Lung cancer is the most common cancer and the leading cause of cancer death worldwide. By 2022, nearly 2.5 million new cases will be diagnosed, resulting in more than 1.8 million deaths. The incidence rate of lung cancer in men is about 2 times higher than in women. In Indonesia, according to GLOBOCAN data for 2022, there were 38,904 cases of lung cancer, making it the second most common cancer in the country.
Many people think that this disease only affects heavy smokers, when in fact anyone can get it, even those who have never smoked. More worryingly, lung cancer often shows no symptoms in its early stages, so many sufferers are unaware until the cancer has reached an advanced stage.
What is lung cancer?
Lung cancer is a cancer that starts in the lungs - usually in the airways (bronchi or bronchioles) or small air sacs (alveoli). The disease is caused by altered (mutated) cells that divide uncontrollably and form a mass or tumor that eventually stops your organ from working properly.
What are the different types of lung cancer?
There are two main types of primary lung cancer. These two forms are classified by the type of cells in which the cancer starts. They are:
Non-small cell lung cancer (NSCLC) - the most common form, accounting for about 80 to 85 out of 100 cases. This cancer can be of three types: squamous cell carcinoma, adenocarcinoma, or large cell carcinoma.
Small cell lung cancer (SCLC) - a less common form that usually spreads more quickly than non-small cell lung cancer.
The type of lung cancer will determine which treatment is recommended.
What are some of the early symptoms of lung cancer?
A cough or pneumonia that comes back after treatment may be an early symptom of lung cancer. The most common signs of lung cancer are
Constant cough
Coughing up blood
Persistent shortness of breath
Fatigue and unexplained weight loss
Pain or soreness when you breathe or cough
Some of these symptoms can occur early (in stage I or II), but often do not appear until the cancer has progressed to an advanced stage, which is why lung cancer can be difficult to detect early. This is why it is important to get screened if you are at high risk.
What are the risk factors for lung cancer?
While there are many factors that can increase the risk of lung cancer, smoking any type of tobacco product, including cigarettes, cigars, or pipes, is the biggest risk factor. Experts estimate that 80% of lung cancer deaths are related to smoking. Other risk factors include
Exposure to secondhand smoke.
Exposure to harmful substances such as air pollution, radon, asbestos, uranium, diesel exhaust, silica, coal products, and more.
Have had radiation treatment to the chest (such as for breast cancer or lymphoma).
Have a family history of lung cancer.
How is lung cancer diagnosed?
A lung cancer diagnosis involves several medical procedures performed by a doctor to detect and confirm the presence of the disease. The doctor will ask you about your general health and any symptoms you are experiencing. The doctor will perform a physical examination and ask you to breathe into a device called a spirometer, which accurately measures the amount of air you breathe in and out.
You may also be asked to have blood tests to rule out other possible causes of your symptoms, such as a respiratory infection. Some of the common tests include
Chest X-ray
A chest x-ray is often the first test to detect lung cancer, which usually appears as a grayish-white mass. However, this test cannot confirm the diagnosis because it is difficult to distinguish cancer from other conditions, such as a lung abscess. If the x-ray results are suspicious, the patient will be referred to a specialist for further evaluation to determine the presence, type, and spread of lung cancer.
CT scan
After a chest X-ray, a CT scan is usually done to get a more detailed picture of the inside of the body using X-rays and a computer. Before the scan, you will be given an injection of a contrast dye to improve the quality of the images. The procedure is painless and takes about 10 to 30 minutes.
PET-CT scan
If the results of the CT scan indicate cancer, a PET-CT scan may be done to help locate active cancer cells, make a diagnosis, and determine treatment options. Before the scan, you will be injected with a small amount of a radioactive substance. During the scan, you will lie on a table that moves inside the scanner. The procedure is painless and takes about 30 to 60 minutes.
Bronchoscopy and biopsy
If the CT scan shows the possibility of cancer, the doctor may perform a bronchoscopy to look inside the airway and take a sample of cells (biopsy). During this procedure, a thin tube with a camera (bronchoscope) is inserted into the airway through the mouth or nose. You will be given a sedative and local anesthetic to make you more comfortable. The bronchoscopy takes about 30-40 minutes. Alternatively, the doctor may perform endobronchial ultrasound (EBUS), a procedure that combines bronchoscopy with ultrasound. EBUS allows the doctor to examine the lymph nodes in the center of the chest and take a biopsy if needed. The procedure takes about 90 minutes and helps determine the spread and type of cancer.
Tumor Marker Test
Tumor markers are proteins produced by cancer cells or normal cells in response to cancer. Tumor marker testing is an ancillary test that helps detect abnormal cell growth. Different cancers produce different tumor markers. For lung cancer, there are two main tests:
CA 72-4: Detects cancer in glandular organs, including lung adenocarcinoma.
Cyfra 21-1: Detects non-small cell lung cancer (NSCLC).
How can we prevent lung cancer?
Since we don't know for sure what causes most cancers, the only preventive measures focus on risk reduction. Some ways to reduce your risk include
Don't smoke, or quit if you do. Your risk of lung cancer begins to decline within five years of quitting.
Avoid exposure to cigarette smoke and other substances that can damage your lungs.
Eat a healthy diet and maintain a healthy weight.
Some studies show that eating fruits and vegetables may help reduce the risk of cancer.
Get screened for lung cancer if you are at high risk.
If you are at high risk of developing lung cancer, it is important to get screened as early as possible. At K-Lab, we offer non-invasive cancer screening using only a blood sample. This screening can detect lung cancer even when it is small and before symptoms appear. If you would like further advice or would like to be screened, we are ready to help you get more accurate and precise early detection. For more information, please contact our WhatsApp clinic at 081381367915.
Source :
Cancer.org - Lung Cancer Kills More People Worldwide Than Other Cancer Types
WHO - Lung Cancer
NHS.uk – Lung cancer
Global Cancer Observatory - Indonesia fact sheet
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