Lung Cancer: Causes, Signs, Prevention and Treatment

Lung cancer is one of the most common cancers for both men and women in Singapore.

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What is Lung Cancer?

Lung cancer, as the name suggests, occurs when the cells lining the airways grow and divide without control, leading to the formation of an abnormal mass or tumour. It is a cancer that can develop over months or years. However, lung cancer symptoms may not appear until much later. There are two major types of lung cancer: small cell lung cancer and non-small cell lung cancer. 

About 85 to 90 percent of lung cancers are non-small cell lung cancers. The major differences between these two types of lung cancer are the size and shape of the cancer cells, recommended forms of lung cancer treatment and the speed at which the cancer spreads. Small cell lung cancer spreads more rapidly.

Until 2015, lung cancer was among the top five leading cancers for both men and women in Singapore, with over 33 percent of men and 15 percent of women affected . 

Who is At Risk of Lung Cancer?

There are a number of risk factors for lung cancer, some of which can be controlled. Smokers are at greater risk of developing lung cancer, with the risk increasing with a greater number of cigarettes smoked in a day, and the more years a person smokes. Breathing second-hand smoke may increase non-smokers’ risk of lung cancer.

Other risk factors include:
Exposure to asbestos, radon gas and certain heavy metals
Family history of lung cancer

What are Some Symptoms and Signs of Lung Cancer?

In its early stages, lung cancer does not usually cause any signs and symptoms. These usually only appear at more advanced lung cancer stages.

Lung cancer symptoms include:
Persistent cough
Shortness of breath
Chest pain
Coughing up blood
Recurring chest infection
Hoarseness
New onset of wheezing
Loss of weight
Loss of appetite

It is recommended to seek medical advice should these symptoms occur.

What Can You Do to Prevent Lung Cancer?

Quit or avoid smoking altogether
Avoid second-hand smoke by distancing yourself from areas where people smoke
Avoid carcinogens, which are potential cancer-causing substances found in certain gases like radon, engine exhaust and polluted air
Consume more fruits and vegetables

How is Lung Cancer Diagnosed?

Imaging tests: a chest X-ray may be conducted to reveal any abnormal mass or nodule. A computed tomography (CT) scan can reveal other lesions in your lungs that may not show up in an X-ray
Lung biopsy: a sample of cells is usually taken to confirm the diagnosis. A biopsy sample may also be drawn from lymph nodes or other areas where the cancer has spread

What are Some Lung Cancer Treatment Options?

At National University Cancer Institute, Singapore (NCIS), patients are managed by a multidisciplinary team of cancer specialists and health professionals. Treatment plans are developed to fit each patient's needs and may include one or a combination of the following treatments:

Surgery

Surgery is the main form of treatment for early-stage lung cancer confined within the lung. Surgeons remove the lobe of the lung where the tumour is located, as well as the surrounding lymph nodes. Minimally invasive “keyhole” surgery is increasingly performed in suitable patients; this tends to result in less pain and faster recovery. 

Other surgical options are also possible, such as pneumonectomy which removes the entire lung, lobectomy which removes a section of the lung, and segmentectomy which removes part of a lobe. In general, lobectomy is the preferred surgical option for non-small cell lung cancer.

Chemotherapy

Cancer cells are killed in a process called chemotherapy, where one or more drugs are administered with an injection through a vein. The drugs are given in a series of treatments over a period of weeks or months, with breaks to allow the body to rest. Chemotherapy may be used as a first-line treatment for more advanced cancer, for selected patients before or after surgery, or combined with radiation therapy.

Targeted Therapies

Targeted therapies are a form of medical treatment involving the use of drugs or other substances. These drugs block or interfere with specific molecules that help cancerous tumours to grow. They are usually used for stage three and four cancer for tumours that are unresponsive to other treatments. 

Commonly used drugs for lung cancer treatment include:
Erlotinib (Tarceva), or gefitinib (Iressa): these drugs, taken daily as an oral pill, block the growth and spread of tumours by targeting a specific protein which causes cancer cells to divide and grow. This protein is found on the surface of lung cancer cells
Bevacizumab (Avastin): new blood vessels are formed by cancers to bring nutrients to the tumour. Avastin is a form of intravenous therapy that inhibits the formation of these new blood vessels. Treatment is administered every two to three weeks

Radiation Therapy

Radiation therapy uses high-energy beams to kill cancer cells. In a procedure called external beam radiation, radiation therapy is directed at the lung cancer from outside the body. 

Other forms of radiation include stereotactic body radiation therapy (SBRT) that is used to treat very early-stage lung cancer when surgery is not recommended. SBRT uses focused beams of high-dose radiation administered over one or a few days. Several beams are directed at the tumour from different angles. 

In another type of radiation, brachytherapy involves placing radioactive material directly into the cancer. As the radiation travels a shorter distance from the source, the effects on surrounding healthy tissues are minimised.

You can also download the brochures below for more information:




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Lung Cancer: Causes, Signs, Prevention and Treatment

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