Lung cancer: a practical guide
What is lung cancer?
As the name implies, it starts in one or both lungs, in the cells that line the bronchi and in other parts of the lung, such as the bronchioles or alveoli. This type of cancer is among the most deadly cancers. Smoking excessively is a high risk factor for contracting this disease, but that does not mean that people who do not smoke can not develop it.
Types of lung cancer
Determine and find out about the type of lung cancer that is developing is essential for defining the type of suitable treatment and its prognosis. It is generally categorized into two types:
Non-small cell lung cancer (non-small cell)
This is the most common type of lung cancer; between 85% and 90% of lung cancers are non-small cell cancers. Includes several types of lung cancer that behave in a similar way. It has 3 main cancer subtypes, the cells of these subtypes differ in size, shape and chemical composition when observed under a microscope:
- Squamous cell carcinoma
- Adenocarcinoma
- Large cell carcinoma
Small cell lung cancer (small cell)
This type of lung cancer is also known as oat cell cancer. Between 10% and 15% of lung cancers are small cell. It usually begins in the bronchi, near the center of the chest.
Symptoms and causes of lung cancer
When talking about risk factors, they refer to any agent that increases the risk of lung cancer, meaning those exposed to these factors are more likely to suffer from this disease.
Several factors can affect the presence of this disease, these are the most common:
Risk factors
- Smoking
Smoking is often linked to squamous cell carcinoma and small cell cancer, and occasionally to adenocarcinoma. Between 80-90% of lung cancers occur in smokers or in people who have recently stopped smoking. Passive smokers, who are frequently exposed to cigarette smoke, are also at risk of developing lung cancer.
- Contact with toxic substances
People who, due to their work or living close to an extraction source, are in frequent contact with asbestos (insulation, mining, textile industry), oil and its derivatives, nickel and radon, are more likely to get this type of cancer.
- Age
Age can increase the risk of suffering from this disease, but it is not exclusive to lung cancer, it is the case for most tumors, which is why it is important to have frequent medical check-ups after the age of 45.
- Gender
This type of cancer is three times more likely to occur in men than women. This is due to the fact that historically, women started smoking between 30 and 40 years later than men.
- Genetics
If there is a family history of this type of cancer, the risk of developing lung cancer is multiplied by four. It is important to check whether parents, siblings, grandparents or uncles have had lung cancer.
- Benign diseases
Patients diagnosed with COPD (chronic obstructive pulmonary disease) have an increased risk of developing lung cancer. Other diseases related to lung cancer are idiopathic pulmonary fibrosis or scleroderma.
Symptoms of lung cancer
Many lung cancers do not show symptoms until they have spread far enough to where they are harder to treat. On the other hand, some people present symptoms in the early stages. As soon as the symptoms appear, it is important to go to the doctor to obtain an early diagnosis and start effective treatment. These are the most common symptoms of this type of cancer:
- Cough that does not go away or gets worse
- Chest pain, which intensifies with deep breathing, coughing or laughing
- Hoarseness
- Unexplained weight loss or loss of appetite
- Coughing blood or saliva or phlegm (brown)
- Difficulty breathing
- Fatigue or weakness
- Infections such as bronchitis or pneumonia that do not go away or that are recurring
- Wheezing
When lung cancer spreads to further organs, it can cause:
- Pain in the bones (back or hips).
- Neurological changes (headache, weakness or numbness arms or legs, dizziness, problems with balance or seizures).
- Jaundice (yellowish skin and eyes).
- Skin rashes
It is very important that the doctor checks the symptoms because many of these symptoms are probably due to conditions other than lung cancer.
Lung cancer diagnosis
At the first signs or symptoms of lung cancer, the attending physician will request tests that may include imaging studies and / or lung tissue biopsies. These are the tests that are usually used to diagnose this type of cancer:
- Chest x-ray
It shows the presence of masses or spots in the lungs.
- Computerized tomography
Provides information on the size, shape and position of a tumor in the lung, and can help detect enlarged lymph nodes that may contain cancer that has spread from the lungs.
- CT-guided needle biopsy
A CT scan is used to accurately guide the needle from a biopsy to the suspicious area. The CT scan continues until the doctor can see that the needle is inside the mass. Then, a biopsy sample is obtained and examined under a microscope.
