Lung Cancer : Symptoms, Diagnosis, and Management
🌿 Understanding Lung Cancer
Lung cancer is one of the leading causes of cancer-related deaths worldwide. Early detection and multidisciplinary management—with pulmonologists playing a key role—can significantly improve survival rates.
⚠️ Signs & Symptoms of Lung Cancer
Lung cancer often remains asymptomatic in early stages, making regular screenings vital.
🩺 Common Symptoms
- ✔ Persistent cough (may worsen over time)
- ✔ Hemoptysis (coughing up blood)
- ✔ Chest pain or discomfort
- ✔ Shortness of breath (dyspnea)
- ✔ Unexplained weight loss & fatigue
- ✔ Hoarseness of voice
- ✔ Frequent respiratory infections
🚨 Advanced Disease Symptoms
- ✔ Bone pain (suggests metastasis)
- ✔ Headache, dizziness (brain metastasis)
- ✔ Swelling in the face/neck (SVC syndrome)
🔴 If you experience these symptoms, consult a pulmonologist immediately.
📋 Diagnostic Workup for Lung Cancer
1️⃣ Clinical Evaluation
- ✔ Detailed history: Smoking, occupational exposure
- ✔ Physical examination: Lung auscultation, lymph node check
2️⃣ Imaging Studies
- 📌 Chest X-ray (CXR) – Initial screening
- 📌 High-Resolution CT (HRCT) Scan – Preferred for detailed lung imaging
- 📌 PET-CT Scan – Determines cancer spread (staging)
3️⃣ Bronchoscopy & Biopsy (Pulmonologist’s Role)
- 🔬 Bronchoscopy with biopsy – Visualizes tumors
- 🔬 Endobronchial ultrasound (EBUS-TBNA) – Biopsies deep-seated lymph nodes
- 🔬 Transthoracic Needle Aspiration (TTNA) – CT-guided biopsy for peripheral lesions
- 🔬 Liquid Biopsy – Detects circulating tumor DNA (less invasive)
4️⃣ Pulmonary Function Tests (PFTs)
📌 Determines lung function before surgery or other treatments.
🩺 Lung Cancer Staging
Pulmonologists guide staging using PET-CT, EBUS, and biopsies.
🩺 Role of Pulmonologist in Lung Cancer Management
- ✔ Early detection & screening (Low-dose CT scans in high-risk patients)
- ✔ Performing bronchoscopy & EBUS for tissue biopsy
- ✔ Assessing lung function before surgery or radiation
- ✔ Providing palliative bronchoscopy for airway obstruction relief
- ✔ Coordinating with oncologists for multidisciplinary care
📖 Treatment Protocol for Lung Cancer
1️⃣ Surgery (For Early-Stage Cancer)
- ✅ Lobectomy (removal of a lung lobe)
- ✅ Segmentectomy/Wedge Resection (for small tumors)
- ✅ Pneumonectomy (entire lung removal if necessary)
- 🔬 Pulmonologists assess surgical risk using PFTs.
2️⃣ Radiation Therapy
- ✅ Used when surgery isn’t an option or post-surgery for residual cancer
- ✅ Stereotactic Body Radiotherapy (SBRT) – For localized lung cancer
3️⃣ Chemotherapy
- ✅ Standard for stage 2-4 cancer
- ✅ Combined with immunotherapy in advanced stages
4️⃣ Targeted Therapy & Immunotherapy
- 🔬 For patients with genetic mutations (EGFR, ALK, ROS1, KRAS, etc.)
- ✅ EGFR Inhibitors: Erlotinib, Osimertinib
- ✅ ALK Inhibitors: Crizotinib, Alectinib
- ✅ Immunotherapy: Pembrolizumab (Keytruda) – Boosts immune response against cancer
5️⃣ Palliative & Supportive Care
- ✅ Airway Stenting & Debulking (By Pulmonologists) – Relieves airway obstruction
- ✅ Oxygen Therapy & Pulmonary Rehabilitation
- ✅ Pain Management & Nutritional Support
💬 Frequently Asked Questions (FAQs)
- 1️⃣ Who is at the highest risk for lung cancer?
✔ Smokers (90% of lung cancer cases)
✔ People exposed to radon, asbestos, air pollution
✔ Family history of lung cancer
- 2️⃣ Can non-smokers get lung cancer?
Yes! Up to 20% of lung cancers occur in non-smokers, often due to pollution, second-hand smoke, or genetic mutations.
- 3️⃣ What is the best screening test for lung cancer?
Low-Dose CT (LDCT) is recommended for high-risk individuals (e.g., smokers >50 years old).
- 4️⃣ How is lung cancer different from COPD or pneumonia?
✔ Lung cancer causes progressive tumors and spreads.
✔ COPD is a chronic inflammatory disease with airway narrowing.
✔ Pneumonia is an acute infection causing fever and cough.
- 5️⃣ What is the survival rate for lung cancer?
✔ Stage 1: 80-90% 5-year survival (if treated early)
✔ Stage 4: <10% 5-year survival (metastatic cancer)
- 6️⃣ Can lung cancer be cured?
✔ Early-stage lung cancer can be cured with surgery.
✔ Advanced lung cancer is managed with chemotherapy, immunotherapy, and targeted therapy.
📢 Key Takeaways
- ✅ Pulmonologists play a crucial role in diagnosing & staging lung cancer.
- ✅ Early detection via Low-Dose CT can save lives.
- ✅ Multimodal treatment (surgery, chemotherapy, immunotherapy) improves survival.
- ✅ Palliative bronchoscopy helps in advanced cases.
