Lung Cancer

What is lung cancer?

Lung cancer is a type of cancer that begins in the lungs. A lung tumour starts off as just a few cells but continues to grow and only causes symptoms very late in the disease. We commonly refer to lung cancer staging as this has a dramatic effect on the prognosis. Broadly, we refer to limited and extensive disease. In the limited stage, the cancer is found in one lung or the nearby lymph nodes.

In the extensive stage, however, cancer has spread throughout a lung and, in some cases, into the opposite lung, to the lymph nodes on both sides and, into the fluid surrounding the lungs and into the bone marrow. In very severe cases, cancer can spread to other organs in the body. The reason for this distinction is that the limited disease is potentially curable while the extensive disease is not curable, and the treatment given would only slow the growth of the cancer.

Types of lung cancer:

There are a number of types of lung cancer, the most common of which is known as non-small cell lung cancer (NSCLC). As with other types of cancers, there are abnormal cells that do not die as they should but continue growing without check. Another type is small-cell lung cancer (SCLC), which is less common but more aggressive, often spreading quickly to other parts of the body.

Some of the early symptoms of lung cancer include loss of weight, a persistent cough, shortness of breath, fatigue, hoarseness, chest pain, and coughing up phlegm or blood. When there is a suspicion of lung cancer, the first investigation is usually a CT scan. The CT scan would show a lung mass, but this is not a definite diagnosis, and further tests need to confirm whether it is cancer or, in some instances, infections could mimic a tumour.

These tests are in the form of a biopsy, where a needle is inserted into the mass, and some cells are aspirated and sent to the pathology lab for identification. This is most often done with bronchoscopy. (See procedures) The prognosis or outcome of cancer largely depends on the stage of the disease (limited vs extensive) and also on the type of cancer that can only be identified by way of a biopsy mentioned above.

What Causes Lung Cancer?

The primary cause of lung cancer is exposure to carcinogens, substances that can lead to cancer. The most significant risk factors include:

• Smoking: The leading cause of lung cancer, responsible for about 85% of cases. This includes both active smoking and exposure to secondhand smoke.
• Radon gas: A naturally occurring radioactive gas that can accumulate in homes and buildings, increasing lung cancer risk.
• Asbestos exposure: Once commonly used in construction materials, asbestos fibers can be inhaled and cause lung damage over time.
• Air pollution: Prolonged exposure to polluted air, particularly in urban areas, can increase lung cancer risk.
• Genetic factors: A family history of lung cancer may increase an individual's risk, suggesting a genetic predisposition.

While smoking remains the most significant risk factor, non-smokers can also develop lung cancer due to these other causes.

Treatment for lung cancer

Treatment for lung cancer depends on the type, stage, and overall health of the patient. Dr. Johan Theron and Dr. Morné Johan employ a multidisciplinary approach to develop personalised treatment plans, which may include:

• Surgery: For early-stage lung cancer, surgical removal of the tumour and surrounding tissue can be curative. Types of surgery include lobectomy, segmentectomy, and pneumonectomy.
• Radiation therapy: High-energy beams are used to target and kill cancer cells. It can be used alone or in combination with other treatments, especially in inoperable cases.
• Chemotherapy: Involves the use of drugs to destroy cancer cells. Chemotherapy is often used for advanced stages of lung cancer or in conjunction with surgery and radiation therapy.
• Targeted therapy: These drugs specifically target genetic mutations or abnormalities in cancer cells. This approach is used for patients whose tumours have specific genetic changes.
• Immunotherapy: This treatment boosts the body's immune system to recognise and fight cancer cells. It's a newer approach showing promise in treating various stages of lung cancer.

FAQ

1. Is lung cancer curable? 2. What is the prognosis for lung cancer? 3. What should I do if I suspect I have lung cancer?