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Signs, Stages, Diagnosis and Treatment of Lung Cancer
It is estimated that around 9.6 million people in the world will lose their lives to cancer in year 2018. 22 percent of these deaths are caused by smoking. Lung cancer is the primary cancer type among the ones triggered by smoking. Studies show that 85% of the individuals with lung cancer are smokers. However number of individuals, who have lung cancer due to secondhand smoking even though they do not smoke themselves, increase with every passing day. Small but effective life style changes yield very beneficial results for decreasing incidence of lung cancer. Prof. İsmail Savaş, M.D. from Chest Diseases Department of Güven Health Group, provides information regarding diagnosis and treatment lung cancer and protection methods within the context of November 1-30, Lung Cancer Awareness Month.
Cancer is the reason behind one out of every six deaths globally. 70% of cancer related deaths are seen in countries with low or moderate income. Incidence and mortality rate of lung cancer is higher among men in comparison to women. While lung cancer is generally seen in individuals over 55 years of age, it recently started to be seen in individuals in their 30s. The most prominent triggering factor for lung cancer is smoking and use of tobacco products. Studies show that some factors other than smoking are also effective in development of lung cancer. These include air pollution, presence of arsenic content in waters, and exposure to asbestos which is used in various industry segments. It has recently been shown that the radon gas that forms due to decay (breaking down) of uranium in stone and soil may also be a factor in lung cancer development. While this exposure does not have importance in outdoors, it became a risk factor after increase of indoor radon amount was proven. Genetic factors are also effective in occurrence of lung cancer along with environmental factors. Risk of lung cancer is higher for individuals with history of lung cancer in close relatives. This risk increases to even higher levels when an individual with genetic predisposition also smokes. A recent research which was conducted this year has shown that risk of cancer is higher for individuals who have more than one close relative with history of cancer.
As a disease which progresses insidiously without showing any signs, identifying lung cancer can be difficult in early stages. The most common signs of lung cancer include recent-onset cough or change in severity of cough, blood in sputum, chest pain that is aggravated by deep breath, laugh and cough, weight loss, loss of appetite, hoarseness, fatigue and tiredness. In addition to these symptoms, infections such as pneumonia and bronchitis, wheezing, bone aches, swelling in head-neck region, headache, occurrence of gland-like swellings in various body parts may also indicate lung cancer. Presenting to a pulmonologist in case of one or several of these complaints has critical importance for early diagnosis of the disease.
The first and most important stage in diagnosis of lung cancer is hearing of patient history and physical examination performed by a physician experienced in assessment of this disease. The next stage is performing Chest X-ray scans, blood tests, Computerized tomography of thorax, PET and Magnetic Resonance imaging methods. However, performing a biopsy, which means obtaining a sample from the tumor, is necessary for final diagnosis. If tumor tissue is in a visible location which can be easily reached, biopsy specimen is obtained from the location with needles. However, a method called Fiberoptic Bronchoscopy, which is the examination of bronchi and lung system with a device that includes a light, becomes necessary in most cases as the tumors of lung cancer are not generally located in easily reached places. Biopsy specimens can be obtained after tumors in distant locations are reached with this method. Endobronchial ultrasonographic needle biopsy, which is shortened as EBUS, may be necessary in some cases to obtain biopsy specimens from lymph nodes caused by the tumor for both diagnosis and treatment of the disease. Moreover, biopsy under guidance of Computerized Tomography and establishing access through bronchial way with bronchoscope are used as methods to obtain biopsy specimens from tumors that are deemed inaccessible in bronchi and tumors located in “peripheral region”. Individuals, especially those above 50 years of age with family history of cancer, history of smoking, should not neglect having lung cancer screenings for early diagnosis of lung cancer. Individuals included in the risk group regarding lung cancer should be monitored with performing various examinations in light of assessments made by physicians. Early diagnosis of lung cancer, which progresses very insidiously, can only be possible under these circumstances.
Treatment methods have been improved in recent years parallel to increase in incidence of lung cancer and technological developments. Especially improvements in surgical methods are beneficial for eradication of the disease while it is still in early stages. While very successful results are achieved with surgical methods used in treatment of the disease, not every patient is eligible for surgery. For example, surgery might not be a proper treatment option for individuals with advanced age who suffer from other diseases such as heart or respiratory failure. Medication therapy and radiotherapy may be a better option for these patients. Today, important improvements are made in both medical therapies and radiotherapy methods and cutting edge technological devices are being used. Moreover, thanks to a better understanding of the biology of tumor, very successful results are also achieved in treatment of lung tumors with medication therapies named target-oriented treatment that directly target the tumor. Along with this, stereotactic radiotherapy, which is applied for some cases where surgery cannot be performed, also yields very successful results in treatment of early stage lung cancers. Above mentioned treatment methods can be performed separately or in combination depending on the decision made by the primary physician of the patient.
It should not be forgotten that lung cancer is a disease which can be prevented with lifestyle changes.
The precautions against lung cancer area may be listed as follows:
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