Diagnosis

Lung cancer is a condition that allows the cells in the lungs to divide uncontrollably, causing growth of tumors around the lungs, and thus reducing an individual inability to breathe. This is why it is important for current and past smokers (and second – hand smokers too) to get their lung screened for possible lung cancer.

Individuals who have a high risk of having lung cancer or probably via family history; it is of importance to consider an annual or monthly screening. Although lung cancer screening is usually offered to older persons ranging from 55 years and above, who had smoked for many years or recently quit.

Most medical practitioners tend to apply the physical examination first before any other screening exercise, so as to detect any abnormal growth or swollen lymph above the collarbone, around the abdomen because some screening exercise might fail to see any form of growth if the tumor hasn’t gotten bigger. Also, weak breathing, abnormal sounds in the lungs, weakness or swollen veins in the arms or certain changes in the fingernails might create a suspicion for lung tumor.

The moment a suspicion is created, the medical doctor / practitioner might suggest some series of test so as to determine the presence of cancerous cells. And these tests / screening methods may include:

• Imaging Tests

Imaging test such as X-ray image helps to show the image of the lungs, and reveals any abnormal growth in the system. Computed tomography (CT) and positron emission tomography (PET) scans would also help to reveal areas of lung tissues with cancer in the body. Some medical practitioners use these scans to determine the progress in cancer treatment.

• Sputum Cytology (Lab Testing)

Once a patient starts having coughed which produces sputum, the doctor might recommend a sputum or blood testing so as to reveal the presence of lung cancer cells. This will help the doctor carefully analyze the cancer cells, revealing what type of lung cancer present and it what stage. It also help to address the cells and determine the prognosis and treatment required.

Once lung cancer has been diagnosed, medical doctor will work to determine the extent (stage) of the cancer. Staging the type of cancer present helps to determine the best and appropriate treatment available.

• Biopsy (Tissue Sampling)

Once a suspicion is created, a doctor might recommend having a sample of abnormal cells in the body to be removed; and this process is called biopsy.

Biopsy can be conducted in a number of ways, including bronchoscopy where the abnormal areas are examined using a lighted tube passed into the lungs from the throat. Also mediastinoscopy, in which an incision is made at the base of the neck and surgical tools are inserted behind the breastbone to take tissue samples from lymph nodes is also an option. Another option is needle biopsy, in which your doctor uses X-ray or CT images to guide a needle through the chest wall and into the lung tissue to collect suspicious cells.

A biopsy sample may also be taken from lymph nodes or other areas where cancer has spread, such as the liver.

Stages of Lung Cancer

Staging lung cancer can help determine how far or severe the cancer has spread in the body system, thus help guide in the treatment plans. The chance of cancer treatment being successful is dependent on when the lung cancer was diagnosed and treated in its early stages, before spreading to other parts. Due to the fact that lung cancer doesn’t cause obvious symptoms in the human body in its early stages, diagnosis often comes after it might have spread.

There are two types of lung cancer: non – small cell lung cancer and small lung cancer; and each one of these lung cancers are staged differently.

Types of Lung Cancer Stages

Non – Small Cell Lung Cancer Stage

Non – small cell lung cancer (NSCLC) is the most common type of lung cancer among individuals than the small cell lung cancer (SCLC), and staging it, medical doctors might need to use imaging scans to determine its clinical stage. This might involve the use of biopsy, which would help determine the stage of the cancer.

Usually, the most common staging method for NSCLC is the TNM staging method with numbers X, 0, 1, 2 etc. so as to differentiate the presence of tumors in the lung or its size. Also the general staging method might also be used.

Staging

• Occult Stage: At this stage, the cancer cells can be picked up in the mucus an individual coughs up. The tumor presence can’t be seen on any form of imaging scans or biopsy. This is also called the hidden cancer.
• Stage 0: At this stage a tumor can be found but it’s relatively small; and the cancer cells in the lung haven’t spread into the deeper part of the lung nor has it spread outside the lungs.
• Stage I: Cancer has been found in the lung tissues but not yet in the lymph nodes.
• Stage II: Cancer is in the lung and lymph nodes in the middle of the chest
• Stage IIIA: Cancer is found in lymph nodes, but only on the same side of the chest where the cancer had first developed.
• Stage IIIB: The cancer has spread to other lymph nodes on the opposite side of the chest and other lymph nodes above the collarbone.
• Stage IV: The cancer has spread out to both lungs, and into other area around the lungs or distant organs.

