lung cancer

What is Lung Cancer?

Lung cancer is a type of cancer that starts as a growth of cells in the lungs. The lungs are two spongy organs in the chest that control breathing and oxygenation of the body.

• Definition: Lung cancer is a disease in which cells in the lungs grow out of control, forming tumors that can invade surrounding tissues and spread to other parts of the body [1].
• Types: There are two main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC is further divided into subtypes such as adenocarcinoma, squamous cell carcinoma, and large cell carcinoma [6].

Causes and Risk Factors

Lung cancer is caused by harmful cells in the lungs growing unchecked. The exact cause of lung cancer is not known, but it is often linked to smoking tobacco products.

• Smoking: Smoking is the leading cause of lung cancer, accounting for about 80-90% of all cases [5].
• Other risk factors: Exposure to radon gas, asbestos, and other carcinogens can also increase the risk of developing lung cancer [4].

Symptoms and Diagnosis

Lung cancer often does not show symptoms until it has spread to other parts of the body. When symptoms do appear, they may include:

• Coughing: A persistent cough or coughing up blood is a common symptom of lung cancer [7].
• Shortness of breath: Lung cancer can cause shortness of breath due to tumors blocking airways or spreading to surrounding tissues [8].

Diagnosis typically involves imaging tests such as X-rays, CT scans, and PET scans, as well as biopsy procedures to confirm the presence of cancer cells.

Treatment Options

Treatment for lung cancer depends on the stage and type of cancer. Common treatments include:

• Surgery: Surgical removal of tumors or affected lung tissue may be an option for early-stage lung cancer [5].
• Chemotherapy: Chemotherapy uses medications to kill cancer cells throughout the body [3].
• Radiation therapy: Radiation therapy uses high-energy rays to destroy cancer cells [2].

References:

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Common Signs and Symptoms of Lung Cancer

Lung cancer can manifest in various ways, and it's essential to be aware of the common signs and symptoms to seek medical attention promptly.

• A new cough that doesn't go away: This is one of the most common symptoms of lung cancer, often accompanied by a worsening cough over time [1].
• Chest pain: Pain or discomfort in the chest area can be a symptom of lung cancer, especially if it persists or worsens over time [2].
• Coughing up blood, even a small amount: This is a serious symptom that requires immediate medical attention [3].
• Hoarseness: A change in your voice or hoarseness can be an early sign of lung cancer [4].
• Shortness of breath: Difficulty breathing or feeling winded even when sitting still can be a symptom of lung cancer [5].
• Wheezing: A high-pitched sound while breathing out can be a sign of lung cancer, especially if it persists or worsens over time [6].

Other possible symptoms of lung cancer include:

• Bone pain: Pain in the bones, particularly in the back, hips, or ribs, can be a symptom of lung cancer that has spread to the bone marrow [7].
• Arm or leg weakness or numbness: Weakness or numbness in the arms or legs can be a sign of lung cancer that has affected the nerves [8].
• Headache, dizziness, or seizure: In rare cases, lung cancer can cause headaches, dizziness, or even seizures due to increased pressure on the brain [9].

It's essential to note that not everyone with lung cancer will experience these symptoms, and some people may have no symptoms at all. If you're experiencing any of these symptoms, it's crucial to consult a doctor for proper evaluation and diagnosis.

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Diagnostic Tests for Lung Cancer

Lung cancer diagnosis involves a combination of medical history, physical examination, and various imaging tests to confirm the presence of cancer.

• Imaging Tests: These are the primary tools used to diagnose lung cancer. They include:

  • Chest X-ray: A chest x-ray is often the first test done to check for any abnormalities in the lungs [1].
  • Computed Tomography (CT) scan: A CT scan provides more detailed images of the lungs and surrounding tissues, helping doctors identify tumors or other abnormalities [2-3].
  • Magnetic Resonance Imaging (MRI) scan: An MRI scan can also be used to visualize the lungs and surrounding tissues, although it is not as commonly used for lung cancer diagnosis [4].
  • Positron Emission Tomography (PET) scan: A PET scan uses a small amount of radioactive material to highlight areas of high activity in the body, which can indicate cancer cells [5].

• Other Diagnostic Tests: In addition to imaging tests, other diagnostic procedures may be used to confirm lung cancer diagnosis. These include:

  • Sputum cytology: This test involves examining mucus from the lungs for abnormal cells [2].
  • Bronchoscopy biopsy: A bronchoscope is inserted through the mouth or nose to collect tissue samples from the lungs for examination under a microscope [6-7].
  • Endobronchial ultrasound (EBUS): EBUS uses high-frequency sound waves to create images of the lungs and surrounding tissues, helping doctors guide biopsies or other procedures [8].

• Screening Tests: For people at high risk of developing lung cancer, such as smokers, a yearly low-dose CT scan (LDCT) is recommended for early detection and treatment [9].

It's essential to note that the specific diagnostic tests used may vary depending on individual circumstances and the stage of cancer. A healthcare professional will determine the most suitable tests based on your medical history and symptoms.

