Lung cancer

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What is it about ?

The term ‘lung cancer’ is used to refer to different types of lung cancer. The main types are “small cell lung cancer” (20-25% of lung cancers) and “non-small cell lung cancer” (75-80% of lung cancers).

Tobacco is the most important risk factor for the development of lung cancer: 8 to 9 in 10 lung cancers are caused by smoking. About 1 in 10 lung cancer is caused by asbestos.

Other elements such as exposure to arsenic, chromium or nickel (often in the context of certain professional activities) or even radiation are also risk factors for lung cancer. Genetic predisposition also plays a role: 10 to 15% of lung cancer cases occur in people who have never smoked.

Where and how often?

Among all cancers diagnosed, lung cancer is second in men and third in women. As long as there are smokers, scientists expect lung cancer to remain one of the most common cancers.

How to recognize it?

If you smoke and are over 40, you are more at risk of developing lung cancer.
The main signs that can indicate lung cancer are:

  • cough or change in cough
  • coughing up blood or streaks of blood,
  • pain (in the chest area but not necessarily),
  • shortness of breath
  • lack of appetite and weight loss,
  • swelling of the lymph nodes in the neck or armpit area (usually hard, painless lumps).

How is the diagnosis made?

Sometimes it is the person’s symptoms that will cause the doctor to order certain tests and make the diagnosis. But the disease can also be discovered by chance during an X-ray examination.

In any case, and especially if you are (a former) smoker and are over 40 years old, the doctor will order an urgent x-ray of the lungs if you cough up blood (or streaks of blood) or if you have the one of the following signs for more than 3 weeks:

  • cough,
  • pain in the chest or shoulders,
  • shortness of breath
  • feeling of tightness in the chest,
  • hoarseness,
  • hard swelling in the neck or back of the neck,
  • weightloss
  • fingers in “drum stick” (the fingertips are widened).

The first (and most important) exam is an x-ray of the lungs. But in some cases, a normal x-ray of the lungs does not give enough certainty. This is why the doctor may possibly suggest carrying out additional examinations. This is the case, for example, when he suspects lung cancer (in smokers with severe symptoms or suspicious signs).

These additional examinations can be a CT-scan, a PET-scan or a bronchoscopy:

  • the CT scan allows you to get a cross section of the chest and to see the lungs better than with a normal x-ray of the lungs. A (contrast) product is often injected into the person to obtain even better quality images.
  • the PET-scan is sometimes used in addition to obtain an image of the areas which present a suspicious lesion. For this scan, the patient is injected with a radioactive substance in order to obtain the images.
  • a bronchoscopy is an exam where a small camera is inserted into the airways through a small tube and allows you to see the area precisely. During this examination, a small piece of tissue may need to be removed from the lung to be analyzed under a microscope (biopsy).

What can you do ?

If you smoke, we can only advise you tostop smoking. If you are not an active smoker, avoid inhaling cigarette smoke as much as possible. Passive smoking is another risk factor for developing lung cancer.

Protect yourself from exposure to asbestos and other substances like arsenic, chromium or nickel.

See the doctor if you notice (especially if you smoke) that you are losing weight, generally feeling tired, sick or weak, coughing up blood, or regularly suffering from pneumonia. Early diagnosis of lung cancer is extremely important to increase the chances of successful treatment, and therefore survival.

What can your doctor do?

If you have been diagnosed with lung cancer, the choice of treatment depends on several factors, such as the type of cancer, the extent of the cancer (is it limited to the lung or has the cancer ever settled in the glands or other organs?) and the patient’s state of health. Depending on all these parameters, a decision may be made to surgically remove the lung cancer, to start chemotherapy or radiation therapy (radiation treatment). Sometimes a combination of these treatments is also offered.

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