Small Cell Lung Cancer Stages

The moment an individual has been diagnosed with the Small Cell Lung Cancer (SCLC), the medical doctor may decide to use the TNM system of staging, after which he/she would divide the cancer into one of these two main stages.

• Limited Stage: In this stage, the cancer can only be found in one lung and nearby lymph nodes which are on the same side of the chest, but it hasn’t spread to both lungs or past the lungs.
• Extensive Stage: Here, the tumor has spread throughout both lungs; to the lymph nodes of both lungs and the chest. It might have spread to the fluid around the lungs (called the pleura) and / or other organs of the body.

Treatment of Lung Cancer

The treatment for lung cancer is dependent on its present location and stage, and more importantly, the health condition of the individual involved. In most cases of lung cancer, surgery and radiation are the most commonly used treatment method, but there are many other treatments that are available for use.

• Surgery

This involves the removal of cancerous lung tissue and tissues surrounding areas where the cancer might have spread. Procedures in surgery involve:

• Wedge Resection: This surgery method involves the removal of a small section of the lung that contains the tumor and also some healthy tissues.
• Segmental Resection: This involves removing a larger portion of the lung, but not the entire lobe.
• Lobectomy: This is the removal of the entire lobe of one lung
• Pneumonectomy: In this form of surgery, the surgeon removes the entire lung. Individuals can live without a lung, that is if he/she has been living in a good health condition before the surgery; thus helping to improve the outcomes after lung removal.

• Radiation Therapy

This is using high energy rays to kill cancerous cells in the body. For individuals who with locally advanced lung cancer, radiation may be used before surgery or after surgery. It is often combined with chemotherapy treatments; but in situations where surgery isn’t an option to be used due to health conditions, radiation therapy combined with chemotherapy is usually advised.

Radiation therapy is also used on cancers that occur in one particular location and haven’t spread; and also used to help relieve certain symptoms like pain for advanced lung cancers.

• Stereotactic Body Radiotherapy

Stereotactic body radiotherapy, also known as radiosurgery, is an intense radiation treatment that aims many beams of radiation from many angles at the cancer. Stereotactic body radiotherapy treatment is typically completed in one or a few treatments. It may be an option for people with small lung cancers who can't undergo surgery. It may also be used to treat lung cancer that spreads to other parts of the body, including the brain.

• Chemotherapy

Chemotherapy is the use drugs to eradicate / kill or shrink cancer cells in the body. It is often used after surgery to kill any cancer that may remain or before surgery to shrink cancers and make them easier to remove. It is usually used alone or combined with radiation therapy.

It has more significant impact on cancers that may have spread to other organs or parts of the body, requiring a mass body wide attack. Although Chemotherapy has its positive intervention but various side effects which include nausea and weight loss are usually present after its application.

• Targeted Drug Therapy

Targeted drug treatments focus on specific abnormalities present within cancer cells. This is the use of particular medications that specifically target a particular behavior in cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die.

Many targeted therapy drugs are used to treat lung cancer, though most are reserved for people with advanced or recurrent cancer. Some of these targeted therapies only work in people whose cancer cells have certain genetic mutations.

Prognosis

Surviving Lung cancer can only be a successful for patients with lung cancer if it is being diagnosed at a very early stage. This will help increase the survival chance of such patients; and that’s why it’s important to seek medical advice once notable changes exist in the body.

According to recent studies by the American Lung Association, it was discovered that, the five – year survival rate for lung cancer is only achievable on 56% percent of cases that are detected locally i.e. within the lungs (Stages I – III). However, only 16% of lung cancer cases are diagnosed at this early stage. But in cases of tumors emerging from lung cancer that had moved to other parts of the body (Stage IV), the rate of survival is only 5%.