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LUNG CANCER

Lung cancer is the most common type of cancer to be diagnosed worldwide.

In 2018, around 2.1 million new cases of lung cancer were diagnosed with 1.76 million lung cancer deaths around the world. In India, lung cancer constitutes up to 6.9% of all new cancer cases and around 9.3% of all cancer related deaths.

Different types of lung cancer

Lung cancers are classified as non-small cell lung cancer and small cell lung cancer based on the differences in their response to treatment and prognosis.

Non-small cell lung cancer (NSCLC)

This type of cancer is further classified into subtypes based on the cells from which they originate. The main subtypes of NSCLC are:

Adenocarcinoma: This cancer starts in the cells which normally secrete mucus and other secretions (glandular cells), mostly on the outer parts of the lungs.

Squamous cell carcinoma: This cancer initiates in flat, thin cells called squamous cells. These cells line the bronchi, which are the large airways that branch off from the windpipe (trachea) into the lungs.

Large cell carcinoma and other rare subtypes such as adenosquamous carcinoma, sarcomatoid carcinoma, etc.

Small cell lung cancer (SCLC)

It usually initiates in cells lining the bronchi in the center of the lungs. The main subtypes of small cell lung cancer are small cell carcinoma and combined small cell carcinoma (mixed tumor with squamous or glandular cells).

Risks for developing lung cancer

The risk of developing lung cancer increases with age. More than half of all newly diagnosed lung cancer cases occur among people aged 60 years or older. Men develop lung cancer slightly more often than women.

If you have a family history of lung cancer, you may be at a higher risk of developing lung cancer.

Smoking is the main cause of lung cancer. You may be at a higher risk if you smoke.

Inhaling the smoke that arises from burning of cigarette, pipe or cigar from the smokers is called second-hand smoke. It is also called environmental tobacco smoke (ETS).

Individuals with HIV/AIDS have a higher risk of developing many types of cancer, including lung cancer.

Systemic lupus erythematosus (SLE or lupus) is an autoimmune disease. People suffering from lupus have a higher risk for lung cancer due to the reduced activity of their immune systems.

Research shows that the different components of outdoor air pollution cause cancer. These components include diesel engine exhaust, benzene, particulate matter and some PAHs.

If you are treated with radiation therapy in the chest for certain cancers, such as Hodgkin lymphoma or breast cancer, you have a higher risk for lung cancer.

Burning of coal, wood, dung, etc. releases particulate matter which is strongly linked to lung cancer when inhaled.

Symptoms of lung cancer you may need to be aware of

Most lung cancers don’t cause symptoms until the disease has advanced and the symptoms may vary from person to person:

• Cough that is persistent or worsens, or a change in an existing chronic cough containing blood
• Pain in the chest, back or shoulders that worsens during coughing, laughing or deep breathing
• Shortness of breath
• Unexplained weight loss
• Fatigue
• Loss of appetite
• Hoarseness or wheezing

Know about the treatment options of lung cancer

Lung cancer is treated in several ways, depending on the type of lung cancer and how far it has spread.
People with non-small cell lung cancer can be treated with surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of these treatments.
People with small cell lung cancer are usually treated with radiation therapy and chemotherapy.

Surgery: Surgery is done to remove cancer tissue from the lung and areas the cancer has spread to, depending on the stage and extent of the cancer. The types of surgeries performed are:
• Removing one lobe of the lung (lobectomy)
• Removing the whole lung (pneumonectomy)
• Removing nearby lymph nodes along with a part/whole of the lung

Chemotherapeutic drugs: The drugs usually consist of a platinum-containing compound (cisplatin or carboplatin) combined with gemcitabine, a taxane (paclitaxel or docetaxel), vinorelbine, or pemetrexed.
• Cisplatin is a cytotoxic drug, which comes under a class of platinum-based compounds, and helps in eliminating cancerous cells.
• Gemcitabine is included in a class of drugs called antimetabolites. It works by slowing or stopping the growth of cancer cells in your body.
• Vinorelbine comes under a class of medications called Vinca alkaloids, and works by eliminating cancer cells.

Monoclonal antibodies: Use of monoclonal antibodies which inhibit new vassel formation like Bevacizumab and other anti EGFR antibodies are commonly used for lung cancer treatment.

Radiation therapy: High-energy rays (similar to X-rays) damages the rapidly growing cancerous cells. Radiation can be given before surgery to shrink the tumor or after the surgery to destroy any cells post-surgery.

Targeted therapy: Drugs are used which can block the growth and spread of cancer cells. The drugs can be pills you take or medicines given directly in your veins.

Is there a way to prevent lung cancer?

Yes, lung cancer can be prevented if proper care is taken. However, you can lower the risk by changing your lifestyle, such as:

Smoking is the root cause for lung cancer. The best way to reduce your risk of lung cancer is to quit smoking.

Avoiding exposure to known cancer-causing agents such as such as diesel exhaust, iron and steel founding, etc. in the workplace and elsewhere, may also be helpful.

A healthy diet with lots of fruits and vegetables may also help reduce your risk of lung cancer. A balanced diet during and after cancer treatment helps maintain strength.

Unintentional weight loss is common during any type of cancer. The weight loss can be due to a drop-in appetite due to the lung cancer treatment.

It is important to have small meals at regular intervals to ensure sufficient intake of nutrition required for the body to tolerate treatment. The meals also help to reduce treatment-related side effects such as nausea.

It is necessary to have enough fluids throughout the day during cancer treatment for preventing dehydration.

What to expect after lung cancer treatment?

Follow up visits are a good time to ask questions and talk about any changes or problems you notice

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