What is this Condition?
Lung cancer usually develops within the wall or lining of the bronchial tree, the system of branching air passages within the lungs. Some people have survived for 5 years or more with diagnosed lung cancer; however, the general prognosis is poor. Although it is largely preventable, lung cancer is the most common cause of cancer death in men and is fast becoming the most common cause in women.
What Causes it?
Medical experts agree that lung cancer is caused by inhalation of carcinogenic pollutants. Pollutants in tobacco smoke cause progressive damage to lung cells.
Who is most susceptible to lung cancer? Any smoker over age 40, especially if he or she began to smoke before age 15, has smoked a whole pack or more per day for 20 years, or works with or near asbestos.
What are its Symptoms?
Because lung cancer rarely causes symptoms in its early stage, this disease is often advanced at diagnosis. Late-stage respiratory symptoms typically include "smoker's cough," hoarseness, wheezing, shortness of breath, coughing up blood, chest pain, fever, weakness, weight loss, appetite loss, and shoulder pain.
Lung cancer may spread to any part of the body, most commonly to the brain and spinal cord, liver, and bone. The effects of cancer spread vary greatly depending on tumor size and location.
Hormonal Effects
Lung tumors may alter the production of hormones that regulate body functions. Possible problems include:
a€? breast enlargement in males
a€? bone and joint pain from cartilage erosion due to abnormal production of growth hormone
a€? Cushing's syndrome (overproduction of certain steroid hormones) and carcinoid syndrome (diarrhea, cramps, flushing, skin lesions, labored breathing)
a€? increased calcium levels in the blood.
How is it Diagnosed?
The person's symptoms and physical exam findings may strongly suggest lung cancer, but firm diagnosis requires further evidence.
a€? Chest X-ray usually shows an advanced tumor, but it can detect a tumor up to 2 years before symptoms appear. It also indicates tumor size and location.
a€? Sputum cytology (the analysis of cells in the sputum), which is 75% reliable, requires a specimen coughed up from the lungs.
a€? Computed tomography scan (commonly called a CAT scan) of the chest may help determine the tumor's size and whether it affects surrounding structures.
a€? Bronchoscopy (visual exam of the lungs using an instrument called a bronchoscope) can locate the tumor site. Specimens taken during this test provide material for cell and tissue analysis.
a€? Needle biopsy of the lungs can detect tumors in the outer portion of the lungs. This procedure allows firm diagnosis in 80% of people with lung cancer.
a€? Tissue biopsy (removal and analysis of affected tissue) can be done if the site of cancer spread is accessible.
a€? Thoracentesis (draining of fluid from the chest) allows chemical and cell analysis of pleural fluid.
Other tests to detect cancer spread include bone scan, bone marrow biopsy (removal of some bone marrow for analysis), and CAT scan of the brain or abdomen.
Also, the doctor will stage the tumor to determine the extent of the disease, help plan treatment, and make a prognosis.
How is it Treated?
Treatment - which consists of combinations of surgery, radiation, and chemotherapy - may improve the prognosis and prolong survival.
Surgery may be performed for certain types of lung cancer. It may include partial or total removal of the lung.
Before surgery, the person may undergo radiation therapy to help reduce the tumor's size. Chemotherapy before radiation helps improve the person's response to radiation. Chemotherapy may involve combinations of certain drugs.
Radiation therapy may also be performed after surgery. Generally, radiation therapy is delayed until 1 month after surgery to let the wound heal. Then, radiation is directed at the part of the chest where the tumor is most likely to spread.
Radiation treatments may be the main form of treatment when surgery is not possible. Radiation implants are another possible treatment.
In laser therapy, still largely experimental, a laser beam is directed through a bronchoscope to destroy local tumors.
What can a Person with Lung Cancer do?
If you're receiving chemotherapy and radiation, take the following steps:
a€? Eat soft, nonirritating foods that are high in protein. To maintain proper nutrition, eat high-calorie snacks between meals.
a€? To conserve your energy, alternate activity with rest periods .
a€? If you're receiving outpatient radiation therapy, avoid tight clothing, sun exposure, and harsh ointments on your chest. As instructed, perform exercises to help prevent shoulder stiffness.
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