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Adrian Harrison - Respiratory Physician

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Lung Cancer

Cancers are composed of abnormal malignant cells - cells which divide and grow in an uncontrolled fashion. Cancers in the lung can either be primary (i.e. lung cancer) or secondary cancers. Primary lung cancers develop from tissues found in the lung. Secondary cancers spread to the lung from other primary sites, such as breast or bowel.  
 
The effects of cancers depend on their size and their type. There are several types of lung cancer - some progress more slowly than others. Cancers in the lung destroy normal lung tissue and they can block off breathing tubes. 
 
The most common cause of all types of lung cancer is cigarette smoke. Other causes include exposure to asbestos, marijuana smoke and high doses of radio-activity. There are a number of chemicals that carry an increased risk of cancer. Sometimes people with lung cancer do not have a history of exposure to a known cause. Genetic risk factors are under investigation.
 
Common signs and symptoms
  • Cough that gets worse with time
  • Coughing up blood (haemoptysis)
  • Chest pain
  • Weight loss and tiredness
  • Increasing breathlessness
  • Sometimes the picture is one of repeated chest infections, often with pneumonia.

 

Diagnosis
Sometimes the combination of symptoms, signs and the chest X-ray make lung cancer very likely. However, tests are always necessary to make a definite diagnosis, and to determine the extent (or stage) of the problem.

 
Tests likely to be needed include:
·        Blood tests and a chest X-ray.
·        CT scans with or without fine needle aspirate (see below)
·        Bronchoscopy (see below).
 
Treatment
Only when the type and extent of the lung cancer is known can a treatment plan be developed. I can advise you about the options available, but the final plan also requires input from the person with the cancer and their close supporters. 
 
Treatment options include:
  • Surgery will only be an option if tests strongly suggest that all tumour can be removed, and lung function tests show that surgery is safe. Surgery is the only form of treatment that holds the possibility of cure from lung cancer. Unfortunately, small cell lung cancer is inoperable in 99% of cases.
  • Radiotherapy is a form of high energy X-ray radiation that kills cancer cells. It shrinks the size of the cancer, but does not cure it. Currently, radiotherapy is not usually offered when lung cancer is not causing symptoms. Often it is better to save this form of treatment until it is needed.
  • Chemotherapy involves treatment with medicines that kill cancer cells. Most (but not all) also suppress the body's immune system to varying degrees while the treatment is being taken. Chemotherapy research is ongoing. Experts called Oncologists ultimately decide when and if chemotherapy is appropriate, and the timing of treatment. They will also advise on the expected results.  
 
The aim of treatment is to keep the person as well as possible even if the cancer cannot be cured. I can advise when it's time to get help from the Cancer Society or a Hospice. Expect there to be regular follow up after the diagnosis and initial treatment have been completed.
 
For more information about lung cancer see www.cancernz.org.nz

This page was last updated at 6:46PM on September 3, 2019.