What
is this Condition?
Lung cancer usually develops within
the wall or lining of the bronchial tree, the system of branching air passages
within the lungs. Some people have survived for 5 years or more with diagnosed
lung cancer; however, the general prognosis is poor. Although it is largely
preventable, lung cancer is the most common cause of cancer death in men and is
fast becoming the most common cause in women.
What
Causes it?
Medical experts agree that lung
cancer is caused by inhalation of carcinogenic pollutants. Pollutants in
tobacco smoke cause progressive damage to lung cells.
Who is most susceptible to lung
cancer? Any smoker over age 40, especially if he or she began to smoke before
age 15, has smoked a whole pack or more per day for 20 years, or works with or
near asbestos.
What
are its Symptoms?
Because lung cancer rarely causes
symptoms in its early stage, this disease is often advanced at diagnosis.
Late-stage respiratory symptoms typically include “smoker’s cough,” hoarseness,
wheezing, shortness of breath, coughing up blood, chest pain, fever, weakness,
weight loss, appetite loss, and shoulder pain.
Lung cancer may spread to any part
of the body, most commonly to the brain and spinal cord, liver, and bone. The
effects of cancer spread vary greatly depending on tumor size and location.
Hormonal
Effects
Lung tumors may alter the production
of hormones that regulate body functions. Possible problems include:
• breast enlargement in males
• bone and joint pain from
cartilage erosion due to abnormal production of growth hormone
• Cushing’s syndrome
(overproduction of certain steroid hormones) and carcinoid syndrome (diarrhea,
cramps, flushing, skin lesions, labored breathing)
• increased calcium levels in the
blood.
How
is it Diagnosed?
The person’s symptoms and physical
exam findings may strongly suggest lung cancer, but firm diagnosis requires
further evidence.
• Chest X-ray usually shows an
advanced tumor, but it can detect a tumor up to 2 years before symptoms appear.
It also indicates tumor size and location.
• Sputum cytology (the analysis of
cells in the sputum), which is 75% reliable, requires a specimen coughed up
from the lungs.
• Computed tomography scan
(commonly called a CAT scan) of the chest may help determine the tumor’s size
and whether it affects surrounding structures.
• Bronchoscopy (visual exam of the
lungs using an instrument called a bronchoscope) can locate the tumor site.
Specimens taken during this test provide material for cell and tissue analysis.
• Needle biopsy of the lungs can
detect tumors in the outer portion of the lungs. This procedure allows firm
diagnosis in 80% of people with lung cancer.
• Tissue biopsy (removal and analysis
of affected tissue) can be done if the site of cancer spread is accessible.
• Thoracentesis (draining of fluid
from the chest) allows chemical and cell analysis of pleural fluid.
Other tests to detect cancer spread
include bone scan, bone marrow biopsy (removal of some bone marrow for
analysis), and CAT scan of the brain or abdomen.
Also, the doctor will stage the
tumor to determine the extent of the disease, help plan treatment, and make a
prognosis.
How
is it Treated?
Treatment - which consists of
combinations of surgery, radiation, and chemotherapy - may improve the
prognosis and prolong survival.
Surgery may be performed for certain
types of lung cancer. It may include partial or total removal of the lung.
Before surgery, the person may
undergo radiation therapy to help reduce the tumor’s size. Chemotherapy before
radiation helps improve the person’s response to radiation. Chemotherapy may
involve combinations of certain drugs.
Radiation therapy may also be
performed after surgery. Generally, radiation therapy is delayed until 1 month
after surgery to let the wound heal. Then, radiation is directed at the part of
the chest where the tumor is most likely to spread.
Radiation treatments may be the main
form of treatment when surgery is not possible. Radiation implants are another
possible treatment.
In laser therapy, still largely
experimental, a laser beam is directed through a bronchoscope to destroy local
tumors.
What
can a Person with Lung Cancer do?
If you’re receiving chemotherapy and
radiation, take the following steps:
• Eat soft, nonirritating foods
that are high in protein. To maintain proper nutrition, eat high-calorie snacks
between meals.
• To conserve your energy,
alternate activity with rest periods .
• If you’re receiving outpatient
radiation therapy, avoid tight clothing, sun exposure, and harsh ointments on
your chest. As instructed, perform exercises to help prevent shoulder
stiffness.
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