CANCER OF THE LUNG :TREATMENT ,DIAGNOSIS AND SYMPTOMS

Lung cancer is the leading cause of cancer death, according to the American Cancer Society. An estimated 154,050 people are expected to die from lung cancer in 2018.


The disease carries a higher risk of death than breast, colon, and prostate cancer combined. It is also largely preventable through not smoking. Lung cancer is more treatable if diagnosed in its early stages.

The prognosis and outlook for lung cancer depend upon the cancer type and the spread. People should talk to their doctor who can provide a more accurate prognosis, taking into account the individual's overall health and the extent of their cancer.

Lung cancer is a serious and potentially deadly disease that affects a person's ability to breath.

However, early diagnostic screening of individuals who are at high risk for lung cancer can help them receive treatment in earlier and more treatable stages. The size and spread of cancer determine people's outlook.

Treatment options include surgery to remove sections or all of the lung, chemotherapy, and radiation therapy, as well as targeted drug therapy.

If a person has concerns that they could be at risk for lung cancer, they should talk to their doctor.
Lung cancer may not produce any noticeable symptoms in the early stages, and many people aren’t diagnosed until the disease has advanced. Read on to learn about nine early lung cancer symptoms, and how early screening may help people at high risk for the disease.



1. Cough will not stop
Be on alert for a new cough that lingers. A cough associated with a cold or respiratory infection will go away in a week or two, but a persistent cough that lingers can be a symptom of lung cancer.

Don’t be tempted to dismiss a stubborn cough, whether it’s dry or produces mucus. See your doctor right away. They will listen to your lungs and may order an X-ray or other tests.

2. Change in a cough
Pay attention to any changes in a chronic cough, particularly if you smoke. If you’re coughing more often, your cough is deeper or sounds hoarse, or you’re coughing up blood or an unusual amount of mucus, it’s time to make a doctor’s appointment.

If a family member or friend experiences these changes, suggest that they visit their doctor. Learn about the symptoms and causes of bronchorrhea.

3. Breathing changes
Shortness of breath or becoming easily winded are also possible symptoms of lung cancer. Changes in breathing can occur if lung cancer blocks or narrows an airway, or if fluid from a lung tumor builds up in the chest.

Make a point of noticing when you feel winded or short of breath. If you find it difficult to breathe after climbing stairs or performing tasks you once found easy, don’t ignore it.

4. Pain in the chest area
Lung cancer may produce pain in the chest, shoulders, or back. An aching feeling may not be associated with coughing. Tell your doctor if you notice any type of chest pain, whether it’s sharp, dull, constant, or intermittent.

You should also note whether it’s confined to a specific area or occurring throughout your chest. When lung cancer causes chest pain, the discomfort may result from enlarged lymph nodes or metastasis to the chest wall, the lining around the lungs, called pleura, or the ribs.

5. Wheezing
When airways become constricted, blocked, or inflamed, the lungs produce a wheezing or whistling sound when you breathe. Wheezing can be associated with multiple causes, some of which are benign and easily treatable.

However, wheezing is also a symptom of lung cancer, which is why it merits your doctor’s attention. Don’t assume that wheezing is caused by asthma or allergies. Have your doctor confirm the cause.


6. Raspy, hoarse voice
If you hear a significant change in your voice, or if someone else points out that your voice sounds deeper, hoarse, or raspier, get checked out by your doctor.

Hoarseness can be caused by a simple cold, but this symptom may point to something more serious when it persists for more than two weeks. Hoarseness related to lung cancer can occur when the tumor affects the nerve that controls the larynx, or voice box.

7. Drop in weight
An unexplained weight loss of 10 pounds or more may be associated with lung cancer or another type of cancer. When cancer is present, this drop in weight may result from cancer cells using energy. It could also result from shifts in the way the body uses energy from food.

Don’t write off a change in your weight if you haven’t been trying to shed pounds. It may be a clue to a change in your health.

8. Bone pain
Lung cancer that has spread to the bones may produce pain in the back or in other areas of the body. This pain may worsen at night while resting on the back. It may be difficult to differentiate between bone and muscle pain. Bone pain is often worse at night and increases with movement.

Additionally, lung cancer is sometimes associated with shoulder, arm, or neck pain, although this is less common. Be attentive to your aches and pains, and discuss them with your doctor.

9. Headache
Headaches may be a sign that lung cancer has spread to the brain. However, not all headaches are associated with brain metastases.

Sometimes, a lung tumor may create pressure on the superior vena cava. This is the large vein that moves blood from the upper body to the heart. The pressure can also trigger headaches, or in more severe cases, migraines.

Easy screening may help
Chest X-rays are not effective in detecting early stage lung cancer. However, low-dose CT scans have been shown to reduce lung cancer mortality by 20 percent, according to a 2011 study.

In the study, 53,454 people at high risk for lung cancer were randomly assigned either a low-dose CT scan or an X-ray. The low-dose CT scans detected more instances of lung cancer. There were also significantly fewer deaths from the disease in the low-dose CT group.

