Lung Cancer
Lung cancer is one of the leading causes of cancer-related loss of life. If cancer patients get Covid-19, the risk of disease increases significantly in most of them.
SANKO University Faculty of Medicine, Department of Internal Medicine, Department of Medical Oncology Faculty Member of Medical Oncology Prof. Dr. Mustafa Yıldırım said that lung cancer is one of the leading causes of loss of life due to cancer.
Reminding that smoking and tobacco products are the most important cause of lung cancer, which affects many people and is an important public health problem, Prof. Dr. Yıldırım said, "However, there are many different factors among the risks of lung cancer."
Emphasising that when lung cancer is diagnosed in a person, many tests are performed to determine the type of cancer and whether it has spread, Prof. Dr. Yıldırım continued as follows:
"When cancer is suspected, blood tests are performed, as well as X-rays, lung tomography or other imaging procedures. A biopsy is performed to remove a small piece of tissue from the tumour, the tissue is tested and examined under a microscope.
Cancer cells can spread and 'metastasise'. The stage of the cancer is determined by looking at the size of the tumour and whether it has spread to the lymph nodes or other parts of the body. The stage is one of the characteristics used to guide treatment choices, increasing as the tumour grows or spreads."
KNOWN RISK FACTORS FOR LUNG CANCER
Underlining that the likelihood of developing lung cancer is affected by many risk factors, Prof. Dr Yıldırım gave information about these risk factors.
Smoking and use of other tobacco products:
Stating that smoking is the most common cause of lung cancer, Prof. Dr Yıldırım said:
"Tobacco smoking is estimated to cause 80 - 85 per cent of lung cancers. Smokers are 10-30 times more likely to develop lung cancer than non-smokers. All kinds of tobacco use including pipe, cigar and chewing tobacco can cause mouth, throat and lung cancers. The risk of lung cancer increases with the number of cigarettes smoked per day and the number of years of smoking. A person's exposure is measured by multiplying the number of packs of cigarettes smoked per day by the number of years smoked. For example, a person who smokes a pack of cigarettes a day for 20 years can be said to have been exposed to '20 pack years' of smoking. Quitting smoking can reduce the risk of lung cancer, regardless of how many years a person has been smoking. The risk of cancer decreases after quitting. It is very difficult to quit smoking, but the chance of success can be increased with counselling, nicotine replacement products and medication."
Passive smoking:
Emphasising that passive smoking can sometimes be dangerous for adults and children, Assoc. Prof. Dr. Yıldırım said, "Second-hand smoking is called 'second-hand smoking' when a person does not smoke but smokes in the immediate vicinity and is exposed to it. Second-hand smoking is born.
LUNG CANCER SCREENING
Underlining that the most important steps to reduce the likelihood of developing lung cancer are to quit smoking, to check whether there is radon in the house, to review ventilation systems if necessary and to take protective measures in workplaces with hazardous substances, Prof. Dr. Yıldırım gave the following information about lung cancer screening:
"Lung cancer screening is not recommended for people considered to be at low risk. For those at high risk, lung cancer screening with low-dose computed tomography scans can reduce the risk of death from lung cancer. This applies to people aged 55 to 74 years, with a smoking history of 30 pack/year or more and who have continued or quit smoking in the last 15 years."
SYMPTOMS OF LUNG CANCER
Stating that when lung cancer is small and in the early stages, the person may feel normal because it may not show any symptoms, Prof. Dr Yıldırım said: "If the cancer grows in advanced stages, most people develop one or more symptoms. However, the symptoms of lung cancer can be the same as the symptoms of other more common problems."
Prof. Dr. Yıldırım summarised the symptoms of lung cancer as "Cough, blood in sputum, shortness of breath, wheezing, hoarseness, swelling of the face, arms or neck, chest, head, arm, shoulder and neck pain, weakening of hand muscles, drooping eyelids and blurred vision, etc.".
