Lung Cancer

Lung cancer is a malignant tumour developed in the lower part of the respiratory system including cells in the bronchus and bronchiole wall.

90% lung cancer cases are related to cigarette smoking. Please pay special attention to lung cancer symptoms if you belong to one or several of the following groups:

• Smokers
  
• Aged 50 or above
  
• Having a long-term history of smoking started at young age (this would increase the risk of getting lung cancer)
  

• If you smoke, quit smoking now.  If you have a relative or friend who smokes, talk with him or her about quitting.
  
• Avoid exposure to excessive cooking oil fumes by: choose cooking methods like steaming, boiling, and stewing. Avoid frying when cooking meals at home. Always use the exhaust gas ventilator in order to reduce cooking oil fumes.
  
• Diet: Avoid intake of preserved or barbecued food.
  
• Living: Reduce incense burning.

Cigarette smoking is a known principal factor for development of lung cancer. If you smoke, it is important to be aware of the following facts:

• Smokers have a risk of getting lung cancer 20 times higher than nonsmoker
  
• 1 in 10 smokers gets lung cancer
  
• Frequent exposure to second-hand smoke will greatly increase the risk of getting lung cancer (2 to 3 times higher than normal)

Besides smoking, the following factors may also increase the risks of getting lung cancer:-

• A prolonged absence of fresh vegetables and fruits, and foods rich in vitamin A from the diet
  
• Prolonged exposure to oil fumes produced during cooking
  
• Frequent intake of BBQ and preserved foods
  
• Prolonged inhalation exposure to smoke produced by incense burning
  
• Race or hereditary factor
  

Any of the following signs and symptoms could indicate lung cance：

• Prolonged fatigue
  
• Poor appetite and weight loss
  
• Persistent cough
  
• Wheezing
  
• Sputum with blood
  
• Chest pain: vague pain or agonizing pain in the chest when coughing or taking a deep breath

Patients with more advanced lung cancer may also experience the following: scrofulous swelling of the neck, face and hand; abdominal distention, bone pain, headache, partial epilepsy or hemiplegia (paralysis of one side of the body)

While smokers should have regular chest checkups, people having any of the aforesaid symptoms should also visit their family doctors promptly. Diagnostic tests for lung cancer include the following:

a) Chest X-ray

b) Sputum cytology examination (sample of sputum being examined under a microscope to check for abnormal cells)

c) Bronchoscopy:examination of the airways by bronchoscopy to visualize the mucosal status. This may reveal areas of tumor that can be biopsied for diagnosis of cancer cell type. The results can then help doctors to determine whether surgery should be given.

d) CT scan / Positron emission tomography scan: this can help to determine whether the tumour may have spread within the chest, such as local lymph nodes. The doctor will then decide if the patient’s lung cancer can be treated with surgery.

Treatments for lung cancer may include surgery, external radiotherapy, chemotherapy and other supportive measures for palliation such as laser, internal radiation therapy, and medicines. Single or combined modalities treatments may be used depending upon the patient’s general health status.

a) Surgery
This treatment method offers the best chance of cure for patients who have early-stage lung cancer that has not spread beyond the lungs. The curative rate of surgery stands at more than 60% among patients in the earliest stage of disease. The volume of resection depends (depends) on the status of the malignant tumor. The operation may involve the removal of a tumor together with some surrounding tissue, while some may involve removal of a whole lobe or even one whole lung.

b) External radiotherapy
This may be given as curative therapy of early-stage lung cancer for patients who are not suitable for surgery because of being too old or having other diseases. Radiotherapy will be useful for destroying cancer cells in patients if there is local spread of tumor, surgically irremovable cancer cells left after operation, or symptoms caused by cancer spread (such as bone pain and brain metastases).

c) Chemotherapy
For patients with metastatic lung cancer, chemotherapeutic drugs (anticancer drugs) will be used to help stop cancer cells from dividing and multiplying. A single or combination of anticancer drugs will be injected into the patient’s body by way of intravenous infusion. The patient will need to take 3-4 weeks of rest before receiving another infusion, while usually 4-6 infusions are given during the whole course.

d) Targeted therapy
This targets at specific molecules involved in a certain tumor type. It causes fewer side effects than traditional chemotherapy by having less impact on hematopoietic stem cells or the immune system. It is suitable for a certain specific type of metastatic lung cancer patient.

Chemotherapy:
While chemotherapeutic drugs can kill cancer cells, they also destroy normal cells in the body, resulting in side effects. Patients may experience nausea, vomiting, hair loss, mouth sores, anaemia, low resistance to bacterial infection, and internal hemorrhage, etc. Hence, your doctor will manage the entire course of chemotherapy with special caution.
Targeted Therapy :
Targeted therapy may cause side effects such as skin rash, mouth sores or diarrhea. Please strictly follow medical advice in using this type of treatment.

The following are some important notes for patients during rehabilitation after surgery, radiotherapy or anticancer drug treatment:

Regular checkups:
Surgery and drug treatment may lead to a partial or even complete relief from symptoms of lung cancer. However, lung cancer has a relatively high chance of recurrence. This is largely due to the fact that most patients are not treated until their cancer have worsened and disseminated, thus affecting the successs rate of curative. Patients should persist in regular subsequent visits to allow close monitor of progress. If cancer recurs, treatment can also be given promptly and hence increase the chance of survival.

Reminders on daily lifestyle:

• Stop smoking
  
• Ensure good ventilation at home
  
• Do appropriate exercises to improve lung function
  
• Stay away from crowded and air-polluted public areas to avoid respiratory infection

Diet:

• Increase intake of food that contains substantial amount of vitamins A and C such as carrot, grape, and pear, etc