Lung Cancer- symptoms, types & treatment

Contributed by Dr. Chandrashekhar Singh, Medical Oncologist, HCG Abdur Razzaque Ansari Cancer Hospital Ranchi

1. How common is lung cancer?
2. Lung cancer is the most common cancer in males worldwide. if we combine both sexes approximately 2.2 million new cases of lung cancer are diagnosed worldwide which accounts for 11 % of all cancers and 2nd only to breast cancer. it is the leading cause of death from cancer worldwide. 1.7 million people die from this disease every year. In India also 72000 new cases of lung cancer were diagnosed in 2020 which accounts for 8 % of all cases.

1. What are the risk factors for lung cancer?
2. Smoking is the leading cause of lung cancer. it is seen that 9 out of 10 lung cancer patients are smokers. Apart from smoking air pollution also cause lung cancer. Occupational exposure to asbestos and previous radiation to the chest can cause lung cancer.

1. What are the symptoms of lung cancer?
2. Long-standing cough is the most common symptom. cough is usually dry initially. It can be associated with blood-tinged sputum or a change in voice (hoarseness of voice). It can be associated with chest pain, drooping of the eyelid, or swelling over the collar bone, loss of weight, and loss of appetite.

1. What are the types of lung cancer?
2. Lung cancer can be small cell type and non-small cell type.  The non-small cell type is further subdivided into squamous cell and adenocarcinoma. Small cell lung cancer is exclusively seen in smokers whereas adenocarcinoma can be seen even in nonsmoker patients. Apart from this, there are other subtypes of neuroendocrine tumors of the lung. It can be of small cell type or large cell type.

1. What are the treatment options for lung cancer?
2. Treatment of lung cancer depends on the stage of the disease. For stage i and ii disease we do surgery and depending on surgery report we give chemotherapy or chemotherapy + radiation therapy. For stage iii disease we give chemoradiation simultaneously followed by immunotherapy and for stage iv disease we have multiple options such as targeted therapy, immunotherapy, chemotherapy or combination of chemo and immunotherapy.

1. What is the prognosis / survival of lung cancer patients?
2. Small cell lung cancer has poorer prognosis as compared to non-small cell.   27% of patients having regional small cell lung cancer survive for 5 years but only 3 % of small cell lung cancer patients having distant spread survive for 5 years.  about 63 % of patients with localized non-small cell lung cancer survive for 5 years but only 7 % of patients with disseminated disease survive for 5 years. We can see that earlier the detection better is the chance of long-term survival.  So early detection saves life.

1. Is there any screening method of lung cancer?
2. If a person between the age of 55-74 has a history of smoking of more than 30 pack years then we use low dose CT chest annually to screen that individual for lung cancer. But in India due to resource constraints and lack of awareness people usually do not opt for screening programs. These programs are very popular in western countries such as USA, UK. so, we need to make people aware about screening programs for various cancers.

1. How can we be safe from lung cancer or how can we prevent lung cancer?
2. Quit smoking right now. This is the thumb rule to prevent lung cancer. It is seen that out of 10 lung cancer patients 9 are smokers. there are various therapies through which we can help people quit smoking. It is seen that 75 % of smokers want to quit smoking but only 2 % can do that. We can help them to quit smoking.