DIAGNOSIS
Noting that if there are symptoms suggestive of lung cancer, the person will be examined, Prof. Dr. Yıldırım said, "If the findings are related to this disease, the doctor will order many tests, including blood, x-rays or scans."
Emphasising that if a chest X-ray or computed tomography (CT) scan shows abnormality that could be cancer, additional tests may be performed to make a diagnosis, Prof. Yıldırım said:
"It will usually be necessary to remove a small piece from the breast and examine it under a microscope, i.e. biopsy. The decision to perform a biopsy does not mean that cancer is present. Biopsies are routinely performed to check both cancer and many other diseases."
Prof. Dr Yıldırım explained how biopsy can be performed as follows:
"1. Bronchoscopy is a procedure in which a flexible tube with a camera and other small instruments is inserted through the mouth or nose and then into the windpipe (called the trachea).
Endobronchial ultrasound bronchoscopy (EBUS) is a technique that combines flexible bronchoscopy with ultrasound to first see lymph nodes in the chest and then take a biopsy of enlarged lymph nodes.
CT-guided fine needle biopsy is performed by positioning the tumour with a CT scan and inserting a thin needle through the skin to remove the small tissue sample.
Needle aspiration is performed by inserting a needle into lumps or lymph nodes that can be felt under the skin or seen with ultrasound.
Thoracentesis is the insertion of a needle and a small catheter into fluid collections in the chest to remove fluid and look at it under a microscope.
Surgery may be needed to remove the tumour completely if it is small or if other biopsy procedures have not been definitive. The most common surgical procedures are mediastinoscopy, which is used to biopsy the lymph nodes in the centre of the chest; video-assisted thoracoscopic surgery (VATS), a less invasive way to biopsy lung tissue; and thoracotomy, a larger surgery to remove larger parts of lung tissue or tumours."
ADVANCED TESTS IN LUNG CANCER
Prof. Dr. Yıldırım also mentioned the advanced tests used in lung cancer and said, "In addition to looking at the tumour with a microscope, some lung cancers can also be tested for abnormal proteins called biomarkers or mutations in their DNA. If present, these biomarkers and genetic mutations can be used to determine the best treatment options."
TYPES OF LUNG CANCER
Stating that there are many different types of lung cancer depending on how they look under the microscope, Prof Dr Yıldırım listed the two main categories used to determine the best treatment approach as follows:
"1. Small cell lung cancer, found in about 10 to 15 per cent of people.
Non-small cell lung cancer (often abbreviated as NSCLC) includes most other types of lung cancer and is found in the remaining 85-90 per cent of people. NSCLC has subcategories, the most common of which are adenocarcinoma, squamous cell carcinoma and large cell carcinoma."
Reminding that the reason why small cell cancer is differentiated from non-small cell cancers is that small cell cancers grow and metastasise differently, Prof. Dr. Yıldırım said, "Small cell and non-small cell cancers have different treatment regimens for surgery, radiation and chemotherapy."
CANCER CARE DURING THE COVID-19 PANDEMIC
Emphasising that COVID-19 is an infection caused by the virus called SARS-CoV-2, Prof. Dr. Yıldırım said. Yıldırım continued as follows:
"People in many regions have been told to stay at home as much as possible to slow the spread of the virus. This is especially important for cancer patients, because most of them have a serious increased risk of disease if they contract COVID-19. However, this risk needs to be balanced against the importance of cancers patients continuing to receive regular medical care to monitor and treat their disease. The oncologist will advise on whether those being treated for cancer need to make any changes to their usual treatment regime or programme. In some cases, reducing the number of appointments that need to be attended in person may be an option. This will depend on a number of different things, including where they live, the type and stage of cancer, the treatment options available and their general health."
Reminding that significant advances have been seen in both the early diagnosis and treatment of lung cancer, Prof. Dr Yıldırım concluded his words as follows:
"Clinical trials are a carefully controlled way of examining the effectiveness of new or new combinations of known treatments. Preventing the disease, especially reducing the use of tobacco products such as smoking, is the best way to fight lung cancer."
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:2024-04-25 10:11:45