Just like other types of cancer lung cancer is also a condition in which cells inside the lungs grow uncontrollably causing the growth of tumors that reduces the breathing ability of the individual. Many cancer research institutes in Singapore as well as abroad have stated that the cases of lung cancer are increasing with every passing year. They have also mentioned that lung cancer screening in Singapore can help a cancer patient to seek treatment but identification of this disease in its earliest stages is quite difficult. This is because the symptoms of lung cancer may be similar to respiratory infection or in some cases, there are no symptoms at all. In this blog, we have explained lung cancer in detail, its types, and how to recognize its symptoms. We have also discussed potential treatments available for lung cancer and how Dr Aneez can help you with this.  

What is Lung Cancer?

Cancer causes specific changes in healthy cells. The healthy cells in our body are programmed to die after a certain stage in their life cycle. This is essential to prevent overgrowth. In cancer, this instruction is overridden as a result of which cells grow and multiply uncontrollably when they should not. This overgrowth of cells leads to tumor and cancer.

In lung cancer, this pattern of overgrowth of cells occurs in the lungs causing improper functioning of the lungs. Lung cancers can happen in any part of the lung, but 90%-95% of cancers of the lung arise from the epithelial cells, which form the lining of the larger and smaller airways i.e. bronchi and bronchioles. That’s why lung cancers are sometimes called bronchogenic carcinomas or bronchogenic cancers. Cancer in the lungs can also arise from the pleura also known as mesotheliomas or rarely from supporting tissues within the lungs such as blood vessels. Lung cancer may spread to lymph nodes or other organs in the body, such as blood or the brain. Conversely, cancer from other parts of the body may also spread to the lungs. When cancer cells spread from one part of the body to another, they are described as metastases.

Several studies on lung cancer screening in Singapore have made surgeons and physicians categorize lung cancers into two main types – small cell and non-small cell.

  •         Small cell lung cancer: It occurs specifically in heavy smokers and is less common as compared to non-small cell lung cancer.
  •         Non-small cell lung cancer: It is an umbrella term for several types of lung cancers such as squamous cell carcinoma, adenocarcinoma, and large cell carcinoma.

These types of lung cancer grow in a different way and are also treated differently. Non-small cell lung cancer is a more common type of lung cancer than small cell lung cancer. In some rare cases, lung cancer tumors contain both NSCLC and SCLC cells.

How Common Is Lung Cancer In Singapore?

Lung cancer is the 2nd and 3rd most common cancer in males and females in Singapore respectively. It has been found that 14.5% of all cancer numbers in men were lung cancer cases. For women, this figure is 7.6%. In the meantime, being the leading cause of cancer deaths in Singapore, lung cancer accounted for 26.6% of deaths in males and 16.1% in females.

Studies also show that small cell lung cancer (SCLC) makes up about 10 – 15% of all lung cancer cases.  It is exclusively associated with cigarette smoking and an aggressive type of cancer that quickly grows and spreads to other parts of the body.  Non-small cell lung cancer (NSCLC) is not as aggressive as SCLC but it is more common. It tends to grow and spread less rapidly as compared to SCLC. About 85% to 90% of lung cancers are non-small cell lung cancers (NSCLC).

What Are the Risk Factors for Lung Cancer?

It has been found in different research studies that several risk factors may increase your chances of getting lung cancer. These include:

SMOKING: Cigarette smoking is the top risk factor for lung cancer. In Singapore, cigarette smoking is associated with about 80% to 90% of lung cancer deaths. This figure also includes the use of other tobacco products such as pipes or cigars which further increases the risk for lung cancer. Those who use tobacco smoke should be aware of the fact that it is a toxic mix of more than 7,000 chemicals and most of them are poisons. However, 70 of them are known to cause cancer.

Research has also concluded that people who smoke cigarettes are 15 to 30 times more likely to get lung cancer as compared to those who do not smoke. No matter you smoke a few cigarettes a day or smoke occasionally, in both situations, you are at high risk of getting lung cancer. The more cigarettes a person smoke per day, the more risk goes up.

People who quit smoking, their chances of meeting with lung cancer is also reduced than if they had continued to smoke.

