The Lung Cancer: Diagnosis, Causes And Treatment
By: 이세린
According to a survey conducted by the Ministry of Health and Welfare in 2020, lung cancer was the 6th most common cancer in South Korea with over a hundred thousand patients. The death rate of lung cancer is about 30 people out of a hundred thousand, ranked first in both male and female cancer death rates and thus has a 5 year survival rate or only 17.5%. So then, why does lung cancer have such a dark future? This is because the only way to fully recover lung cancer is by surgically removing the part of lungs that have cancer cells, but this treatment can be used at stage one or two cancers as one cannot remove too many parts of the lungs. Because of this, numerous studies have been done to find a way to diagnose lung cancer at its early stage as lung cancer doesn’t have symptoms noticeable enough for the patient until it becomes advanced.
Lung cancer can be divided into two big categories: non-small cell lung cancer and small cell lung cancer, the former being the most common. Like the name suggests, small cell lung cancer has diminutive and round looks when seen with a microscope. With non-small cell lung cancer, the cancer cells are larger. Typically, small cell lung cancer grows faster than non-small cell lung cancer. Even so, non-small cell lung cancer is often diagnosed after the cancer has spread to other areas of your body. As mentioned before, this is why early detection and treatment are so important.
Non-small Cell Lung Cancer Treatment
Stage 1 & 2
For these stages, due to the tumor being relatively small, minimally invasive surgery is done to remove the cancer cells; also known as lobectomy. Like I said before, what’s so great about lobectomy is that it can fully cure cancer, but it also has a big downside: because this surgery removes 20~25% of one’s lungs it greatly reduces pulmonary function. When removing parts of the organ that has tumor cells, a much larger piece is cut as cancer cells are usually widespread. So as to reduce side effects and maintain pulmonary functions, sublobar resection such as wedge resection and segmentectomy are attempted for small bronchoalveolar carcinoma(a type of non-small cell lung cancer). In addition, video-assisted thoracoscopic surgery is being actively tested and has been found to have better results when compared with thoracotomy. However, despite many researches showing excellent results, using a video thoracoscope creates limits to movements of surgical instruments. With that being said, this treatment is only effective when done on early stages of cancer, so for other stages, chemotherapy is done simultaneously.
Stage 3
When lung cancer reaches this stage, chemotherapy and radiotherapy is held before surgery and pneumonectomy is done in need. Small cell lung cancer is likely to be disseminated or at least locally advanced at diagnosis, making the possibility of resection immediately unlikely. Chemotherapy is, therefore, the cornerstone of therapy. There have been significant improvements to minimize side-effects of the therapy, so that the majority of treatment is given as an outpatient. Radiation therapy uses powerful X-ray beams to kill cancer cells or keep them from growing. This treatment may be performed before surgery to shrink the tumor. It may also be used in combination with other treatments, in this case with chemotherapy. Significant improvements have been made for radiotherapy by reducing side effects and lessening damage to other organs such as proton therapy and heavy ion therapy. Recently, heavy ion therapy has been done for prostate cancer and has shown no side effects at all, and thus, all of the cancer cells were removed. Researchers predict that these treatments will be applied to other cancers including lung cancer.
Stage 4
At this point, any surgical treatment doesn’t have any effect on the tumor as cancer cells are spread all over the human body. In conclusion, chemotherapy and radiotherapy are the most common treatments though targeted therapy and immunotherapy are also widely used. As researchers have learned more about the changes in non-small cell lung cancer cells that help them grow, they have developed drugs to specifically target these changes. Targeted drugs work differently from standard chemotherapy drugs. They sometimes work when chemo drugs don’t, and they often have different side effects. At this time, targeted drugs are most often used for advanced lung cancers, either along with chemo or by themselves. Immunotherapy, on the other hand, is the use of medicines to help a person’s own immune system to recognize and destroy cancer cells more effectively.
In conclusion, there have been many developments in lung cancer treatment. As technology becomes more and more advanced, the survival rate of cancers is increasing day by day. However, no matter how much therapies improve, the best we can do is try not to get cancer in the first place. Cigarette smoking is the number one cause of lung cancer. Even if we do get lung cancer, early diagnosis is crucial for increasing life expectancy and quicker treatments. I’m looking forward to studying about lung cancer treatments in the future.
Sources:
Treatment Choices for Non-Small Cell Lung Cancer, by Stage
Small cell lung cancer: Treatment review