Overview
Lung cancer is among the most prevalent and deadly forms of cancer. In the UK, approximately 47,000 people are diagnosed with the illness annually. Lung cancer primarily affects the elderly. It is uncommon in those younger than 40. More than four out of ten individuals diagnosed with lung cancer in the UK are 75 or older. Although persons who have never smoked can develop lung cancer, smoking is the leading cause (72% of cases). This is because smoking includes the inhalation of a variety of harmful chemicals. In the early stages of lung cancer, there are typically no signs or symptoms, although many patients later develop the following:
- An ongoing cough
- Spitting up blood
- Chronic shortness of breath
- Inexplicable fatigue and weight loss
- A soreness or discomfort when breathing or coughing
Consult a physician if you exhibit these symptoms.
How can you get lung cancer?
Although smoking is the leading cause of lung cancer, persons who have never smoked can also develop the ailment. Cigarette smoking is the most significant risk factor for lung cancer. It accounts for around 70% of all cases. More than sixty distinct carcinogenic (cancer causing) toxins have been identified in tobacco smoke. If you smoke more than 25 cigarettes per day, your risk of developing lung cancer is 25-times that of a nonsmoker. While cigarette smoking is the most significant risk factor, the use of other tobacco products can increase your risk of developing lung cancer and other types of cancer, including esophageal cancer and mouth cancer. These items include:
- Cigars
- Pipe tobacco
- Snuff (a powdered form of tobacco)
- Tobacco gum
Cannabis use is also associated with an increased risk of lung cancer. The majority of cannabis smokers also consume tobacco. While they tend to smoke less tobacco than conventional cigarette smokers, they typically inhale more deeply and retain the smoke for longer. It has been estimated that smoking four joints (manufactured cigarettes with a mixture of tobacco and cannabis) is equivalent to smoking twenty cigarettes. Even if cannabis is smoked without tobacco, it is still potentially hazardous. This is due to the fact that cannabis contains cancer-causing chemicals. Frequent exposure to the tobacco smoke of others (passive smoking) can raise the chance of getting lung cancer in nonsmokers.
Radon is a naturally occurring radioactive gas produced by the trace amounts of uranium found in all rocks and soils. It is occasionally seen in buildings. If radon is inhaled, it can cause lung damage, particularly in smokers. In England, radon causes a tiny proportion of lung cancer deaths.
Certain chemicals and compounds used in a variety of industries and vocations may raise the chance of acquiring lung cancer. These compounds and chemicals include:
- Arsenic
- Asbestos
- Beryllium
- Cadmium
- Coal and coke emissions
- Silica
- Nickel
Furthermore, research indicates that long-term exposure to diesel exhaust raises the risk of getting lung cancer. According to a recent study, the risk of acquiring lung cancer increases by almost 33%if you reside in a region with high levels of nitrogen oxide emissions (mostly produced by cars and other vehicles).1
Cough in lung cancer
Any sort of lung cancer is correlated with coughing. However, coughing is a common symptom of certain types of lung cancer because the malignant cells in the lungs restrict the airways. Small cell undifferentiated lung cancer and squamous cell carcinoma are more likely to be accompanied with coughing. Certain traits may be more strongly linked to lung cancer than others when determining the origin of your cough; consisting of:
- A persistent cough (usually lasting more than 8 consecutive weeks)
- A cough which may be dry or productive (it produces mucus)
- A cough that prevents one from sleeping
- Spitting up blood (hemoptysis)
- Combined chest discomfort and coughing
- Insufficiency of breath
- Lung problems such as recurrent bronchitis or pneumonia
Not all patients with early lung cancer cough. The Lung Cancer Alliance reports that approximately fifty percent of persons with early-stage lung cancer have a cough, before the cancer cells have migrated to other organs.2 A 2017 study found that approximately 57% of lung cancer patients have a cough.3 In advanced lung cancer, the proportion is higher. Several studies suggest a relationship between lung cancer coughs and gastrointestinal disorders, while additional research is required.4
Is it lung cancer or is it a regular cough?
