Staging of the lung cancer

Chemotherapy is a chemical treatment where anti cancer drugs are used to protect further cancer invasion or reduce existing issues due to cancer. In lung cancer treatment chemotherapy could be used to

· Shrink down the size of the tumor before surgery

· To completely eliminate the left out cancer cells post surgery

· In cases where the cancer is advanced and spread across the lungs chemotherapy is used to prolong the patient’s life by checking further spread of the disease.

Generally Small Cell Lung Cancers respond very positive to chemotherapy, whereas in Non Small Cell Lung Cancer the chemotherapy is used in stage 4 cases.

Chemotherapy could be administered orally or intravenously through the veins. Chemotherapy drugs could be a single chemical or a composition of chemicals which is decided based on the patient’s health condition and their ability to withstand the side effects.

The common drugs used in lung cancer chemotherapy are paraplatin, platinol, docetaxel, doxorubicin, VePesid, gemcitabine, taxol and topotecan. There are still many other drugs used in the procedure. The type of drugs and the combination and the regimen is decided by the doctor taking into consideration various factors.  It’s advisable to go to the clinic to get the chemotherapy.

Surgical procedure is the much sought after in most cases of lung cancer. Unless and until the stage is Non Small Cell Lung Cancer Stage 3B or Stage 4, surgery is possible. The surgical procedure could be varied depending upon the location and severity of the tumor and the patient’s fitness.

Ø In case of a small tumor and the patient’s lungs are affected then a wedge shaped portion of the lungs is removed.

Ø In case the patient could be able to survive without a lung then the oncologists prefer lobectomy.

Ø Pneumonectomy is removal of the entire lung where the cancer is very severe. Such procedures are recommended only for patients with completely healthy lung functioning.

Every patient before taking up the surgical procedures should take tests which are called Pulmonary Function Tests which evaluate the health of the lungs and whether the patient could withstand a surgery.

Small Cell Lung Cancers are very rarely treated with surgical procedures. SCLC s where the tumor is very small a chemo or radiation would suffice. Surgery might be used in early stage SCLC when the lesions begin, but even that is very rare.

Staging of the lung cancer is one of the crucial phases in the disease treatment cycle. The lung cancer could be basically categorized as Small Cell Lung Cancer (SCLC) or Non Small Cell lung Cancer (NSCLC). The staging involves surgery as well. The staging is done partially before surgery based on the location of the cancer, its size and how far it has spread to other parts. In the surgery the lymph is totally cleared and the pathologist could have a clear picture of the cancer. Mediastinoscopy is a widely used procedure to examine the tissues near the trachea.

Small Cell Lung Cancer could be in a

Ø Limited stage: the infection is on one side of the chest and radiation could be of some use.

Ø Extended Stage: The infection is present on both the lungs and the prognosis is generally negative.

Non Small Cell Lung Cancer could follow into the following groups

Ø Stage 1A: Not in the bronchus and not affected the lymph nodes.

Ø Stage 1B: Not in trachea and not spread to lymph nodes or invaded the lungs.

Ø Stage 2A: Not in bronchus but has affected the lymph node.

Ø Stage 2B: Not in trachea and has spread to the lymph nodes.

Ø Stage 3A: The tumor is spread but has not invaded the vital organs.

Ø Stage 3B: Tumor has spread to the vital organs and even to the fluid around the lungs.

Ø Stage 4: The tumor has spread to other organs outside the lungs.

The first step in cancer diagnosis is a normal chest x ray. The chest x ray is generally not very suggestive of the tumor severity and size if any. In case of any abnormalities are observed then the next step is a CT scan. CT scan is basically a three dimensional scan of the lungs which will give a clear picture of the case. The next recommended step is sputum cytology in which the oncologist tests a sample of the phlegm or fluid in the lungs for trace of cancer cells.

The results of the chest x ray, CT scan and cytology after multiple reviews if in case tend to be positive for lung cancer then the biopsy is conducted. Biopsy is nothing but examination of the tissues extracted from the lungs. The advantage of biopsy is that the pathologist is able to test a sample of the tissue directly under the microscope.  The biopsy might be fiber optic where a tube is inserted via the mouth or nose down till the lungs so that a pinch of the affected area could be taken for examination. Another method would be a needle biopsy where a needle is inserted through the skin into the tumor cells.

There are actually no defined symptoms for lung cancer. There are some indications for lung cancer, but these are very generic and could be mistaken for any other general respiratory sickness. As the tumor develops the following symptoms might be observed.

Ø Persistent cough

Ø Pain in the chest area occurs in most cases. This could be very mild but might persist for a longer time.

Ø Short breaths could occur due to the accumulation of the fluid from the tumor in and around the ducts.

Ø Blood in the phlegm and also hemoptysis (blood discharge when coughing)

Ø Breathing difficulties like wheezing might be caused. When the tumor becomes large in size then there might be a blockage in the lungs due to the congestion.

Ø Symptoms like pneumonia might occur repetitively.

Ø Rapid weight loss, Dizziness, Loss of appetite, Tiredness, Joint pain, Numbness in limbs are the other common symptoms.

Definitely these are very generic symptoms. But a patient analysis of the symptoms and the patient’s health a doctor should be able to recommend for a lung cancer screening.  When there is a combination of chronic cough and long term smoking then there is a high chance of lung cancer and its better to take the diagnostic tests.