Information About Lung Cancer

Lung Cancer

Overview

What is lung cancer

The lungs are the two organs located within the chest cavity and are responsible for the exchange of gases during breathing. Cancer occurs when the cells lose control of the cell division cycle and begin to multiply rapidly, in an out of control fashion forming tumours within the lungs. Being one of the deadliest forms of the disease, cancer of the lungs occurs within its tissues and will begin to spread to the entire organ.

Those who smoke have a high risk of developing cancer as the cigarette smoke inhaled contains a large number of carcinogens – substances that cause DNA damage to the cells thus leading to uncontrolled cell division. However, in recent years, there is a rising trend of non-smoking related cases of lung cancer in women. That’s why experts recommend annual lung cancer screening in Singapore to get a detailed picture of your lungs, giving your information about your respiratory health.

Symptoms of Lung Cancer

Unfortunately, in the early stages of the disease, it rarely shows any signs and symptoms. According to a lung cancer specialist in Singapore, symptoms will only appear after the disease has progressed to its later stages.

Signs and symptoms of lung cancer may include:

  • A new cough that doesn’t go away
  • Coughing up blood, even a small amount [Hemoptysis]
  • Shortness of breath
  • Chest pain
  • Hoarseness
  • Losing weight without trying
  • Bone pain
  • Headache

When to see a doctor?

It is advised to immediately seek the advice of a lung specialist in Singapore when you begin to notice any signs and symptoms similar to the ones stated above.

These specialists would also be able to provide guided strategies to help those who are unable to give up the habit of smoking such as counselling, medication, and alternative products to cigarettes.

Causes

As mentioned above, cigarette smoke contains carcinogens that damages the cells. This damage to lung tissue can occur almost immediately. The body has “fail-safes” that are put in place to prevent cells from going rogue and repairthe damage. However, over time, the cumulative effect of the damage may be too much for the body to handle thus leading to lung cancer.

Types of Lung Cancer

Lung surgeons in Singapore believe that lung cancer can be divided into two major groups that can be determined through testing and observation of lung cells under the microscope:

  • Small Cell Lung Cancer is most commonly exclusive to heavy smokers.
  • Non-Small Cell Lung Cancer is the term used by doctors to group all the other type of lung cancers which include squamous cell carcinoma, adenocarcinoma and large cell carcinoma.

Risk Factors

Some lifestyle choices can be changed to prevent developing this. However, other factors such as family history and genetics cannot be controlled.

Risk Factors for Lung Cancer include:

  • Smoking is one of the main causal factors of lung cancer. Its cumulative effect combined with the addictive properties of nicotine make it difficult to quit. However, quitting does significantly reduce the risk of developing the disease.
  • Exposure to secondhand smoke also increases the chances of developing lung cancer as there is exposure to the same types of carcinogens.
  • Radiation therapy that has been taken to treat other forms of cancer or in the lungs would also increase the likelihood of lung cancer as it can damage the DNA of the cells.
  • Exposure to Randon gas produced during the natural breakdown process that occurs in soil, rock and water around us. However, this becomes toxic at high amounts.
  • Exposure to asbestos and other carcinogens in one’s workplace or place of residence.
  • Family history of lung cancer can also pose as a risk as the gene coding for abnormal cell growth can be passed down from generation to generation.

Complications

Lung Cancer can cause complications such as:

  • Shortness of breath will be experienced by cancer patients as the tumours may grow to obstruct major airways. The damage caused to the tissue can also cause the leakage and accumulation of interstitial fluid (pleural effusion) which prevents the lung from expanding fully when inhaling.
  • Coughing up blood (hemoptysis) can occur as a result of damage to the lung tissues. If the bleeding becomes severe, there is a possibility of death.
  • Pain may be felt in the lungs and in other areas of the body that cancer spreads to such as the bones.
  • Metastasis of cancer cells occurs when the cancer cells breach the lining of the lungs and travel via the bloodstream to distant sites thereby spreading cancer to the rest of the body.