People at high risk
The study prompted the U.S. Preventive Services Task Force to issue a draft recommendation that people at high risk for lung cancer receive low-dose CT screenings. The recommendation applies to people who:

have a 30-pack year or more smoking history and currently smoke
are between the ages of 55 and 80
have smoked within the past 15 years
Takeaway
If you’re experiencing any of the symptoms associated with lung disease or meet any of the criteria that apply to people at high risk, talk with your doctor about whether low-dose CT screening is appropriate for you.

In about 40 percent of people diagnosed with lung cancer, the diagnosis is made after the disease has advanced. In one-third of those diagnosed, the cancer has reached stage 3. Receiving a low-dose CT screening could prove to be a very beneficial measure.

Diagnosis

If a doctor identifies a suspicious lesion on a lung cancer screening, or a person is experiencing symptoms that could indicate lung cancer, several diagnostic tests are available to confirm the next steps.

Examples of these include:

Imaging studies: Computed tomography (CT) and positron emission tomography (PET) scans might reveal areas of lung tissue with cancer. Bone scans can also indicate cancerous growths. Doctors may also use these scans to track the progress of treatment or to ensure cancer has not returned, following a course of treatment.

Tissue sampling: If a doctor identifies a suspicious lesion on an imaging study, they may recommend taking a sample of lung tissue to test for potentially cancerous cells.

There are different ways to take a tissue sample, and the method often depends on the location of the lesion.

One example is when a doctor performs a bronchoscopy, which involves inserting a special thin, lighted scope with a camera on the end. This helps the doctor to see the lesion and then to obtain samples.

Less accessible lesions in the lungs may require a more invasive surgical procedure to remove lung tissue, such as thoracoscopy or video-assisted thoracic surgery.

Lab testing: A doctor may also order sputum testing or blood testing to check for the presence of lung cancer.

A doctor will use this information to determine what type of lung cancer may be present, and how advanced the disease has become.

The importance of early diagnosis
Early diagnosis of lung cancer can be lifesaving. This is because lung cancer cells can travel to other areas of the body before a doctor detects them in the lungs. If this spread or metastasis has taken place, it makes treating the disease much more difficult.

Sometimes, a doctor will recommend a person have lung cancer screenings. These are performed using a low-dose CT scanner. Not everyone is a candidate for this screening, but it can help doctors identify lung cancer earlier in some individuals.

According to the American Lung Association, people who may be candidates for lung cancer screenings are those who:

are between 55 and 80 years of age
are a 30 pack-year history of smoking, meaning they smoked one pack per day for 30 years or two packs per day for 15 years
are a current smoker or smoker who has quit within the past 15 years

Insurance will often cover this screening if a person meets all these criteria. However, people should always check with their insurance company before signing up for lung cancer screening.

Staging

The staging of cancer indicates how far it has spread through the body and its severity. This classification helps clinicians support and direct treatment for the best results.

Each stage determines whether cancer has or has not spread or has spread to nearby lymph nodes. It may also take into account the number and size of the tumors.

The lymph nodes are part of the lymphatic system, which connects to the rest of the body. If cancer reaches these, it can metastasize, or spread further, becoming more dangerous.

Staging for lung cancer is extremely complex and extensive with several sub-groups within each stage.

Initially, clinicians divide it into small cell and non-small cell classifications.

Staging definitions may vary, but doctors typically stage non-small cell lung cancer using the tumor size and the spread to guide them in the following way:

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 tumor has developed in the lung, but is under 5 centimeters (cm) and has not spread to other parts of the body.
• Stage II: The tumor 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 the lungs.

Treatment

Treatments for lung cancer depend on its location and stage, as well as the overall health of the individual.

Surgery and radiation are the most common approaches to treating lung cancer, but other treatments are available. For example, doctors often treat small cell lung cancer with chemotherapy.

Possible treatments include:

Surgery: A doctor may operate to remove cancerous lung tissue and tissue in the surrounding areas where cancer may have spread. This sometimes involves removing a lobe or large segment of the lung in a procedure called a lobectomy.

In severe cases, the surgeon may remove a lung in its entirety. A person can live without a lung, but being in good health prior to surgery helps to improve outcomes after lung removal.

Chemotherapy: This treatment uses drugs to shrink or eradicate cancer cells. These medications target rapidly dividing cells, which makes them ideal for treating cancer.

Chemotherapy treatment has a more significant impact on cancers that have spread to different parts of the body and require a body-wide attack.

However, chemotherapy is a powerful intervention and can have side effects including extreme nausea and weight loss.

Radiation therapy: This approach uses high-energy rays to kill cancerous cells. A doctor may also use radiation to shrink a tumor before removing it surgically.

Radiation therapy is mainly useful on cancers that occur in one location and have not spread.

Targeted therapy: This is the use of particular medications that specifically target a particular behavior in cancer cells. Examples include medicines that stop cancer cells from multiplying.

Lung cancer treatment often involves the collaboration of medical experts in many areas. These specialists may include:

• surgeons
• radiation oncologists
• specialists in lung treatment called pulmonologists
• pulmonary therapists