There is no straightforward method for determining if a cough is due to lung cancer. Your cough could be harmless or it could be a symptom of a variety of underlying disorders. To diagnose and treat coughs, doctors follow professional guidelines5 and will enquireabout medical and smoking histories. They will inquire about symptoms such as fever, chills, exhaustion, shortness of breath, hoarseness, chest pain, and weight loss. They will also want to know when your cough began, whether it is worse at night, and whether it worsened or developed new symptoms. If the doctor suspects lung cancer, they will request screening and other diagnostic testing to confirm a diagnosis. A 2005 study6 examined the symptoms of British lung cancer patients at the time of their diagnosis. In addition to cigarette smoking, they identified a number of frequent symptoms6 related with lung cancer at the time of diagnosis:
- Hemoptysis
- Losing weight
- Decreased hunger
- Breathing difficulty (dyspnea)
- Chest pain
- Cough
- Fatigue
In addition to smoking, the strongest relationships6 with lung cancer were:
- Sputtering blood
- Breathing difficulty
- Respiratory irregularities
What are the sign and symptoms of lung cancer
Typically, there are no indications or symptoms in the earliest stages. Lung cancer symptoms emerge as the disease advances. The principal lung cancer symptoms are:
- A cough that persists for two to three weeks
- A persistent cough that is getting worse
- Chest infections that recur repeatedly
- Spitting up blood
- A soreness or discomfort when breathing or coughing
- Chronic shortness of breath
- Chronic fatigue or lack of vitality
- Appetite loss or unexplained weight loss
Less frequent lung cancer symptoms:
- Alterations to the appearance of your fingers, such as their becoming more curled or their tips growing larger (finger clubbing)
- Having trouble swallowing (dysphagia) or experiencing pain during swallowing
- Wheezing
- A raspy voice
- Enlargement of the face or neck
- Chronic ache in the chest or shoulders
When to see a doctor
See a physician if you have any of these signs of lung illness, especially a persistent cough, blood-streaked mucus, wheezing, hoarseness, or a recurring lung infection. Patients will have a comprehensive examination, which may include X-rays or other diagnostics. Go to the emergency department immediately if having any of the following:
- Coughing up a significant quantity of blood
- Suddenly shortened breath
- Sudden weakness
- Sudden vision problems
- Persistent chest discomfort
Complications
It is crucial to understand the potential outcomes of lung tumour development and treatment. Nonetheless, the following health issues do not occur in every patient, even those in identical circumstances:
- Cancer can grow in regions that obstruct airways and restrict channels, leading to breathing difficulties. This is defined as dyspnea
- Lung tumours account for about a quarter of hemoptysis cases in the US. The condition of spitting or coughing up blood from the lungs or bronchial tubes is sometimes referred to as hemoptysis. Less than 10% of hemoptysis cases are deemed to be severe
- Horner's syndrome can arise when malignancies migrate to the nerves in the neck or face. This syndrome is characterised by drooping eyelids, contracted pupils, and a lack of perspiration on one side of the face
- Approximately 15% of cancer patients develop elevated calcium (hypercalcemia) levels in their blood. The term for this is hypercalcemia. Some patients are asymptomatic, while others suffer symptoms such as nausea, loss of appetite, exhaustion, and depression
- Occasionally, the condition can become so widespread that the body begins to retain water. Hyponatremia can develop if this occurs and sodium levels fall too low. This syndrome may manifest as disorientation, exhaustion, and, infrequently, convulsions
- When lung tumours arise, they infiltrate the space between the lung and chest wall (the pleural region) and suffocate it. When this occurs, extra fluid can fill the area, resulting in a condition known as pleural effusion. Pleural effusion can result in chest pain and shortness of breath. Your doctor can undertake procedures to drain the fluid and prevent it from accumulating again
- Pancoast's Syndrome can arise when tumours affect the nerves that travel from the neck to the shoulder/arms (brachial plexus). This illness may manifest as arm or hand numbness, weakness, or pain
- Spinal Cord Compression (SCC): Spinal cord compression can develop when tumours exert excessive pressure on the spinal cord. If you begin to develop numbness in your fingers and toes, difficulty walking, or incontinence, you should go to the hospital immediately
- Superior Vena Cava Syndrome (SCVS): When the disease has become too widespread, tumours can press against the vein, resulting in SCVS. This problem occurs in less than 3.8% of lung cancer patients. However, you should consult a doctor immediately if you experience facial or upper-body edoema, as this is a medical emergency. Additional symptoms include a persistent cough and shortness of breath
- Venous Thromboembolism (VTE): When lung cancer tumours occupy space and overcrowd particular regions of the body, they might cause those areas to malfunction. This can cause additional health problems, such as vein obstruction and blood clots (venous thromboembolism). Deep vein thrombosis (DVT) occurs when the blood clot travels to a deeper vein, such as the leg. When the clot breaks off and travels to the lungs, commonly known as a pulmonary embolism, this is the second type of VTE. Your physician can prescribe anticoagulants to dissolve blood clots before they become a problem
Occasionally, therapies may create complications or side effects in a patient, although every patient's body reacts differently. Length of treatment, dosage, disease stage, and general health (including medical history) all play a role in a patient's response to the numerous therapies and treatments a doctor may prescribe. Some potential consequences of lung cancer treatment include:
- Chemotherapy can occasionally result in pulmonary damage. This condition is characterised by cough, fever, difficult respiration, and hypoxemia (low oxygen in the blood).
