Lung Cancer

Lung Cancer begins in your lungs which are 2 spongy organs whose function is to help you breathe through gaseous exchange (when you inhale, oxygen is replenished within your cells that pass through your lungs, and when you exhale carbon dioxide is released).

Lung Cancer causes your lung cells to divide uncontrollably when they should not, which lead to the growth of tumours thus reducing an individual’s ability to breathe.

There are two major types of lung cancer based on the appearance of lung cancer cells under the microscope.

  • Small cell lung cancer occurs mostly in heavy smokers and is less common than non-small cell lung cancer
  • Non-small cell lung cancer is a term that houses several types of lung cancers that behave in similar ways. These include: Squamous cell carcinoma, adenocarcinoma and large cell carcinoma.

The staging of lung cancer indicates how far and severe the cancer has spread through your body and is extremely complex.

Non-small cell lung cancer is typically staged using the tumour size and the spread to guide them.

  • Occult, or hidden: Cancer does not show on imaging scans, but cancerous cells might appear in the phlegm or mucus and may have reached other parts of the body.
  • Stage 0: The doctor finds abnormal cells only in the top layers of cells lining the airways.
  • Stage I: A tumour has developed in the lung, but is under 5 cm and has not spread to other parts of the body.
  • Stage II: The tumour is smaller than 5 cm and might have spread to the lymph nodes in the area of the lung, or smaller than 7 cm and spread to nearby tissues but not lymph nodes.
  • Stage III: Cancer has spread to the lymph nodes and reached other parts of the lung and surrounding area.
  • Stage IV: Cancer has spread to distant body parts, such as the bones or brain.

Small cell lung cancer has its own categories, limited and extensive, referring to whether cancer has spread within or outside of the lungs.

Statistics

Lung Cancer is the leading cause of cancer deaths in South Africa and also in the United States.

Lung Cancer is the 3rd most diagnosed cancer in South Africa according to Discovery and the 2nd most diagnosed cancer according to the South African ranking. Lung Cancer tops the most diagnosed list for men and is the 3rd most prevalent cancer diagnosed for women.

Lung Cancer is the 4th most costly Cancer in South Africa.

There is a five-year survival rate of around 54% in early stage lung cancer, but only around 4% in advanced, inoperable lung cancer.

Signs and Symptoms

Signs/ symptoms for lung cancer only show when Lung Cancer is in its advanced stages and may include:

  • A new cough that doesn’t go away
  • Coughing up blood, even a small amount
  • Shortness of breath
  • Chest pain
  • Hoarseness
  • Losing weight without trying
  • Bone pain
  • Headache

Diagnosis

Low-dose CT scans may be used to screen for lung cancer. This is usually done for people aged 55 and older who were heavy smokers but are otherwise healthy.

Other tests include:

  • X-Ray Imaging which can reveal an abnormal mass or nodule in the lungs.
  • A CT scan can reveal small lesions in your lungs which are otherwise not detected in an X-Ray
  • Sputum Cytology: With a cough that yields sputum (phlegm/ mucus), the sputum can be analysed under the microscope to determine the presence of cancerous cells
  • A Biopsy (tissue sample) of abnormal cells may be removed for analysis in several ways.
  • Bronchoscopy lets doctors look at your lungs and air passages to better determine the cause of your lung problem.
  • Mediastinoscopy is a thoracic (midback  and neck) surgical procedure which examine the space in the thoracic cavity between the lungs for various abnormal indications as well as diagnostic tissue sampling.
  • Needle Biopsy is the use of X-ray or CT images to guide a needle into the affected area in your lungs to collect suspicious lung tissue.

Risk Factors

Individuals who smoke are most at risk for Lung Cancer with the risk increasing depending on how long a person has been smoking and how many cigarettes an individual has smoked.

Prolonged exposure to second-hand smoke also increases the chances of being diagnosed with Lung Cancer.

Exposure to Radon Gas, Asbestos, arsenic, chromium and nickel which are carcinogens increase your risk of developing lung cancer.

Family history plays a huge role in whether an individual will be diagnosed with lung cancer or not.

Treatment

A treatment plan will be discussed by your team of various doctors and is based on factors such as your overall health, the stage of cancer and your preference.

Your treatment can include chemotherapy for small cell lung cancer however, the most common treatments are surgery and radiation therapy.

In surgery a piece of lung, called a lobe, or a large segment of the lung can be removed and is called a lobectomy. Only in severe cases is the lung completely removed.