How does lung cancer manifest itself

The main symptoms of lung cancer usually appear in advanced stages, making it difficult to diagnose in early stages.

In early stages lung cancer usually does not manifest symptoms, which makes its diagnosis a chance finding in tests performed for another reason or in tests performed for the early diagnosis of lung cancer (which are low-dose CT scans).

When lung cancer gives symptoms, the most frequent are:

  • Persistent cough, with a tendency to worsen.
  • Recurrent pulmonary infections.
  • Hemoptysis (or sputum with blood).
  • Chest pain when breathing or coughing.
  • Sensation of shortness of breath.
  • Persistent feeling of tiredness or lack of energy.
  • Decreased appetite or unwarranted weight loss.

Other symptoms, although less frequent can be:

  • Clubbed fingers (fingertips tend to become more curved).
  • Difficulty swallowing or pain when swallowing.
  • Wheezing when breathing.
  • Hoarse voice.
  • Swelling of the face and neck.
  • Persistent shoulder and/or back pain.

How do you know if lung cancer is advanced?

When lung cancer is advanced, it usually gives the symptoms described above. However, from a clinical point of view, we refer to advanced lung cancer when it is no longer located only in the lung, but there is evidence that malignant cells have spread to other parts of the body, such as the mediastinal nodes (in the mediastinum, outside the lung) or other organs, such as the brain, bones and liver.

How long can a person with lung cancer live?

Lung cancer survival depends on several factors:

  • The type of cancer (non-small cell or small cell).
  • The stage at which it is diagnosed (early versus advanced stages).
  • The presence of other associated pathologies.
  • The tumor’s response to treatment. Nowadays there are more and more targeted therapies depending on the characteristics of each tumor.
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When talking about lung cancer survival, it is important to bear in mind that the data are estimates, generally based on previous survival rates of a large number of patients affected by a specific type of tumor. However, these data, although they can serve as an initial guideline, cannot predict what will happen to a particular person. Sometimes these statistics can be confusing and can create more uncertainty for patients than the diagnosis and treatment of lung cancer already entails.

In general, it is accepted that the 5-year survival rate for non-small cell lung cancer is 61% in localized stages, 35% in locally advanced stages and 6% when distant metastases are present.

As for small cell lung cancer, the 5-year survival rate is 27% in localized stages, 16% in locally advanced stages and 3% when distant metastases are present.

How can it be prevented?

To date, no effective form of prevention has been demonstrated to reduce lung cancer. However, some strategies to reduce the risk of its appearance are:

  • Not smoking.
  • Quitting smoking.
  • Avoid passive smoking.
  • Avoid spaces with high concentrations of radon.
  • Avoid exposure to carcinogens such as asbestos, arsenic, chromium and nickel.
  • Maintain an active lifestyle and a healthy diet.

Although there are as yet no sufficiently reliable prevention strategies, what has been shown to reduce lung cancer mortality more than any treatment is early detection of lung cancer. Fundamental studies in this respect are the New England Journal of Medicine study by Henshcke, the National Lung Screening Trial (NLST), NELSON with a Belgian and Dutch population and the Italian MILD.

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Early detection or screening for lung cancer is currently aimed at people over 55 years of age with a cumulative exposure to tobacco of more than 30 packs per year. However, the indications for screening need to be refined to ensure that all individuals at high risk of lung cancer have access to it.

For more information, please consult with a specialist in Thoracic Surgery.