Lung Cancer
Lung cancer cause and symptom examination, effective prevention and treatment, and improved lung cancer survival rate
Lung cancer is the number one killer of cancer in Hong Kong, and most lung cancer patients are smokers. Early-stage lung cancer has no obvious symptoms and is usually discovered during chest X-rays during other examinations. If lung cancer can be diagnosed early, patients who receive diagnosis and treatment at the early stage will have a survival rate of 50% in the next five years. It is also crucial to protect against lung cancer by avoiding smoking or inhaling secondhand smoke.
Lung cancer ranks first among fatal tumors in Hong Kong, with both men and women having the highest mortality rates from malignant tumors. Data indicates that men are more likely to develop lung cancer than women. Lung cancer typically arises from changes in the epithelial cells of the bronchi and bronchioles, leading to uncontrolled growth of lung tissue cells. If not detected early, the malignant tumor may spread to nearby tissues or other parts of the body. However, early detection and treatment can significantly improve the five-year survival rate for patients treated in the initial stages. Therefore, in addition to avoiding smoking or secondhand smoke, regular health check-ups are critical.
Survival Rate of Lung Cancer
Lung cancer is the number one killer of cancers, and its survival rate is closely related to the time spent on diagnosis and treatment. Surveys show that if lung cancer patients are discovered in the first stage and receive immediate treatment, their survival rate in the next five years can be as high as 50%. However, if lung cancer is only discovered in the third stage, the survival rate in the next five years will drop to about 15%.
50%
First-phase five-year survival rate
15%
Phase III five-year survival rate
Symptoms of Lung Cancer
Lung cancer has no obvious symptoms in the early stage and is usually detected only during other X-ray examinations for the chest. As the condition worsens, lung cancer patients may experience the following symptoms:
Common symptoms
- Shortness of breath
- Persistent cough
- Blood in the sputum
- Hoarse voice
- Difficulty in Swallowing
- Pain when taking deep breaths
- Repeated infections of the chest and lungs or prolonged lack of healing
- Loss of appetite
- Weight Loss
- Fatigue
Less common symptoms
- Increased thirst and frequent urination
- Clubbing of fingers or toes (enlargement and thickening of the fingertips or toes)
- Numbness or tingling in the shoulders or upper arms
- Unexplained hoarseness
- Swelling and discoloration of the upper body
- Horner's syndrome (ptosis, miosis)
If lung cancer develops to an advanced stage, cancer cells have the opportunity to spread in the body, and patients may also experience symptoms such as swelling of lymph nodes in the neck, abdominal distension, bone pain, headache, or swelling of the neck, face, and hands; they may even experience localized cerebral epilepsy or hemiplegia. Therefore, it is recommended that once the above symptoms are discovered, you should seek medical treatment as soon as possible to evaluate whether you have lung cancer.
Causes of Lung Cancer
Smoking
Smoking is the main cause of lung cancer. The risk of lung cancer among smokers is 20 times higher than that of non-smokers, and up to 90% of male lung cancer patients are smokers.
Second-hand smoke
Secondhand smoke is also a major cause of lung cancer; people who are exposed to secondhand smoke for a long time have more than twice the risk of developing lung cancer compared to the general population.
Inhalation of chemical substances
Long-term exposure to certain chemicals or building materials, such as asbestos, nickel, and uranium.
Long-term inhalation of cooking fumes
Long-term inhalation of cooking fumes in the kitchen environment
Unhealthy diet
Frequent consumption of grilled or pickled foods, and a lack of intake of foods rich in Vitamin A, as well as fresh vegetables and fruits.
Hereditary factors
Patients with parents or siblings diagnosed with lung cancer will have a higher risk of developing lung cancer than others.
Lung Cancer Examination and Assessment
Preliminary Inspection
The earlier detection of lung cancer brings a higher chance of recovery. Therefore, smokers or frequent passive smokers should have regular check-ups and stay vigilant. If you suspect any symptoms of lung cancer, you should seek medical advice and examination.
- Medical consultation: Medical History (e.g. gynaecological disease, obstetric history), allergies, family medical history, plans for pregnancy and contraception methods, menstrual cycle, etc.
- Physical examination: Measure height, weight, blood pressure, check for anaemia and thyroid disease.
- Chest X-ray examination: It is the most basic method for detecting lung cancer, showing whether there are tumors or other abnormal substances in the lungs. If the X-ray shows any abnormalities, further examinations can be scheduled. However, lesions smaller than 1 cm are difficult to detect and interpret.
- CT scan: It is one of the most effective ways to detect lung cancer, providing more detailed images than a chest X-ray. It can detect tumors smaller than 0.3 cm and help doctors determine the stage of cancer.
- MRI: Similar to CT scanning, it provides detailed soft tissue images, but it uses radio waves and strong magnetic fields instead of X-rays. It is often used to check whether cancer cells have spread to the brain or spinal cord.
