MEDICAL BLOGS:LUNG CANCER (Part -1)

There are three types of lung cancer described and it is important to know which type one is suffering from, as the treatment is tailored accordingly:

1.    Non small cell lung cancer ( NSCLC)

·      85% of cases fall under this category

·      There are three sub types namely squamous cell, adenocarcinoma and large cell carcinoma.

2.    Small cell lung cancer  

·      10-15% of cases fall under this category.

·      Also known as Oat cell carcinoma. It is known to spread faster than other lung cancers.

3.    Carcinoid lung cancer

·      5% of cases fall under this category

·      Also called Neuroendocrine tumors. Grow slowly and spread is rare.

Non Small Cell Lung Cancer ( NSCLC)

Adenocarcinoma:

·      40% of NSCLC are adenocarcinomas.

·      Common in current or former smokers.

·      Also most common type of lung cancer seen in non-smokers.

·      It is more common in women than in men.

·      More likely to occur in younger people than other types of lung cancer.

·      Adenocarcinoma is usually found in outer parts of the lung.

·      It tends to grow slower than other types of lung cancer and is more likely to be found before it has spread.

            Squamous cell (epidermoid) carcinoma:

·      25% to 30% of all lung cancers are squamous cell carcinomas.

·      These cancers start in early versions of squamous cells, which are flat cells that line the inside of the airways in the lungs.

·      They are often linked to a history of smoking and tend to be found in the central part of the lungs, near a main airway (bronchus).

            Large cell (undifferentiated) carcinoma:

·      10% to 15% of lung cancers.

·      It can appear in any part of the lung.

·      It tends to grow and spread quickly, which can make it harder to treat.

Other subtypes: A few other rare sub types of NSCLC exist, such as adenosquamous carcinoma and sarcomatoid carcinoma, but are much less common.

American Cancer Society’s guidelines for lung cancer screening

·      Screening is meant to find cancer in people who do not have symptoms of the disease.

·      Patients should be asked about their smoking history

·      Patients who meet all of the under mentioned criteria may be considered as candidates for lung cancer screening:

*55 to 74 years old 

*In fairly good health.

*Have at least a 30 pack-year smoking history. A pack-year is the number of cigarette packs smoked each day multiplied by the number of years a person has smoked. Someone who smoked a pack of cigarettes per day for 30 years has a 30 pack-year smoking history, as does someone who smoked 2 packs a day for 15 years.

*Are either still smoking or have quit smoking within the last 15 years. 

*If you fit all of the criteria listed above for lung cancer screening, you and your doctor should talk about screening, including possible benefits and harms, as well as the limitations of screening.

·      Like with any type of screening, not everyone who gets screened will benefit.

·      Screening with low dose CT, will not find all lung cancers, and not all of the cancers that are found will be found early.

·      One might need more CT scans, or even invasive tests such as a lung biopsy, in which a piece of lung tissue is removed with a needle or during surgery. These tests have risks of their own.

·      Those who have metal implants / pace makers are not screened as it interferes with the CT images.

SIGNS & SYMPTOMS OF NSCLC 

Most lung cancers do not cause any symptoms until they have spread. If you go to your doctor when you first notice symptoms, your cancer might be diagnosed early.
Yellowing of the skin and eyes (jaundice), from cancer spread to the liver

The most common symptoms of lung cancer are:

·      Persistent cough

·      Coughing up blood or rust-colored sputum

·      Chest pain that is often worse with deep breathing, coughing, or laughing

·      Hoarseness

·      Weight loss and loss of appetite

·      Shortness of breath

·      Feeling tired or weak

·      Infections such as bronchitis and pneumonia that don’t go away or keep coming back

·      New onset of wheezing

·      When lung cancer spreads to distant organs, it may cause:

·      Bone pain (like pain in the back or hips)

·      Nervous system changes (such as headache, weakness or numbness of an arm or leg, dizziness, balance problems, or seizures), from cancer spread to the brain or spinal cord

·      Lumps near the surface of the body, due to cancer spreading to the skin or to lymph nodes, such as those in the neck or above the collarbone 

·      Most of these symptoms can be caused by something other than lung cancer.

Still, if you have any of these problems, it’s important to see your doctor right away so the cause can be found and treated, if needed.

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Author- 

   

Dr. Ganjoo 

Head-Yoddhas Medical Expert Panel