Questionnaires by Dr. Yogesh Nishchal, Senior Consultant Medical Oncologist
Q. What is lung cancer?
A – Uncontrolled growth of abnormal cells in lung leads to lung cancer
Q. Types of lung cancer
A – Lung cancers are broadly divided into two types :
- Non-small cell Lung cancer (~ 85%)
3 subtypes: a) Adenocarcinoma
b) Squamous cell carcinoma
c) Large cell carcinoma
- Small cell Lung cancer (~15%) : tend to grow more rapidly than NSCLC
Q. Causes
A – Single most common cause is smoking tobacco (cause of ~80% deaths).
Other causes: chemical and asbestos exposure, air pollution, genetic changes, secondary smoke exposure
Q. Prevention
A – All lung cancers cannot be prevented but a majority of them can be avoided by :
- Stop smoking
- Avoid secondary smoke exposure
- Having a Balanced diet
- Avoiding radon exposure
Q. Statistics in India
A – As per estimate, more than one lakh new cases of lung cancer are expected over next 5 years.
It constitutes nearly 7% of all new cancers and around 10% of all cancer related deaths.
It is more common in males (~70%) but incidence slowly rising in females. Highest incidence is between age of 55 – 70 years.
Q. Screening
Currently there is no screening done in India for lung cancer.
Screening is usually done with low dose CT scan in those with high risk (age 55-80 years, heavy smoker, current smoker or stopped in last 15 years)
Q. Diagnosis
A – Imaging (CXR / CT / PET / MRI)
Biopsy (CT guided / via bronchoscopy / VATS, video assisted thoracoscopy)
Q. Symptoms
A – Voice change (hoarseness), persistent cough (dry or productive), frequent chest infections, chest pain, breathing difficulty with wheezing
Others – bone pain and fractures, coughing of blood, appetite and weight loss, severe headache with nausea and vomiting, blood clots.
Q. Stages
NSCLC
– Occult or hidden
-Stage 0 – only abnormal cells on surface
-Stage 1 – upto 4 cm size tumour
-Stage 2 – upto 7 cm size tumour
-Stage 3 – spread to lymph nodes and other areas of lung
-Stage 4 – spread to distant body parts like bones, liver etc.
SCLC
Limited stage – within one side of lung / nodes
Extensive – spread beyond lungs
Q. Survival data
A – Chances of being alive at 5 years after diagnosis
NSCLC SCLC
Stage
Localised 64% 29%
Regional 37% 18%
Distant 8% 3%
Overall 26% 7%
Q. Treatment
A – Depends on type, extent (stage), fitness of patient and patient preference
Options include surgery (usually for early cancer), systemic therapy (chemotherapy, immunotherapy, targeted therapy), radiation therapy, combination of chemotherapy and radiation (usually stage III)
Others – Radiofrequency ablation (RFA), pain killers, oxygen therapy
