Lung cancer

Lung cancer is the abnormal growth of cells in the lungs. Smoking cigarettes is one of the major reasons of lung cancer. The risk of the disease depends upon the number of cigarettes you smoke and for how long. You can, however, minimize the risk of lung cancer by quitting smoking even at a later age.

Lung cancer may happen in individuals who do not smoke or those who are passive smokers. While the exact cause of lung cancer may not be detected in most cases, but other reasons like cigar and pipe smoking, tobacco smoking, exposure to radon gas, exposure to carcinogens and asbestos, family history of lung cancer may affect your lungs.

The signs and symptoms of lung cancer include bone pain, persistent coughing, shortness of breath, changes in chronic cough, blood in cough, headache, voice hoarseness, wheezing, headache, etc.

If you observe any of the above signs, check out with a doctor immediately. Computerized topography scanning or lung cancer screening helps in determining whether you have cancer in the lungs. It is often found that lung cancer screening reveals benign conditions and therefore, more invasive testing procedures are required for a better diagnosis. Here, are some of the tests done to detect lung cancer or not:

• Tissue sampling- A biopsy test is done by removing sample of tissues from the lung. A procedure, called bronchoscopy allows the doctor examine any abnormal cells in your lungs by passing a lighted tube through your throat into the lung.

Needle biopsy is another procedure where doctors use CT images or X-ray scans for guidance of a needle through the chest wall through your lung tissues for collecting any suspicious cells.

Mediastinoscopy, on the other hand, is an effective procedure that makes a cut at the base of your neck and surgical instruments are placed inside to collect sample tissues from suspicious lymph nodes.

• Imaging tests- Also known as X-rays, these tests help reveal any abnormal tissues or nodules. What X-rays cannot reveal, CT scans help in spotting small lesions in the lungs.
• Sputum cytology- The procedure helps examining your cough under the microscope for lung cancer cells.

The preventive measures for lung cancer include having a diet rich in vegetables and fruits, cutting out smoking, avoiding second-hand smoking, testing your home environment for radon, avoiding carcinogens, exercising and so on.

The treatment choice for lung cancer depends upon several factors, such as the type and stage of cancer, your overall health, your preferences and diagnosis by your doctor. The treatment options for lung cancer include surgery, chemotherapy, radiation therapy, clinical trials, targeted drug therapy, palliative care, etc. Before having treatment for lung cancer, there are certain preparations to be taken.

• Your physician conducts elaborate tests to assess your health condition. He reviews your medical history and tries to understand your health condition and the treatments required for the same. Inform your doctor about any surgeries in the past, and about any related problems like blood clots post surgery, breathing problems, etc. You may be enquired about the medical conditions of your family members and whether any of them had any problem with anaesthesia.
• Tell and show your doctor about the list of medicines you have been taking and all over-the-counter supplements that you have been taking. Some medications may raise your blood pressure during the surgery, increase the risk of bleeding or prolong the effects of anaesthesia. In that case, your doctor may advice you to stop taking certain medications from the list.

Some of these medicines include aspirin, blood thinners, herbal medicines or vitamins. Aside from this, there are other tests that will be performed to assess the condition of your lung cancer. These tests include electrocardiogram, pulmonary function tests, blood and urine tests and a thorough physical examination.

• A second opinion is required, so be sure to meet another physician to understand better about your lung condition, the stage of lung cancer and the treatments required.
• You are asked to stop drinking or smoking before from the midnight till the surgery is over.

Once, the type of treatment option is determined, the doctor carries out the procedure.

Surgery

• Before the surgery starts, you are administered anaesthesia to help you sleep through the procedure.
• The doctor makes a big incision in the chest and opens the chest cavity to get access to the lungs. More incisions are made on the sides of the chest to separate the ribs to help remove cancer tissues from the diseased areas.
• There are different types of surgeries required for lung cancer and the option chosen depends upon the condition of your cancer.

Lobectomy- The doctor performs the procedure by removing an entire lobe from your lung. The left lung has two lobes, while the right lung has three lobes.

Video guided thoracic surgery- This is a minimally invasive procedure in which the doctor makes small incisions in the chest, instead of opening them. A small thin tube is inserted through one of the incisions with a camera attached to its end and other surgical instruments are inserted through the remaining small cuts. With imaging guidance, the surgeon eliminates the cancerous tissues.

Wedge resection- This is a minimally invasive procedure that involves making incisions in the chest and inserting instruments for removal of cancerous tissues from the lung.

Pneumonectomy- For this, the surgeons perform and open chest surgery for removing an entire lung.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells by reaching to the far-fetched abnormal cells through the bloodstream. It can be given in the form of oral pills or by creating an IV line in the arm and injecting chemo through it into the body.

Sometimes, chemotherapy is administered before a surgery by shrinking the cancerous tumours before eliminating them, or to relieve you from pain. During chemotherapy you are asked to lie down while the procedure is carried out. It is often performed as an outpatient basis so the patient is generally discharged on the same day.

Radiation therapy

During a radiation therapy, you are required to lie down still on the table. You are alone in the room while an instructor is in another room with whom you can communicate during the procedure regarding any obligations or requirements related to the procedure. Radiation beams are directed on the cancerous portion of your chest. Sometimes, radiation therapy is given internally, called Brachytherapy that creates incisions in the chest for placing seeds or catheters inside near the cancerous areas.

Targeted therapy

This is a new cancer treatment quite popular these days since it uses drugs to targeted specific cell abnormalities.

The recovery time of lung cancer may take several weeks to many months. If you had a large incision, it will ache for some time for which you will be given pain killers. Since lung cancer surgery is a big procedure, you are kept under constant nursing care. The nurses will have new dressings for your wounds after a day or two.

For bigger incisions, it takes some time to heal, so you are allowed to go home with the stitches. However, you may have to come back to the hospital once again for cutting the stitches. The stitches or clips may stay up to 10 days or more. After the surgery, you will have fluids through drips, but you can start drinking again within 24-48 hours by taking small sips of water. While at the hospital, you will gradually recover and your doctors and nurses will encourage you to move around.

You are likely to feel tired for several weeks or months after the surgery. It is suggested to try sitting, walking and moving around a bit as per your physical endurance. You need several follow-up appointments with your doctor to evaluate your condition after the surgery.