- Magnetic resonance imaging (MRI)
Provides detailed images of the soft tissues in the body. It can detect the possible spread of brain cancer or spreading to the spinal cord depending on the presence of certain symptoms.
- Positron emission tomography (PET)
Very useful if it is suspected to be a small cell lung cancer in the early stages (or limited). You can see if the cancer has spread to the lymph nodes or other organs, which can help determine treatment options.
- Bone scintigraphy
It helps show if the cancer has spread to the bones. A small amount of low-radioactivity material is injected into the vein and settles in areas where bone has changed in the skeleton over the course of several hours.
- Sputum cytology
The phlegm produced when coughing is examined under a microscope to determine if it contains cancer cells. This test helps find cancers that originate in the main airways.
- Needle biopsy
A hollow needle is often used to obtain a small sample of a suspicious looking lump. An advantage of this procedure is that they do not require a surgical incision.
- Bronchoscopy
It helps find some tumors or obstructions in the larger airways of the lungs. This study can be used to find a tumor in the lung or to take a sample of a tumor to find out if it is cancerous.
- Endobronchial ultrasound
Uses sound waves to create images of the interior of the body. A small instrument resembling a microphone called a transducer, emits sound waves and collects echoes when they bounce off body tissues.
Treatments for lung cancer
According to the patient’s general health, the type and the stage of cancer, the following treatment options will be considered:
Surgery
If the cancer is limited to the lungs and has not spread to other organs or tissues, surgery is viable. The purpose is to treat removing as much cancerous tissue. The types of surgeries to eliminate lung cancer are:
- Wedge resection: removes a small part of the lung where the tumor is, as well as a section of healthy tissue
- Segmental resection : removes a larger part of the lung, but not an entire lobule
- Lobectomy : removes the entire lobule of a lung
- Pneumonectomy : removes the entire lung
The techniques used in this type of surgery have advanced considerably. Minimally invasive surgery and video thoracoscopic surgery reduce time spent in hospital following surgery.
Radiation
Use high-energy energy beams, such as X-rays or protons, to destroy cancer cells. In locally advanced lung cancer, radiation is used before or after surgery. Usually, this treatment is combined with chemotherapy when surgery is not an option. For advanced types of lung cancer that have spread to other parts of the body, radiation therapy can help relieve symptoms, such as pain.
Chemotherapy
Medication is administered (orally or intravenously) to kill cancer cells. A combination of medication is given over a period of several weeks to months, with breaks in between, for recovery.
It is usually used after surgery to kill any remaining cancer cells. It can be used alone or in combination with radiotherapy. For people with advanced lung cancer, chemotherapy can be used to relieve pain and other symptoms.
Targeted therapy
This treatment focuses on specific abnormalities present within the cancer cells. By blocking these abnormalities, treatments with targeted drugs can destroy cancer cells.
Alternative and complementary treatments
They are complements to conventional treatments for the treatment of lung cancer:
- Palliative care:
specialized care focused on relieving pain and other symptoms of cancer. An interdisciplinary treatment that includes the patient, their home environment and other specialists to provide treatment on various fronts (nnutrition, physiotherapy, psychology, etc).
- Acupuncture:
the application of needles, heat, pressure and other treatments in one or more places on the skin known as pressure points. This type of therapy helps relieve nausea and vomiting, which can be side effects of conventional therapies used to fight cancer.
- Aromatherapy with essential oils:
Essential oils from plants are used as therapy to improve physical, emotional and spiritual well-being. In cancer patients it is used as supportive care to improve the quality of life, by decreasing tension and anxiety.
- Cognitive-behavioral therapy:
A type of psychotherapy that helps patients modify their behavior by changing the way they think and feel about certain things. It is useful to make the patient face his illness from a more conscious and realistic perspective.
- Medicinal cannabis*:
The use of cannabis derivatives as a complementary treatment for cancer is becoming more increasingly popular. Especially relieving the side effects of conventional treatments (nausea, vomiting, loss of appetite, pain) In addition to the problems caused by stress such as anxiety and sleep problems. Cannabis derivatives help improve these symptoms.
(*Always check to see if it is legal in your jurisdiction before obtaining any cannabis-based product.)