What is lung cancer
Dr. Jaime Pujadas Olano, specialist in Medical Oncology in Barcelona, defines lung cancer as the abnormal increase of cells in lung tissue, specifically in the lower respiratory tract at the level of the bronchi. It states that it is the first in terms of mortality, causing one million deaths per year in the world, and that in Spain alone 20,000 new cases are diagnosed each year.
Symptoms of lung cancer
Dr. Jaime Pujadas Olano agrees with Dr. Prof. José María Borro Mate, specialist in Thoracic Surgery in Valencia, and Dr. Enriqueta Felip Font, specialist in Medical Oncology in Barcelona, on the symptoms of lung cancer:
- Hemoptysis: blood in the sputum.
- Persistent cough.
- Chest pain.
- Dyspnea: shortness of breath.
- Toxic syndrome: tiredness and loss of appetite and/or weight.
Causes of lung cancer
Dr. José Felipe Coll Klein, specialist in Pneumology in Barcelona, explains the main risk factors for lung cancer:
- Smoking: this is the most important and best known cause. Smokers or former smokers account for 95% of patients diagnosed with lung cancer. Smoking a pack a day for 20 years increases the risk of contracting lung cancer, therefore, it is essential to stop smoking. It is very important to know this fact, since there is no closer relationship than that of tobacco as a possible cause of lung cancer in the body. It is only after 10 or 15 years of quitting smoking that our organism decreases the risk to almost the same as someone who has never smoked.
- Redon gas. Exposure to it increases the risk of lung cancer, since it is a radioactive gas emitted by the disintegration of certain chemical elements.
- Exposure to carcinogenic substances, such as asbestos, uranium, arsenic or petroleum products.
- Genetic predisposition: this is the most common and important cause after smoking. Nowadays it is possible to carry out studies to determine the genetic predisposition to lung cancer.
- Marijuana: marijuana cigarettes contain a lot of tar and pollute the body.
- Pulmonary tuberculosis: Lung cancer can nest in old tuberculosis scars.
- Talcum powder: talc, in its mined form, contains asbestos, a carcinogenic substance.
- Respiratory diseases. These chronic diseases, such as Silicosis and Beliriosis, are caused by exposure to certain substances that also increase the risk of lung cancer.
- Air pollution: the concentration of polluting gases is a risk factor for lung cancer.
- Excess or deficiency of vitamin A: nutrition is paramount in disease prevention. Not having adequate levels of vitamins increases the risk of many types of cancer.
Diagnosis of lung cancer
It is usually detected mostly in patients with an average age between 55 and 75 years. It is still more common in men, although more and more women are being diagnosed with the disease. The diagnosis of lung cancer is usually very late, since these lesions are inside the lung and do not show symptoms until they are advanced. A thoracic CT scan allows early diagnosis of small nodules in patients at high risk of lung cancer, such as smokers or former smokers.
Lung cancer treatments
The treatments to be applied in patients with lung cancer are the following, as listed by Dr. Rafael Rosell, specialist in Medical Oncology in Barcelona:
- Surgical surgery: it is a very powerful weapon when it is possible to remove the entire tumor.
- Chemotherapy. This is the most commonly used treatment in most patients with advanced lung cancer.
- Radiotherapy: it is useful mainly in cases in which there are involved lymph nodes and the margin of the affected tumor. It can also be used palliatively to control pain or a single focus that is in progression.
- Targeted therapies: these are treatments in which small molecules are used, administering a drug that blocks a specific mutation and manages to control the disease quickly and effectively.
- Immunotherapy: this is the most modern and revolutionary treatment. Recently, results of clinical trials have been presented that confirm that this type of treatment is beneficial in any type of lung tumor. However, further research is needed to determine which types of patients may benefit from it and at what stage of treatment.
Lung cancer treatment will depend on the histological subtype (adenocarcinomas, squamous cell carcinoma, microcytic carcinomas), the genetic and molecular profile of the patient and the stage of the disease. Once again, Dr. Jaime Pujadas Olano explains the stages of cancer and the appropriate treatments for them:
- Stages I and II. These are early stages, in which surgery and stereotactic radiotherapy for patients with a higher surgical risk are optional.
- Stage III. This is a locally advanced stage. Radiotherapy and chemotherapy will be fundamental, sometimes combined with monoclonal antibodies, and surgery only in selected cases.
- Stage IV. This is the advanced stage, in which the treatments will be systemic: chemotherapy, monoclonal antibodies and/or immunotherapies. The aim is to delay the progression of the disease as much as possible and to achieve a longer life with the best possible quality of life for the patient.
Ways to remove lung cancer
There are several procedures for the removal of lung cancer. The choice of one or the other will depend on the size and location of the tumor, according to Dr. Laureano Molins López-Rodó, a specialist in Thoracic Surgery in Barcelona:
- Pneumonectomy: consists of the removal of the entire lung. It is usually used when the tumor is central and large. There are also other surgical techniques to avoid pneumonectomy, such as bronchoangioplasty.
- Lobectomy: one of the lobes of the lung is removed. This type of intervention is most frequently used when the tumor is located in one of the five lobes of the lung.
- Segmentectomy: a lung segment smaller than a lobe is removed. It is used when the patient has little respiratory capacity and/or the tumor is smaller than 2cm in diameter.
Lung cancer unit
Finally, Dr. Enriqueta Felip Font, talks about the lung cancer unit. This is an organization that attends patients suspected of having lung cancer who require diagnosis, as well as patients already diagnosed who come for treatment. It also helps patients to obtain second medical opinions and to redirect individualized treatment according to the type of lung cancer they have, the degree of extension and the genetic and molecular characteristics of the malignant cells.
The lung cancer unit is made up of a multidisciplinary team, consisting of medical oncologists, pulmonologists, radiotherapists, surgeons, anatomopathologists and nursing staff, all to offer the best treatment in a personalized way. Psychological or psychiatric care for patients who need it, nutritional counseling and complementary medicine for the treatment of anxiety and pain are also essential. The lung cancer unit makes it easy for patients to receive and complete all tests and treatments in the same place and as quickly as possible.