Investigation

Lung cancer screening

We at the International Centre for Thoracic Surgery offer a comprehensive screening program  for lung cancer which involves a Low dose CT scan of the thorax with a comprehensive lung function test.

All persons who qualify for the set criteria or who feel the need to consult please make an appointment by clicking here.

  • Chest X-Ray – usually the first tool for spotting large lesions.
  • CT scan – always used to confirm the x-ray findings. Helps in detecting smaller lesions and also other pathologies if any.
  • MRI – occasionally used sometimes. To gauge the depth of tumour involvement across planes
  • PET CT scan – once the cancer is confirmed or suspected this scan is done to evaluate the spread of the disease and for purposes of staging or as a response to treatment.

If you have a cough and currently produce sputum, looking at the sputum under the microscope can sometimes reveal the presence of lung cancer cells.

In a procedure known as a biopsy, abnormal cells form within the lungs are removed and studied. This can be done through a bronchoscopy where a tube with a light and camera system attached is inserted through the throat and into the lungs to inspect damaged areas.

In this procedure, the doctor aims to take tissue samples from the lymph nodes. This is done through an incision at the base of the neck followed by the use of surgical tools to take the tissue samples.

Another option is the needle biopsy in which the doctor uses medical imaging such as X-ray to help guide a needle into areas of interest in the lungs for sample collection.

These samples are then sent to the lab for detailed testing to tell the doctor what type of cancer you have and severity at which it has progressed.

Treatments

During surgery, your surgeon works to remove lung cancer and a margin of healthy tissue. Procedures to remove lung cancer include:

  • Wedge Resection to remove a small section of lung that contains the tumour along with a margin of healthy tissue.
  • Segmental Resection to remove a larger portion of the lung, but not an entire lobe.
  • Lobectomy to remove the entire lobe of one lung.
  • Pneumonectomy to remove an entire lung.
  • If you undergo surgery, your surgeon may/will also remove lymph nodes from your chest in order to check them for signs of cancer.

Questions to ask your surgeon pre-surgery

  • What type of surgery will I have? Will lymph nodes be removed?
  • How long will the operation take?
  • How long will I be in the hospital?
  • Can you describe what my recovery from surgery will be like?
  • Who should I contact about any side effects I experience? And how soon?
  • What are the possible long-term effects of having this surgery?

This form of treatment involves the use of X-rays and protons to generate powerful beams of energy that will be precisely directed to the locations of the cancer cells to kill it. This may be used pre-surgery for those with cancer that has not spread to the rest of the body. For people who are unable to undergo surgery, this combined with chemotherapy would be the primary treatment method. Lastly, for those with cancer that has spread to the rest of the body, this may be a form of treatment to reduce pain.

This is usually a combined treatment of both oral and injectable medication administered over weeks or months. These are extremely strong drugs used to kill the cancer cells and can be used pre-surgery to shrink cancer. It can also be coupled with radiation treatment for those that are unable to undergo surgery. Lastly, for those with cancer that has spread throughout the body, this is a form of treatment to reduce pain.

Also known as radiosurgery, this method is used for patients who are unable to undergo surgery. Powerful beams of energy are aimed at cancer from a variety of angles. This is a common solution for those suffering from small lung cancer or cancer that has metastasized to areas such as the brain.

This treatment aims to block the damage from within the cells to prevent the cells from going rogue. As mentioned above, normal cells become cancer cells when the DNA is damaged and the cells lose control of theircell cycle. These drugs aim to combat said damage and are commonly used for those with advanced or recurrent cancer.

This is another treatment reserved for those with forms of cancer that have progressed to advanced stages or those with recurring cancers. One way that cancer cells can multiply without control into tumours is that it produces proteins that tell the body’s immune system that it is a normal cell and not to destroy it. These drugs aim to impede this protein production and thus use the body’s immune system to help fend off cancer.

This is a special field of medicine that aims to minimise patient discomfort during the treatment process. This is done by tackling any pain caused by signs and symptoms of the illness. Studies have shown that those who undergo palliative care simultaneously with their cancer treatment reported improvement in mood, quality of life and even an increase in survivability.

Request an Appointment