Friday, 10 August 2018

Early Diagnosis is key to fighting Lung Cancer

Lung cancer is the second most common cancer in the developed world and is responsible for most cancer deaths. It accounts for 13.3 percent of all cancer cases worldwide and in India, it ranks fourth amongst all cancers, second in males and sixth among females.
Tobacco consumption:
Smoking tobacco is a primary factor for causing cancer with the risk increasing with the number of packs, years smoked etc. Exposed non-smokers also have an increased risk from second-hand smoke. It is responsible for 85-90 percent cases of lung cancer. Screening for lung cancers is not routinely advised and is only recommended for high-risk current or former smokers who have smoked more than one pack daily for at least 30 years or more.
Types & Symptoms of Lung Cancer:
Broadly, lung cancer is divided into two types — Small-cell Lung Cancer and Non-small Cell Lung Cancer. In the non-small cell variety, there are subtypes like squamous and adenocarcinoma. Most cases usually present in advanced stages (65-70 percent) i.e Stages III and IV. The common symptoms are persistent cough, breathlessness on exertion, chest pain and blood in sputum. Spread to distant organs may also occur which may lead to bone pains due to spread to bones and seizures, loss of consciousness or weakness of one half of the body due to brain metastases. In the early stages, the disease is usually picked up during evaluation for some other cause.
Diagnosis:
The primary steps in evaluation are biopsy or CT scans of the chest and abdomen. In early stages surgery is considered as it offers the best chance of cure. For a patient to be fit for lung surgery (lobectomy/ pneumonectomy) they would have to fulfill fitness criteria as prescribed by the physician. Post-surgery chemotherapy is usually given in stages B3 and beyond. In those patients who are medically inoperable stereotactic radiotherapy is an option. Combined modality treatment with radiation and chemotherapy is usually offered in stage III.
Management of metastatic lung cancer or stage IV lung cancer has undergone a paradigm shift in the last few years. With the advent of new drugs the outcome of stage IV lung cancer (NSCLC) has changed for the better with the average survivals reaching almost two years. But as patients live longer, they develop new problems like brain metastases and need for supportive care. The main message for the society must be to avoid smoking and promote healthy living. Those having persistent cough or unexplained breathlessness or blood in the sputum must get themselves evaluated to rule out lung cancer.