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Lung cancer: When the cells turn rogue
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Lung cancer: When the cells turn rogue

Apart from smoking and tobacco use, occupational hazards, passive smoking and air pollution can also cause cancer of the lung

Apart from smoking and tobacco use, occupational hazards, passive smoking and air pollution can also cause lung cancer

The lungs are the nucleus of the respiratory system performing the vital function of bringing oxygen into the body and expelling carbon dioxide. Lung cancer can derange this function by attacking the healthy lung cells.

David (name changed), an octogenarian from Mumbai, was caught off-guard when he learned of his lung cancer diagnosis.

When he began experiencing a cough, he presumed that it was nothing out of the ordinary and so did his family physician who prescribed cough-relieving medications.

While he got temporary respite, the cough proved adamant, soon making a comeback.

After over two months of recurrent cough, he spotted blood in his cough one day, raising suspicion that something was awry.

His CT scan proved his doubts right as he was diagnosed with adenocarcinoma, a type of lung cancer.


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What causes cancer?

According to National Cancer Institute (NCI), USA, cancer is a condition where some of the cells grow uncontrollably and spread to other parts of the body.

Normally, our cells multiply and form new cells according to the signals of the body and die off due to damage or ageing, to be replaced by new cells.

As NCI explains, cancer is caused due to mutation in the genes that control the division of these cells. As a result, they grow and divide uncontrollably without paying heed to the signals of the body and refuse to die.

These abnormal tissues form a mass called a tumor which can be malignant (cancerous) or benign (non-cancerous). Malignant tumors can spread to other parts of the body and destroy normal tissues.

How cancer affects the lung

“Cancer destroys the viable tissues of the lung, affecting their functions. As cancer grows, it spreads to other parts of the lungs, reducing the amount of healthy lung tissues available for respiration,” says Dr Sai Vivek, consultant, medical and hemato-oncologist at Aster International Institute of Oncology, Bengaluru.

“Once cancer has grown beyond a certain stage, it can spread to other organs (metastasis), affecting their functioning,” he adds.

Symptoms of lung cancer

“The signs start to appear at the beginning of stage 2 and escalate by stage 3,” says Dr Amit Gawande, consultant pulmonologist and critical-care specialist from Mumbai, who treated David.

“Lung cancer is commonly detected by the end of stage 2, when the symptoms worsen, as people tend to suppress the early symptoms like cough, without probing the cause,” he adds.

Dr Gawande lists the following symptoms of lung cancer:

  • Chronic cough
  • Blood in cough
  • Fatigue
  • Weight loss
  • Loss of appetite
  • Breathlessness

Agreeing with Dr Gawande, Dr Vivek says, lung cancer doesn’t develop in a week or a month. It takes a few months for the cells to multiply and form a mass. It is only after several cell replication cycles that symptoms begin to manifest.

He also mentions voice changes and recurrent fevers as probable signs.

Does smoking cause cancer?

David found his diagnosis hard to digest as he had always associated lung cancer with smoking, and he had never lit a cigarette in his life.

“While cigarette smoking and tobacco use are the biggest risk factors for lung cancer, there is an increasing number of non-smokers who are being diagnosed with the condition. It is a myth that only smokers get lung cancer,” says Dr Vivek

He mentions passive smoking, occupational exposure to certain carcinogens (like asbestos), and air pollution as some of the risk factors for cancer.

Treatment

The treatment is decided based on the age of the individual, the extent of the disease, and the ability of an individual to tolerate the treatment.

Dr Gawande lists the various treatment modalities for cancer:

  • Surgery: Includes removing the tumor and the surrounding tissues. It is usually performed in the early stages when there is no spread.
  • Chemotherapy: This procedure uses certain chemicals that attack cancer cells and is administered either intravenously or orally as tablets.
  • Radiotherapy: In this form of treatment, high energy radiation is used to shrink tumors and kill cancer cells.
  • Immunotherapy: Uses a person’s immune system to fight cancer.
  • Gene mutation therapy: This procedure tries to alter the gene mutation that results in cancer.

“In David’s case, we were sceptical about going for an aggressive mode of treatment like chemotherapy, radiation and surgery as his old age would affect his ability to tolerate the side-effects and hinder his quality of life,” says Dr Gawande.

“After considering the opinion of his family, we zeroed in on oral chemotherapy. This included taking one tablet a day, which would slow down the cancer progression while not significantly affecting his quality of life like traditional chemotherapy,” adds Dr Gawande.

Takeaways

  • Lung cancer is one of the most common forms of cancer.
  • Cancers are caused by mutation of genes that control cell division.
  • Cancer is divided into four stages based on the size and location of the tumor.
  • Chemotherapy, surgery, radiotherapy, etc. are some of the treatments for lung cancer.

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