer is a journey that no one needs to take alone. There are many forms of support to help you through every stage: diagnosis, treatment and survivorship. Whether you meet with other cancer survivors like yourself, use complementary therapies or individual coping mechanisms, support is available. Listed below are just some of the ways to find help...and hope.

Support Groups

Getting together with other cancer patients in a support group is a valuable coping tool. Support groups are usually focused on a single disease or topic, such as breast cancer survivors or people coping with life-changing side effects from their cancer or cancer therapy. These groups allow participants to meet others like themselves and seek strength from each other. Most major cities and cancer hospitals offer support groups that meet weekly or monthly. There are also dozens of online support web sites or message boards for those who may not have access to a traditional meeting.

Complementary Therapies

Complementary therapies are used in conjunction with cancer treatment, in an effort to reduce treatment side effects, ease depression and anxiety and help cancer patients take their mind off the negative aspects of their situation. Complementary therapies may include mind-body exercises like yoga, tai chi and Qi gong; visualization or guided imagery; using art or music as therapy and self-expression and traditional Eastern medicine such as acupuncture.

Physical Activity

Staying physically active as much as possible during cancer treatment has many positive benefits. Physical activity stimulates the release of endorphins, a hormone that helps elevate mood, as well as decreasing feelings of fatigue.

Exercises for cancer patients can range from simple stretches done in the bed or chair, to more active pursuits such as walking or light gardening work. However, it’s important not to push yourself too hard. Check with your doctor before attempting any physical activity to make sure you are up to it.

Journaling/Blogging

Many people find it helpful to keep a journal of their cancer treatment experience. It may be as simple as recording symptoms and side effects into a notebook, or may include personal emotions and opinions about what they may be going through. Journals can be private, like a diary, or shared with loved ones and even strangers.

Increasingly, people are turning to the Internet to share their cancer journey with the world at large and to seek out others with similar experiences. Many cancer patients have begun their own web log, or “blog” to publicize their battle with cancer. Twitter, a mini-blogging technology that limits posts to 140 characters, has also proven to be a helpful tool for cancer patients to keep friends updated and reach out to others.

About Us

St. Gregorios Medical Mission Hospital was started in 1975, and was registered under the Travancore — Cochin Literacy, Scientific and Charitable Act with Reg No. A334/78. The Institution is owned and controlled by the society of the Malankara Orthodox Syrian Church, the head of which is His Holiness Baselious Marthoma Paulose II, Read more

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