Short notes on the symptoms, etiology and treatment of lung cancer
Technically known as bronchial carcino, lung cancer is the leading cause of cancer death in men of all countries. It is four times more common in men than in women. This is possibly because smokers are more in men than in women. Of all the causes bringing about lung cancer the one that has been established beyond doubt is smoking. 90% of lung cancer patients are smokers.
The increased risk of lung cancer in smokers is directly proportional to the amount of smoking per day and the tar content in citrates. Death rate from lung cancer is 40 times more in smokers than in non smokers. Those who give up smoking have lesser chance of contracting lung cancer.
Pathology of lung cancer- Lung cancer affects the body in three ways:
1. Local invasion:
Carcinoma of the bronchus arises from the epithelial cells that lie in the bronchus. Subsequently the tumours invade the deeper layers of the bronchial wall and spread into surrounding lung tissue. It may cause ulceration and bleeding from the bronchus. The malignant (tumours) cells spread to the lymphatic system causing the glands to enlarge.
2. Maliganant cells from the lungs may enter the blood stream and form metatasis leading to secondary deposists in bones, liver and brain. Tumours develop in all these parts.
3. Toxins produced by malignant cells lead to certain extra pulmonary (outside the lung) manifestations like functional aberrations such as damage to nervous system, clubbing of fingers, hypertrophy of glands and several other complications.
Symptoms of lung cancer:
At early stages, lung cancer is symptomless. Persistant cough which does not yield to any treatment is the earliest symptom. Shortness of breath, chest pain, wheezing, hoarsenses of the voice are all early symptoms of localised lung cancer. When lung cancer is in the metastasis stage symptoms include severe headache, unsteadiness of gait, tumours in the bone, enlargement of liver, jaundice, tender skin nodules etc.
Progressive loss of weight, weakness associated with persistant cough must arose, suspicion of lung cancer. Presence of enlarged glands in neck and clubing of fingers provide further supportive evidence on physical examination.
X-ray of the chest is the most important step in the diagnosis of lung cancer. A dense opacity- (non clear) of the lungs with irregular enlarged hilar glands suggests bronchial carcinoma.
Bronchoscopy is another important method of diagnosis. Inspection of intrabronchial portion of the tumour and biopsy (removal of a small amount of tissue) for histological examination are very important. Other methods of diagnosis include CT scan, magentic resonance imaging etc. Treatment: The treatment depends on the state of the disease. These are as follows:
1. Surgical treatment:
Surgical removal of the tumour is the best method if the tumours are detected at an early stage and are not spread to other organs. If only one lobe of the lung is affected it can be removed by lobectomy.
Small tumours can be destroyed by subjecting them to radiation.
Some of the cytotoxic (drugs that are toxic to malignant cells) drugs in combination with raditation therapy are known to be beneficial. Some of these cytotoxic drugs are nitorgen mustard, cyclophosphamide, methotrexate, vincrystine etc. Treatment with these drugs prolongs the survival of the patients for upto one year. It should be pointed out however both radiotherapy and chemotherapy also have so many side effects.
Patients suffering from lung cancer very frequently have their immune system retarded. Immune stimulating drugs are helpful in preventing secondary infections.
5. Palliative treatment includes nutritions diet, vitamin supplements and analgesics to suppress the pain.