Cancer caused due to Cigarette smoking can occur in almost any part of the body such as the mouth and throat, esophagus, stomach, pancreas, colon, rectum, liver, voicebox (larynx), trachea, bronchus, urinary bladder, and cervix, kidney, and renal pelvis, and causes acute myeloid leukemia.

SECONDHAND SMOKE: Smoke from other people’s cigarettes, pipes, or cigars is known as secondhand smoke which can also cause lung cancer. Secondhand smoke and the harmful chemicals present in it can cause sudden infant death syndrome, ear infections, respiratory infections, and asthma attacks in infants and children. Secondhand smoke is also known to cause heart disease, stroke, and lung cancer in adult nonsmokers.

RADON: It is a naturally occurring gas that originates from rocks and dirt. It gets trapped in houses and buildings and cannot be seen, smelled, or tasted.

OTHER SUBSTANCES: Some of the other potential substances resent at some workplace and increase the risk of lung cancer are asbestos, diesel exhaust, arsenic, and some forms of silica and chromium. Many of these substances have a higher risk of getting lung cancer which is even higher for those who smoke.

FAMILY HISTORY OF LUNG CANCER: Those who have successfully survived lung cancer are at high risk of developing other types of lung cancer again, especially if they smoke. If your parents, brother or sister, or children have had lung cancer, then you are at high risk of developing this disease.

RADIATION THERAPY TO THE CHEST: Those who have survived from cancer and had gone through radiation therapy to the chest, such people are at higher risk of lung cancer.

DIET: Studies are still going on many different foods and dietary supplements to see whether or not they contribute to causing lung cancer in any way (directly or indirectly). There is much we still need to know. It has been found that smokers who consume beta-carotene supplements have a high risk of lung cancer.

What Are The Symptoms Of Lung Cancer?

There are no signs or symptoms in the early stages. Symptoms of lung cancer develop as the condition progresses. When lung cancer starts showing signs in its early stages, these may vary from person to person which include:

  •         A cough that does not go away or gets worse with time
  •         Coughing up blood or rust-colored sputum
  •         Chest pain that gets worse with deep breathing, coughing, or laughing
  •         Feeling tired or weak
  •         Hoarseness
  •         Infections such as bronchitis and pneumonia that keep coming back
  •         Loss of appetite
  •         New onset of wheezing
  •         Shortness of breath
  •         Unexplained weight loss

When it spreads and reached its advanced stages, it may cause:

  •         Bone pain includes pain in the back or hips.
  •         Nervous system changes such as headache, numbness of an arm or leg, dizziness, or weakness or balance problems, or seizures (if cancer spreads to the brain).
  •         Yellowing of the skin and eyes (jaundice) if cancer spreads to the liver.
  •         Swelling of lymph nodes such as those in the neck or above the collarbone.

If you experience any of the above-mentioned symptoms, don’t hesitate to go for lung cancer screening in Singapore. It will clear all your doubts regarding lung cancer.

Robot-Assisted Thoracic Surgery As A Treatment For Lung Cancer

We suggest robot-assisted thoracic surgery as a substitute for traditional surgery which requires a large open incision, breaking and spreading the chest, and Laparoscopy which is again a minimally invasive surgery in which a small incision is made to perform some procedures. Robotic surgery is one of the most effective and least invasive surgical treatments available today.

Benefits of robotic surgery comprise of:

  •         Less pain in the area of the incision
  •         Faster recovery
  •         Fewer possible complications
  •         Less chance of infection
  •         Shorter hospital stay
  •         Smaller, less noticeable incision scars

Dr Aneez D.B Ahmed is currently the Director & Senior Consultant Surgeon at International Centre for Thoracic Surgery in Mount Elizabeth Novena Specialist Centre, Singapore. He has been a practitioner in the field of thoracic surgery for more than 15 years. His specialization is in thoracic oncology as he has served as the Head of Service of Thoracic Surgery in the Department of General Surgery in Tan Tock Seng Hospital (TTSH), Singapore. His interest in robotic surgery led him to be recognized as the first in the ASEAN cohort to get Level III Certificate Specialist training in Robotic Thoracic Surgery from the European College of Cardiothoracic Surgery (EACTS).

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