Understanding Lung Cancer

Lung cancer is one of the most prevalent and deadly forms of cancer worldwide. It is a complex disease that affects the lungs, impairing their ability to function effectively, and easily spreads to different parts of the body.

An Overview of Lung Cancer

Lung cancer arises when abnormal cells grow uncontrollably in the lungs, resulting in the formation of tumors. These tumors can interfere with breathing, hinder oxygen exchange, and spread to other body parts through the bloodstream or lymphatic system. The two major types of lung cancer are non-small cell lung cancer (NSCLC), and small cell lung cancer (SCLC). NSCLC is the most common, comprising around 85% of all lung cancer cases, while SCLC is less common but more aggressive.

As per the World Health Organization, lung cancer is responsible for the most cancer-related deaths worldwide. In 2020, there were an estimated 2.2 million new cases of lung cancer and 1.8 million deaths, accounting for approximately 11.4% of all cancer cases and 18.0% of cancer-related deaths worldwide.

In the UAE, lung cancer is a significant health concern. With increasing urbanization and lifestyle changes, the incidence of Lung cancer has been rising in recent years. According to the UAE Ministry of Health and Prevention, Lung cancer is the third most common cancer in the country, following breast and colorectal cancer. Previously reported trends suggested that lung cancer cases in the UAE are primarily diagnosed in males, and it is closely linked to smoking.

Risk Factors for Lung Cancer

Although smoking is the leading cause and risk factor of lung cancer, other risk factors also play a role in its development. These include:

• Passive Smoke: Exposure to secondhand smoke can increase the risk of lung cancer in non-smokers.
• Occupational Exposures: Certain jobs, such as those involving being around asbestos, radon, uranium, arsenic, and diesel exhaust, can raise the risk of lung cancer.
• Air Pollution: Prolonged exposure to air pollutants, particularly in urban areas with high pollution levels, may contribute to lung cancer development.
• Family History: People with a family history of lung cancer may have a greater risk of developing the disease.
• Genetic Predisposition: Specific genetic factors can also influence a person's susceptibility to lung cancer.

Symptoms

The symptoms of lung cancer differ depending on the type of cancer, its stage, and the tumor's location within the lungs. In its early stages, lung cancer may not cause noticeable symptoms, making early detection challenging. However, as the disease progresses, the following symptoms may manifest:

• Persistent Cough
• Shortness of Breath
• Chest Pain
• Unexplained Weight Loss
• Coughing up blood
• Wheezing
• Fatigue

It is crucial to remember that these symptoms can also indicate other respiratory conditions or health issues. However, if any of these symptoms persist for weeks or worsen, it’s important to seek medical attention for a thorough evaluation.

Diagnosis of Lung Cancer

When a person presents with symptoms suggestive of lung cancer, a series of diagnostic tests and procedures are undertaken to confirm the diagnosis and determine the stage of the disease.  

• Physical Examination and Medical History: A thorough physical exam is conducted to understand the patient's medical history, including any risk factors and smoking habits.
• Imaging Tests: Chest X-rays are usually the initial imaging test, which may reveal suspicious lung masses, but not accurate enough to detect lung  nodules. If necessary, more detailed imaging tests such as computed tomography (CT) scans or positron emission tomography (PET) CT scans may be executed to assess the extent of the disease and check for any metastasis (spread to other parts of the body).
• Biopsy: To definitively diagnose lung cancer, a tissue sample from the lung tumor is required. This is typically obtained through a biopsy, which can be done using various methods, including bronchoscopy, needle biopsy, or surgical biopsy.
• Molecular Testing: In non-small cell lung cancer or NSCLC cases, molecular testing is often performed on the tumor tissue to identify specific genetic mutations or biomarkers. These mutations help guide targeted therapy options, which may be more effective in certain patients.
• Staging: Once the diagnosis is confirmed, further tests may be conducted to determine the lung cancer stage. Staging helps assess the extent of cancer spread and guides treatment decisions.

A lung cancer diagnosis can be emotionally challenging for the patient and their loved ones. In addition to medical support, psychological and emotional support during the diagnostic process is essential.

Treatment Options

Treatment depends on various factors, including the type of lung cancer, its stage, the overall health of the patient, and the presence of specific genetic mutations. The primary treatment options for lung cancer include:

• Surgery: removal of the tumor and nearby lymph nodes, effective for early-stage lung cancer.
• Radiation Therapy: using high-energy radiation to target and kill cancer cells and can be used alone or with other treatments.
• Chemotherapy: Powerful drugs to kill or inhibit cancer cells, used for both types of lung cancer.
• Targeted Therapy: Focuses on specific genetic mutations, more effective with fewer side effects.
• Immunotherapy: uses the immune system to fight cancer, especially promising for advanced cases.
• Combination Therapy: Utilizes multiple treatments for optimal results.
• Local therapy: such radiofrequency ablation or cryotherapy, and even stereotactic therapy can be used in specific conditions.
• Palliative Care: Relieves symptoms and improves the quality of life for advanced cancer patients.

Patients must discuss their treatment options thoroughly with their healthcare team to understand potential benefits and risks of each approach.

Prevention and Awareness

Preventing lung cancer primarily involves adopting a healthy lifestyle and avoiding exposure to risk factors. This comprises quitting smoking and avoiding secondhand smoke, adopting a balanced diet, maintaining a healthy weight, and engaging in regular physical activity. Raising awareness about early detection and seeking medical attention for persistent respiratory symptoms is also crucial. Regular health check-ups can aid in the timely identification of lung cancer, increasing the chances of successful treatment.