Lung Cancer Diagnosis And Treatment

lung cancer

Lung cancer is one of the most common types and approximately 47,000 people in the UK are diagnosed every year. Lung cancer mainly affects older people and it is rare for anyone younger than 40 to be diagnosed with the dreaded disease. Fact is, more than 4 out of 10 people with lung cancer in the UK are 75 years or older.

Although there are instances where non-smokers develop lung cancer, smoking is the most common cause in about 72% of cases. This is mainly because smoking cigarettes involves inhaling several toxic chemicals and substances. While there is currently no National Screening programme, some areas within the UK will be offering screening services.

What Is Lung Cancer?

Lung cancer is a condition that occurs when abnormal cells grow uncontrollably in one or both lungs. As these cells grow, they can form tumours and interfere with normal lung functions such as providing oxygen to the body through the blood. Lung cancer starts in the lungs and can often spread to lymph nodes or other organs including the brain.

Types of Lung Cancer

Cancer that starts in the lungs is referred to as primary lung cancer. If it spreads to the lungs from another place in the body, it is called secondary lung cancer. Any type of cancer can spread to the lungs but the most common are breast cancer, bowel cancer, kidney cancer, testicular cancer, bone cancer and melanoma skin cancer among others.

In terms of primary lung cancer, there are two main forms which are classified by the type of cells in which cancer starts to grow.

Non-small-cell lung cancer (NSCLC)

This is the most common form and accounts for more as much as 87% of cases. There are three different types namely squamous cell carcinoma, adenocarcinoma or large-cell carcinoma.

  • Adenocarcinoma is the most common and starts in the mucous gland cells in the lining of the airways
  • Squamous cell cancer develops in the fat cells that cover the surface of your airways and usually grow near the centre of the lung
  • Large cell carcinoma typically starts along the outer edges of the lungs. They are less common than adenocarcinoma or squamous cell carcinoma making up 10%-15% of cases

Small-cell lung cancer (SCLC)

This is less common accounting for about 12 out of every 100 cases and mostly caused by smoking. These cancer cells tend to grow faster than NSCLC and travel to other parts of the body, metastasizing much easier. There are two types namely Small cell carcinoma (oat cell cancer) and combined small cell carcinoma.

Signs And Symptoms

There are several possible causes for various symptoms so it’s important to know what signs to look out for. Sometimes doctors can identify unusual changes to a patient’s chest x-ray but that doesn’t necessarily mean lung cancer as it could be an infection.

If doctors want to find a more detailed diagnosis, they will run different tests or scans to find a definitive answer. We’ve listed the most common symptoms of lung cancer below:

  • Coughing most of the time
  • Your long-term cough may sound different or it’s painful
  • Being out of breath when doing things you never had a problem with before like climbing stairs
  • Coughing phlegm or sputum containing blood
  • Aches or pains in the chest or shoulder
  • Recurring chest infections or a chest infection that doesn’t improve
  • Loss of appetite
  • Always feeling tired or fatigued
  • Unexplained weight loss

Treatment Options

Treatment will largely depend on the type of cancer, the stage it’s in and a patient’s general health. If they can diagnose the condition early and the cancer cells have not spread or are in a small area, surgery can remove the affected area of the lung.

If surgery is not an option due to a general health issue, radiotherapy would be recommended to destroy the cancerous cells. Chemotherapy is the other alternative especially if the cancer cells have spread too much for surgery or radiotherapy to be an effective treatment option.

Targeted Therapies

Besides surgery, chemotherapy and radiotherapy (radiation), there are a number of medicines known as targeted therapies. These specially formulated medicines target the specific genes or proteins of cancer or the tissue environment contributing to the growth. Doctors often use targeted therapies in conjunction with chemo, radiation and other treatments.

Cancer starts when certain genes in healthy cells change which is called a mutation. There are many different cell types – blood cells, brain cells, and skin cells where each one has a specific function. If the gene structure changes, the proteins will change as well making cells divide abnormally or live too long. While targeted therapy is a useful treatment option, it cannot cure lung cancer and only slows the mutation.

Lung Cancer Screening

Screening means testing people for the early stages of a disease before the appearance of any symptoms. There may not be a national screening programme for lung cancer in the UK but the NHS will offer Lung Health Checks in some areas.

The reason why there is no national screening programme in the UK is that it isn’t clear that screening everyone will save lives. Some tests are expensive and can carry additional risk of lung damage. Tests can also find changes to the lungs that that appear similar to cancer which could result in unnecessary biopsies.

So, for now, NHS England is looking at low dose CT scans as a possible lung cancer screening test. It will be aimed primarily at people who smoke or those who used to smoke. Take a look at the interesting developments in lung cancer clinical trials.

Coping With Cancer

Whether you or a loved one have been diagnosed with cancer, there are people and organisations that provide incredible support. Macmillan Cancer Support will offer advice to help you cope with emotional, relationship or health issues during and after cancer treatment.

VirtualOutcomes has various online courses to help pharmacy teams provide patients with the latest information and best possible care. Please contact us for more information and join the conversation on Facebook, Twitter and LinkedIn.