- Sputum examination: Observe sputum under a microscope to see if there are cancer cells.
- Bronchoscopy: Examine the bronchial mucosa of the patient, and then take tissue samples for pathological examination to determine the type of cancer cells.
Further Evaluation
After the initial examination, the doctor may also ask the patient to undergo further cancer evaluation such as mediastinoscopy, computer scan and ultrasonic endoscopy to determine carefully and classify and stage the patient's lung cancer.
- Mediastinoscopy: The patient is put under general anaesthesia to make two to three small incisions at the bottom of the neck and on the top of the breastbone. An endoscope is inserted to observe the lymph nodes and thymus glands surrounding the lungs and heart.
- CT scan: The patient will be injected with a contrast agent before the scan. Then a CT scan will be used to take X-ray images of body tissues from different angles to form a 3D picture.
- Ultrasound endoscopy: A soft tube with an ultrasound transducer is inserted into the patient's oesophagus through the mouth. The rebounding sound waves from the heart and lungs will be visualized by the computer to observe if the lymph nodes in the chest cavity are swollen.
Types of Lung Cancer
Small cell lung cancer
This type of cancer develops from the smallest cell of the lung, usually the one in the bronchial wall. Cancer worsens with the rapid spread of cancer cells to other parts of the body in the early stage, making it difficult to cure.
Non-small cell lung cancer
- Squamous cell carcinoma: Commonly found on the inner wall of the trachea, usually caused by smoking.
- Adenocarcinoma: Caused by mutations in the cells that secrete mucus from the tracheal lining
- Large Cell Carcinoma: Cancer cells are large and relatively round.
Carcinoid
Neuroendocrine tumors are a relatively rare type of lung cancer.
Lung cancer diagnosis and treatment
There are four main methods for diagnosing and treating lung cancer, which can be used alone or in combination with other methods to relieve symptoms, depending on the patient's condition.
- Chemotherapy
Chemotherapy, also known as “Chemo”, uses an intravenous injection to inject cytotoxic drugs through the bloodstream to kill the cancer cells by blocking their growth and division.
- Radiology
Also known as "radiotherapy," this method uses high-energy rays to target and kill cancer cells. It can be used as a curative treatment for early-stage lung cancer and is also applicable when tumors have locally spread or as a means to eliminate residual cancer cells after treatment. Radiation therapy is suitable for patients who are elderly or have other health issues that make them unsuitable for surgery.
- Targeted Therapy
- Immunotherapy
Designed for patients with intermediate to advanced non-small cell lung cancer, some advanced patients with strong immune signals (PD-L1) may even be able to receive immunotherapy alone without chemotherapy. Some non-metastatic stage III patients can undergo immunotherapy as consolidation therapy after concurrent chemoradiotherapy, which helps reduce the risk of recurrence.
Recovery and Rehabilitation of Lung Cancer
Lung cancer has a high recurrence rate, so patients need to have regular check-ups during their recovery period so that they can receive timely treatment if a recurrence occurs.
In addition, patients have to pay attention to their daily diet and adopt a balanced diet. If patients have any other chronic diseases or dietary concerns, seek medical advice from doctors. Adequate hydration can reduce mucus viscosity and facilitate coughing up the sputum.
Patients should also maintain a regular lifestyle and a pleasant mind. Proper rest and adequate sleep can help relieve stress and promote recovery after the surgery. Keep the house well-ventilated and avoid going to crowded places with turbid air to help prevent respiratory infections. Adequate exercise can also enhance lung function and foster recovery.
Most importantly, patients must quit smoking and avoid inhaling second-hand smoke to better let their lungs recuperate.
Lung cancer prevention
To prevent lung cancer, we need to take action. In addition to avoiding bad habits, it is recommended to have regular physical examinations to ensure your health.
- People who have never smoked should avoid bad habits.
- People who have a smoking habit should quit smoking as soon as possible.
- In daily life, reduce your visits to places where many people smoke and try to avoid secondhand smoke.
- It is necessary to find out and test whether the residence contains harmful substances such as asbestos.
- Employees should follow safety guidelines and wear protective masks in the appropriate workplace.
- Start with your diet, eat more fruits and vegetables, and maintain a healthy body.
- Regular health checkups are essential for prevention.
Early detection of diseases and understanding of abnormal bodily functions allow for follow-up actions and thus play a protective role.
Lung Cancer FAQ
The genetic mutations associated with lung cancer are usually acquired during a person's lifetime and are not hereditary. Acquired mutations in lung cells are usually caused by exposure to factors in the environment, such as carcinogenic chemicals in tobacco smoke.
Shortness of breath and wheezing may also be the early signs of lung cancer. In addition to shortness of breath, some people may have a mild cough. Others may have difficulty in breathing but no cough.
Lung cancer mainly occurs in older people. Most people evaluated for lung cancer are 65 years or older; a very small number of people diagnosed are younger than 45 years old. The average age of those diagnosed is about 70 years old.
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