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Treatment Options for Lung Cancer

Lung cancer treatment options have evolved significantly in recent years, offering patients more effective and targeted therapies. Here are some key points about drug treatments for lung cancer:

• Targeted Therapies: Drugs such as afatinib (Gilotrif), osimertinib (Tagrisso), erlotinib (Tarceva), dacomitinib (Vizimpro), and gefitinib (Iressa) can be given to patients with specific genetic mutations in their lung tumors [2].
• Immunotherapy: Atezolizumab (Tecentriq) is an immunotherapy drug that has been approved for the treatment of extensive stage small cell lung cancer, often used in combination with chemotherapy [8].
• New Developments: Sotorasib, a new drug, has shown promise in reducing tumor size and improving survival among patients with lung tumors caused by a specific DNA mutation [4].

Approved Drugs

The following drugs have been approved for the treatment of lung cancer:

• Afinitor (Everolimus)
• Atezolizumab
• Atezolizumab and Hyaluronidase-tqjs
• Doxorubicin Hydrochloride

Additional Treatment Options

Depending on the type and stage of lung cancer, treatment may also include:

• Surgery
• Chemotherapy or other medications
• Radiation therapy
• Local treatments such as laser therapy [7]

It's essential to consult with a healthcare professional for personalized advice on treating lung cancer.

References: [1] Not available in context. [2] Drugs such as afatinib (Gilotrif), osimertinib (Tagrisso), erlotinib (Tarceva), dacomitinib (Vizimpro), and gefitinib (Iressa) can be given ... [3] KEYTRUDA is a prescription medicine used to treat: a kind of lung cancer called non–small cell lung cancer (NSCLC). [4] The new drug sotorasib reduces tumor size and shows promise in improving survival among patients with lung tumors caused by a specific DNA mutation, according ... [5] Oct 1, 2024 — Approved Targeted Therapy Drugs · EGFR (including EGFR exon 20) · ALK · ROS-1 · NTRK · MET · RET · BRAF V600E · HER2 [6] FDA approved cemiplimab-rwlc (Libtayo®) immunotherapy drug for first-line treatment for NSCLC patients with high PD-L1 expression and who are not eligible for ... [7] Depending on its type and stage, lung cancer may be treated with surgery, chemotherapy or other medications, radiation therapy, local treatments such as laser ... [8] For extensive stage small cell lung cancer, you might have an immunotherapy drug called atezolizumab (Tecentriq). You have it with chemotherapy. So you need to ...

Differential Diagnosis of Lung Cancer

Lung cancer can be challenging to diagnose due to its similarity in symptoms and presentation with other conditions. Here are some key points to consider:

• Pneumonia: Lung cancer can mimic pneumonia, especially when it presents as a localized pneumonic-type lung adenocarcinoma (L-PLADC) [7]. This type of cancer can be difficult to distinguish from an infectious process.
• Bronchitis and Carcinoid Lung Tumors: These conditions can also present with similar symptoms such as cough, hemoptysis, and dyspnea [2].
• Pleural Effusion and Pneumothorax: Lung cancer can cause pleural effusion (fluid accumulation in the pleural space) or pneumothorax (collapsed lung), which can be mistaken for other conditions [1].
• Colorectal Cancer and Sarcoma: Multiple pulmonary nodules of cannonball appearance are associated with colorectal cancer and sarcoma, making differential diagnosis challenging [5].
• Other Conditions: Lung cancer can also mimic benign conditions such as papilloma and adenoma, fibroma (fibrous polyp), lipoma, endochondroma and chondroesteoma, intratracheal stroma, gumma, tuberculoma, lymphoma, amyloid, and COPD [8].

Key Takeaways

• Lung cancer can be difficult to diagnose due to its similarity in symptoms with other conditions.
• Differential diagnosis is crucial to rule out other potential causes of lung-related symptoms.
• A thorough medical history, physical examination, and diagnostic imaging are essential for accurate diagnosis.

References:

[1] Oct 21, 2024 — Differential Diagnoses · Bacterial Pneumonia · Bronchitis · Carcinoid Lung Tumors · Mycoplasmal Pneumonia · Pleural Effusion · Pneumothorax. [2] Feb 17, 2021 — Lung cancer must be differentiated from other conditions that cause hemoptysis, cough, dyspnea, wheezing, chest pain, dysphonia, dysphagia, ... [3] by P Jurczak · 2024 · Cited by 1 — Atypical clinical manifestations of lung cancer can resemble various other, benign conditions, such as pneumonia, lung abscess, scars caused by infections, ... [5] Mar 16, 2023 — Multiple pulmonary nodules of cannonball appearance are associated with colorectal cancer and sarcoma. Thyroid cancer and ovarian cancer are ... [7] by Q Li · 2022 · Cited by 14 — In clinical practice, a number of delayed diagnoses of localized pneumonic-type lung adenocarcinoma (L-PLADC) mimicking pneumonia have been ... [8] by CJ TRIPOLI · 1941 · Cited by 1 — Benign: papilloma and adenoma; fibroma (fibrous polyp); lipoma; endochondroma and chondroesteoma; intratracheal stroma; gumma; tuberculoma; lymphoma; amyloid ...