Lung cancer is a common cancer and is gradually becoming the leading cause of cancer related death in men. Recently there has also been a rising incidence in women as well.
In India, Only 15-20% lung cancer cases are detected in early stages. Although age is no bar for lung cancer, so fat it is more common in older people, but can occur in young people and even adolescents.
Smoking and Lung cancer
Cigarette smoking is the most common risk factor for lung cancer; but 10-20% of people overall, and 20% of women with lung cancer are non-smokers. Even smoking a few cigarettes can increase the risk of lung cancer.
People who quit smoking continue to have a lifetime higher risks for lung cancer; more that never smokers. It means that once any one quits smoking, the risk of developing lung cancer goes down; but never becomes zero.
Warning signs and symptoms
There is no effective screening modality for lung cancer; you need to be vigilant if you have the following symptoms or signs persisting for 3 or more weeks:-
- Cough & Fever
- Blood in sputum
- Appearance of any neck swelling
- Change in voice
- Unexplained weight loss & appetite
Pulmonary Tuberculosis or Chest TB is very common in India. Still any unexplained shadow or fluid collection in chest X-ray should not be labelled as Pulmonary Tuberculosis until and unless proven otherwise.
Relevant investigations include CT Scan of Chest and/or Bronchoscopy. Further test include Sputum Cytology or Biopsy from any suspicious tumour seen on above investigations and whole body PET CT for staging.
One should not go for anti-tubercular medication without relevant investigations have been done to rule out any underlying lung malignancy.
Prevention
Prevention is better than Cure. Quit smoking and take medical or psychological assistance if you need. Many hospitals offer quit smoking assistance programs.
Treatment
Surgery forms the mainstay of treatment of early stage lung cancer. Most early cases need Lobectomy/Pneumonectomy and Mediastinal Lymph Node Dissection as a curative approach.
As is true for all cancers, taking a biopsy for confirmation of diagnosis or surgical removal of lung mass does not lead to spread of cancer.
Most cases of advanced cancer can be treated by combination of chemotherapy (administration of oral or injectable medication directed towards cancer) and radiation therapy.
Today we talk about precision therapy for cancers, whether it is surgical resection or precision radiation therapy. More and more targeted therapies are now available for treatment of lung cancer.
Myths about lung cancer
- Smoking does not cause lung cancer.
- It does not occur in smokers.
- Any shadow in chest of fluid can be due to TB, so immediately start anti TB medicines
- Cancer spreads by biopsy.
- Once a smoker, always a smoker, quitting smoking does not help.