Human body is made up of many types of cells. During our normal course or aging, cells grow, divide, and produce more cells to keep the body healthy. However, at times, this process may not happen properly and may result in to cells becoming abnormal, forming more cells, in an uncontrolled manner.
These extra cells form a mass of tissue, called a growth or a ‘tumour’. Tumours can be benign, which means non cancerous, or malignant, which means cancerous. Lung cancer occurs when a malignant tumour forms in the tissue of the lung.
WHAT IS CANCER OF THE LARYNX?
The larynx is often called the “voice box” of living being”. The larynx and vocal cords sit above the wind pipe and are the entrance to the lungs. The larynx makes sound for speaking and protects the airway during swallowing. The vocal cords change the sound and pitch of the voice. They close tightly when a person swallows and open to allow breathing. The hypopharynx surrounds the larynx. It is a part of the oesophagus or food pipe. Food enters the oesophagus, as it passes through the neck and chest into the stomach. Several types of cancer may occur in these two areas. Almost all of these cancers start from the thin, flat cells (squamous cells) that line the larynx and hypopharynx. Squamous cell cancer does not form suddenly. It starts when the cells begin to change. The cells become pre-cancerous. Most pre-cancerous cells will not become cancers. If the causes (like smoking) stop, these pre-cancerous cells usually go away.
WHAT CAUSES LUNG CANCER?
Smoking is the leading cause of lung cancer. Apart from smoking, other risk factors are exposure to environmental pollution, exposure to chemicals like asbestos and gases like Radon. 80% of lung cancer can be attributed to smoking. The longer you have been smoking, greater the risk. But quitting smoking anytime considerably reduces the risk of getting lung cancer. Even after the diagnosis of lung cancer, quitting smoking will certainly improve general health and the chances of success of the current treatment. Passive smokers are also at an increased risk of getting lung cancer
SOME OF THE COMMON SYMPTOMS ARE:
Chronic cough
Chest pain
Hoarseness of voice
Weight loss
Loss of appetite
Bloody or rust-colored sputum (spit or phlegm)
Shortness of breath and fever without a known reason
In case the cancer has spread beyond lungs, the symptoms could be varied like:
Bone pain
Weakness
Numbness of the arms or legs
Dizziness
Yellow coloring of the skin and eyes (jaundice)
DIAGNOSIS AND MANAGEMENT
In order to diagnose the lung cancer a detailed medical history combined with a series of tests and physical examination is done by the surgical oncologist.
DIAGNOSIS:
Battery of tests which include imaging studies, blood tests to find out the cause of symptoms and confirm the disease and also to know the stage of the disease.
Chest X-ray : Once a malignant tumour begins to cause symptoms, it is usually visible on an X-ray. However an X-ray is not effective in detecting small tumours. Therefore some other tests would be required even if the X-ray picture appears normal.
Sputum cytology: This is an initial test to arrive at a diagnosis. A sample of phlegm (mucus you cough up from your lungs) is evaluated for cancer cells. The absence of cancer cells. However, does not rule out lung cancer, if cancer cells are detected, further tests will be done to confirm the diagnosis.
Fine needle biopsy : This test confirms the presence of lung cancer. Under this procedure, a biopsy is done to confirm the diagnosis. A bronchoscopy (described below) is done to get a sample of tissue from the cancer site and also the adjoining lymph nodes. This tissue sample is examined by the pathologist for cancer cells.
Bronchoscopy : This is done to detect cancers in all pathways. Within the lungs. A lighted, flexible tube called a bronchoscope is passed through your mouth / nose into your wind pipe and finally into your lungs. This enables your doctor to visualize all pathways and detect any cancerous areas. During this, test samples are also taken for examination by the pathologist at a later date. Your doctor gives you some sedatives and local anaesthesia to ensure that your remain relaxed and comfortable during the procedure.
Blood tests: Complete blood count (CBC) and blood chemistry is done. A CBC determines whether your blood has the correct number of various cell types. Blood Chemistry tests may help in detecting the spread of cancer to your liver and the bones.
Other tests which might be used under special circumstances are:
Mediastinoscopy
Thoracentesis
Thoracoscopy
Certain imaging tests that might confirm the diagnosis as well as determine the extent of spread are: Computed Tomography (CT): It is a very sensitive test that can detect cancer at an early stage. This test ascertains the exact size, shape, and position of the tumour, along with enlarged lymph nodes. Magnetic Resonance Imaging (MRI): Your doctor will recommend this test, if he suspects that the cancer has spread to your brain or spinal cord. PET scan: This test may detect a lung cancer at an early stage. It also helps in determining the extent of the spread of lung cancer. Radionuclide Bone Scan: This test helps in detecting the spread of cancer to the bones.
These treatments will be prescribed either on their own or in a combination, depending on the stage of the cancer. Surgery
Depending on the type and stage of the cancer, surgery may be suggested by your doctor to remove the tumour and some of the lung tissue around it. He might remove either a lobe or sometimes even the entire lung, depending on the spread and severity of the cancer. However, after this surgery, you will be able to return to your normal activities, provided you do not have a pre-existing disease in the lung like emphysema or chronic bronchitis.
Laser surgery may also be administered if you have other medical problems or if the cancer is widespread. Chemotherapy
In Chemotherapy, certain drugs will be used to destroy the cancer cells. These drugs will be administered either through a vein, or orally. Usually a combination of drugs is given. Radiation Therapy
Radiation Therapy will kill or shrink the cancer cells by using high-energy rays (such as X-rays). The source of radiation is usually external.
External beam radiation therapy will be usually given in daily doses, 5 days a week, for a period of 4 to 6 weeks.
Combination Therapy
You might be prescribed a combination therapy. In this therapy, you will be administered a combination of surgery with either chemotherapy of radiation therapy, or both. Chemotherapy and radiation therapy are administered either before the surgery to shrink the tumour so that it can be surgically removed or after the surgery to target residual tumour