- Lymphedema is sometimes treated with surgical lymph node excision or radiation therapy. This treatment may cause uncomfortable swelling due to lymphatic fluid accumulation caused by poor circulation (lymphedema)
- Chemotherapy can sometimes produce peripheral neuropathy, which is a tingling or numbing sensation in the hands and feet. If the tumours progress sufficiently to cause nerve injury, this might potentially result in neuropathy
- Chemotherapy and radiation cannot discriminate between healthy and cancerous cells in the presence of neutropenia. When this occurs, white blood cells and cancer cells are eliminated, resulting in neutropenia or an increased risk of infection since white blood cells combat infection. Antibiotics can be prescribed by physicians to fight this condition
- Radiation can occasionally induce upper respiratory lung infections, including pneumonia. Inflammation of one or both lungs can lead to pneumonia. This problem occurs primarily when the lung's air sacs (alveoli) fill with fluid or pus. This results in flu-like symptoms that can linger for weeks, including a severe cough, fever, and weakness
Contact your physician promptly if you develop lung cancer problems due to illness or treatment. They will be able to provide recommendations and prescribe pain and discomfort-alleviating drugs.
Prevention
If you smoke, quitting immediately is the greatest approach to prevent lung cancer and other dangerous illnesses. No matter how long you have smoked, it is always beneficial to quit. Each year you abstain from smoking reduces your risk of developing serious diseases, such as lung cancer. After 10 years of abstinence from smoking, your risk of acquiring lung cancer is half that of a smoker. A physician or pharmacist can also offer guidance on quitting smoking.
According to research, consuming a low-fat, high-fibre diet that includes at least five daily servings of fresh fruits and vegetables and an abundance of whole grains can reduce the risk of lung cancer, as well as other cancers and heart disease.
There is substantial evidence that regular exercise can reduce the risk of lung cancer and other types of cancer. It is advised that most individuals engage in at least 150 minutes of moderate-intensity aerobic activity and at least two days of strength-training exercises per week.
Summary
Lung cancer typically does not create apparent symptoms until it has progressed throughout the lungs or to other organs. This indicates that the prognosis for this condition is less favourable than for many other types of cancer. About one-third of those diagnosed with the illness survive at least one year, and one-fifth survive at least 10 years. However, survival rates vary significantly based on the cancer's stage at the time of diagnosis. Early detection can make a significant difference.
References
- Hamra GB, Laden F, Cohen AJ, Raaschou-Nielsen O, Brauer M, Loomis D. Lung Cancer and Exposure to Nitrogen Dioxide and Traffic: A Systematic Review and Meta-Analysis. Environmental Health Perspectives [Internet]. 2015 Nov;123(11):1107–12. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629738/
- lca. Symptoms of Lung Cancer [Internet]. GO2 Foundation for Lung Cancer. Available from: https://go2foundation.org/what-is-lung-cancer/symptoms/
- Molassiotis A, Smith JA, Mazzone P, Blackhall F, Irwin RS, Adams TM, et al. Symptomatic Treatment of Cough Among Adult Patients With Lung Cancer. Chest. 2017 Apr;151(4):861–74.
- Harle A, Blackhall F, Molassiotis A, Yourke J, Dockry R, Holt K, et al. Cough in Patients With Lung Cancer: A Longitudinal Observational Study of Characterization and Clinical Associations. Chest [Internet]. 2019 Jan 1;155(1):103–13. Available from: https://www.sciencedirect.com/science/article/pii/S0012369218325741?casa_token=09_wrqK8YB4AAAAA:yQtOWQnxmp4orQe_5epyWcj7l6_jwqfZuEiiFJHa8E2rTjTpWZviLdL68snj40LlXZy5tqw
- Irwin RS, French CL, Chang AB, Altman KW, Adams TM, Altman KW, et al. Classification of Cough as a Symptom in Adults and Management Algorithms. Chest [Internet]. 2018 Jan;153(1):196–209. Available from: https://journal.chestnet.org/article/S0012-3692(17)32918-5/pdf
- Hamilton W, Peters T, Round A, Sharp D. What are the clinical features of lung cancer before the diagnosis is made? A population based case-control study. Thorax. 2005 Dec 1;60(12):1059–65.