Lung Cancer : Type, Symptom, Cause, Diagnosis, Stage, And Treatment

Lung cancer (Lung carcinoma) is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung.Lungs are a pair of cone-shaped breathing organs inside the chest.Each lung has sections called lobes.The left lung has two lobes.The right lung is slightly larger and has three lobes.Sometimes lung cancer does not cause any signs and symptoms.It may be found during a chest-x ray done for another condition.Lung cancer can spread to through tissue, the lymph system, and blood.

The symptoms of lung cancer

• Coughing up blood
• Shortness of breath
• Wheezing
• Chest pain or discomfort
• Blood in sputum
• Weakness
• Fever
• Clubbing of the fingernails
• Feeling tired
• Hoarseness
• Loss of appetite
• Weight loss 
• Bone pain
• Superior vena cava obstruction
• Swelling in the face
• Veins in the neck
• Difficulty swallowing

There are two main types of lung cancer :

• Non small cell lung cancer (NSCLC) is a disease in which malignant (cancer) cells form in the tissue of the lung.
• Small cell lung cancer (SCLC) tends to spread quickly.

Non small cell lung cancer has different kinds of cancer cells :

• Squamous cell carcinoma (Epidermoid carcinoma) is Cancer that begins in squamous cells, which are thin, flat cells that look like fish scales.
• Large cell carcinoma is Cancer that may begin in several types of large cells
• Adenocarcinoma is Cancer that begins in the cells that line the alveoli and makes substances such as mucus.

The Causes of Lung Cancer

• Smoking cigarettes, pipes
• Family history of lung cancer
• Second-hand smoke
• Air polution
• Exposure to Radon gas
• Asbestos
• Some metals such as aluminium production, cadmium, iron, arsenic, nickel compounds and beryllium compunds
• Ionizing radiation such as plutonium, X-radiation, and gamma radiation
• Rubber production and crystalline silica dust
• Some toxic gases such as methyl ether, sulfur mustard, and ether
• Some products of combustion such as coal, soot, coke production, and diesel engine exhaust

Diagnosis

Tests and proscedures are to detect, diagnose the lung cancer as the following :

• Physical Exam and History. Physical exam is an exam of the body to check general signs of health.History is about patient's health habbit such as smoking, job, and illness.
• Laboratory Test is a medical procedure to use test samples of tissue, blood, urine or other substances in the body.
• Chest X-Ray is an x-ray of organs and bones inside the chest.An x-ray is a type of energy beam that can go through the body and onto film. It makes a picture of areas inside the body.
• CT Scan (Computerized Tomography) or CAT Scan (Compurized Axial Tomography) is a procedure that makes a series of detailed pictures of areas inside the body.
• Sputum Cytology is a procedure in which a pathologist views a sample of sputum (mucus coughed up from the lungs) under a microscope to check for cancer cells.
• Fine-Needle Aspiration (FNA) Biopsy of the Lung is the removal of tissue or fluid from the lung by using a thin needle.
• Bronchoscopy is a procedure to look inside the trachea and large airways in the lung for abnormal areas.
• Thoracoscopy is the surgical procedure to look at the organs inside the chest to check for abnormal areas.
• Thoracentesis is the removal of fluid from the space between the lining of the chest and lung by using a needle.
• Light and Electron Microscopy is the laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
• Immunohistochemistry as a test that uses antibodies to check for certain antingens in a sample of tissue.

Tests and procedures are used in the staging process

• MRI (Magnetic Resonance Imaging) is a procedure that uses a magnet, radio waves, anf a computer to make a series of detailed pictures of areas inside the body.
• CT Scan (CAT scan)
• PET Scan (Positron Emission Tomography Scan) is a procedure to find malignant tumor cells in the body.
• Radionuclide Bone Scan is a procedure to check if there are rapidly dividing cells such as cancer cells in the bone.
• Pulmonary Function Test (PFT) is a test to see how well the lungs are working
• Endoscopic Ultrasound (EUS) is a procedure in which an endoscope is inserted into the body.
• Mediastinoscopy is the surgical procedure to look at the organs, tissues, and lymph nodes between the lungs for abnormal areas.
• Anterior Mediastinotomy is the surgical procedure to look at the organs and tissues between the lungs and between the breastbone and heart for abnormal areas.
• Lymph Node Biopsy is the removal of all parts of a lymph node.
• Bone Marrow Aspiration and Biopsy is the removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone.

Stage of Non Small Cell lung cancer

• Hidden Stage  (Ocult) : Cancer cannot be seen by imaging or bronchoscopy.Cancer cells are found in sputum.
• Stage 0 (Carcinoma in situ) : Abnormal cells are found in the lining of airways.
• Stage IA : The tumor is in the lung only.Tumor is 3 centimetres.

• Stage IB : Cancer has spread to the main bronchus and the innermost layer of lung lining.Cancer is larger than 3 centimetres, but not larger than 5 centimetres.
• Stage IIA : Cancer has spread to certain lymph nodes on the same side of the chest as the primary tumor.Cancer has spread to the main bronchus and the innermost layer of lung lining.Cancer is 5 centimetres.Or cancer has not spread to lymph nodes is larger than 5 centimetres, but not larger than 7 centimetres.Cancer has spread to the main bronchus and the innermost layer of lung lining.

• Stage IIB : Cancer has spread to the main bronchus and the innermost layer of lung lining.Cancer is larger than 5 centimetres, but not larger than 7 centimetres.Part of the lung may have collapsed or inflammed.Or The cancer is larger than 7 centimeters.It has spread to main bronchus, diaphragm, chest wall, and membrane around the heart.

• Stage IIIA : Cancer has spread to certain lymph nodes on the same side of the chest as the primary tumor.It may have spread to the main bronchus, lung lining, chest wall lining, diaphragm, membrane around the heart.

• Stage IIIA : Cancer has spread to certain lymph nodes on the same side of the chest as the primary tumor.It may have spread to the main bronchus, lung lining, chest wall lining, diaphragm, membrane around the heart, major blood vessels, trachea, esophagus, sternum, and carina.The whole lung may have collapsed.

• Stage IIIA : Cancer has spread to heart, major blood vessels, trachea, esophagus, sternum (chest bone), and carina.Cancer may have spread to the nerve that controls the larynx.

• Stage IIIB : Cancer has spread to main bronchus, chest wall, diaphragm, membrane around the lung or lining the chest wall, heart, major blood vessels, trachea, esophagus, sternum, and carina.Cancer may have spread  to the backbone and / or the nerves that control diaphragm and larynx.

• Stage IIIB : Cancer has spread to  certain lymph nodes on the same side of the chest as the primary tumor.It may have spread to heart, major blood vessels, trachea, esophagus, sternum (chest bone), and carina.

• Stage IV : Cancer has spread to other part of the body such as brain, bones, liver, kidney, and adrenal gland.

Treatment Of Lung Cancer

• Treatment and long-term outcomes depend on the type of lung cancer, the stage (spread degree), and person's overall health, measured by performance status.
• Common treatments include Surgery, Chemotherapy and Radiotherapy.
• Non Small Cell Lung Cancer is sometimes treated by surgery.
• Small Cell Lung Cancer is treated by chemotherapy and radiotherapy.