Testing healthy people for
lung cancer
People with an increased risk
of lung cancer consider annual computerized tomography (CT) scans to look for
lung cancer. If you're 55 or older and smoke or used to smoke, talk with your
doctor about the benefits and risks of lung cancer screening.
Some studies show lung cancer
screening saves lives by finding cancer earlier, when it may be treated more
successfully. But other studies find that lung cancer screening often reveals
more benign conditions that may require invasive testing and expose people to
unnecessary risks and worry.
Tests to diagnose lung cancer
If there's reason to think
that you may have lung cancer, your doctor can order a number of tests to look
for cancerous cells and to rule out other conditions. In order to diagnose lung
cancer, your doctor may recommend:
·
Imaging tests. An X-ray image of your lungs may reveal an abnormal mass or
nodule. A CT scan can reveal small lesions in your lungs that might not be
detected on an X-ray.
·
Sputum cytology. If you have a cough and are producing sputum, looking at the
sputum under the microscope can sometimes reveal the presence of lung cancer
cells.
·
Tissue sample (biopsy). A sample of abnormal cells may be removed
in a procedure called a biopsy.
Your doctor can perform a biopsy in a number of ways, including
bronchoscopy, in which your doctor examines abnormal areas of your lungs using
a lighted tube that's passed down your throat and into your lungs;
mediastinoscopy, in which an incision is made at the base of your neck and
surgical tools are inserted behind your breastbone to take tissue samples from
lymph nodes; and needle biopsy, in which your doctor uses X-ray or CT images to
guide a needle through your chest wall and into the lung tissue to collect
suspicious cells.
A biopsy sample may also be taken from lymph nodes or other areas
where cancer has spread, such as your liver.
Lung cancer staging
Once your lung cancer has
been diagnosed, your doctor will work to determine the extent (stage) of your
cancer. Your cancer's stage helps you and your doctor decide what treatment is
most appropriate.
Staging tests may include
imaging procedures that allow your doctor to look for evidence that cancer has
spread beyond your lungs. These tests include CT scans, magnetic resonance
imaging (MRI), positron emission tomography (PET) and bone scans. Not every
test is appropriate for every person, so talk with your doctor about which
procedures are right for you.
Stages of lung cancer
·
Stage I. Cancer
is limited to the lung and hasn't spread to the lymph nodes. The tumor is
generally smaller than 2 inches (5 centimeters) across.
·
Stage II. The
tumor at this stage may have grown larger than 2 inches, or it may be a smaller
tumor that involves nearby structures, such as the chest wall, the diaphragm or
the lining around the lungs (pleura). Cancer may also have spread to the nearby
lymph nodes.
·
Stage III. The
tumor at this stage may have grown very large and invaded other organs near the
lungs. Or this stage may indicate a smaller tumor accompanied by cancer cells
in lymph nodes farther away from the lungs.
·
Stage IV. Cancer
has spread beyond the affected lung to the other lung or to distant areas of
the body.
Small cell lung cancer is
sometimes described as being limited or extensive. Limited indicates cancer is
limited to one lung. Extensive indicates cancer has spread beyond the one lung.
The treatments for lung cancer depend on the stage of the
cancer, personal characteristics, health status, type of the cancer and age. A
number of therapies are provided to a patient as there is no single treatment
available for lung cancer. Radiation, surgery and chemotherapy are considered
as the major lung cancer treatment.
- Surgery : One of the oldest
methods for treating lung cancer is surgery. The surgical removal of the
tumor and surrounding lymph nodes is done if there is I or II stage cancer
that has not metastasized. Palliative or curative are the two types of
lung cancer surgeries. Palliative surgery may not remove cancer but can
remove an open airway or obstruction that was making the patient
uncomfortable. Curative surgery removes all types of cancerous tissue in
those patients who are in early stage lung cancer.
- Chemoembolization:Strong chemicals are used in
chemotherapy that interferes with cell division process and damages DNA or
proteins. The aim of these treatments is to rapidly divide the cells. The
normal cells can be recovered from any chemical-induced damage whereas
cancer cells cannot be recovered. The medicines in chemotherapy travel in
a systematic way by passing from the complete body and destroying the
original tumor cells that have spread in the whole body. Usually many
therapies are combined that also includes many types of chemotherapy
- Radiation Therapy :Radiation therapy may be
employed as a treatment for both NSCLC and SCLC. Radiation therapy uses
high-energy X-rays or other types of radiation to kill dividing cancer
cells. Radiation therapy may be given as curative therapy, palliative
therapy (using lower doses of radiation than with curative therapy), or as
adjuvant therapy in combination with surgery or chemotherapy. Radiation
therapy generally only shrinks a tumor or limits its growth when given as
a sole therapy, yet in 10%-15% of people it leads to long-term remission
and palliation of the cancer. Combining radiation therapy with
chemotherapy can further prolong survival when chemotherapy is
administered. External radiation therapy can generally be carried out on
an outpatient basis, while internal radiation therapy requires a brief
hospitalization.
- Targeted Therapy :Targeted therapy drugs more
specifically target cancer cells, resulting in less damage to normal cells
than general chemotherapeutic agents. Erlotinib and gefitinib target a
protein called the epidermal growth factor receptor (EGFR) that is
important in promoting the division of cells. This protein is found at
abnormally high levels on the surface of some types of cancer cells,
including many cases of non-small cell lung cancer.
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