Early Diagnosis Of Lung Cancer

EBUS device yields hopeful results for early diagnosis of the lung cancer.

EBUS device yields hopeful results for early diagnosis of the lung cancer.

Lung cancer is the most prevalent type of cancer among men and fifth most prevalent type of cancer among women at our country while it is the leading cause of cancer death worldwide. Screening programs and modern diagnostic methods are crucial for early diagnosis and treatment of the insidiously progressing disease. Endobronchial ultrasound, called EBUS, is used for diagnosis and treatment of many lung diseases, especially including the lung cancer. Prof. İsmail Savaş, M.D., from Chest Diseases Department of Güven Hospital informs about lung cancer and EBUS.

Prevalence of lung cancer is increasing among women

Lung cancer is a type of cancer characterized with abnormal cell growth in lung tissue and bronchi. It usually originates from bronchial system – the upper respiratory tract that lies below the level of the vocal cords – or the lung tissue that occupies the rib cage. The disease develops secondary to habits. Since smoking is more common in men, lung cancer is more prevalent in men than women. Consequently, smoking is the most important triggering factor for the lung cancer. Moreover, environmental factors, such as air pollution and radiation, and genetic factors are effective in development of the lung cancer. People with family history of cancer are under higher risk of lung cancer when exposed to environmental factors including but not limited to air pollution and radiation. Recently, genetic factors are accused of the increasing prevalence of the lung cancer among women.

Be vigilant if the characteristics of your cough have changed!

Lung cancer progresses insidiously. The disease usually reaches an advanced stage when the initial symptoms are manifested. Primary symptoms are; cough, expectoration, chest pain, shortness of breath (dyspnea), fatigue and tiredness. Since coughing is a chronic condition for smokers, this symptom is usually ignored. At this stage, a small change in characteristics of cough can be an alarming sign for the lung cancer. Hemoptysis (coughing up blood) is the most distinguishing symptom of the disease. Therefore, smokers with any change in characteristics of coughing and hemoptysis should immediately visit a doctor.

High-risk groups should be tracked with screening programs

Initial diagnostic steps include physical examination and detailed history of the patient. Then, examination methods, such as roentgenogram, Chest PA X-ray, computerized tomography and more detailed screening techniques, are employed for some patients. There are several risk groups regarding the lung cancer. For example; smoker men over 50 years of age with family history of lung cancer are in this group. Annual screening programs may play a critical role in diagnosis of lung cancer at early stage. In screening programs, computerized tomography is scanned at an early stage and chance of early management is obtained if a nodule or an abnormal structure is visualized. For patients who are not in risk groups regarding the lung cancer but present to physicians with signs that are suggestive of this disease; computerized tomography is scanned when a nodule is identified on chest X-ray. Next, diagnosis is made through an examination method, called bronchoscopy, where a device with a light source is inserted into bronchi and specimens are obtained if there is a visible mass lesion.

EBUS reaches all locations of the chest cavity that are deemed inaccessible

Lung cancer may spread into chest cavity followed by whole body through lymphatic circulation, also called white circulation, located behind the bronchi. Lymph glands should be biopsied not only for diagnosing the condition, but also for identifying the stage. The tumors that reside in posterior part of lungs may be overlooked when brochi are accessed with bronchoscope, which is an endoscopy device that has an ordinary light source. Interior surface of the bronchi can be simultaneously imaged with EBUS devices by connecting an ultrasound probe over the tip of bronchoscopy devices if the targeted location of the chest cavity is deemed inaccessible or somewhere that can be reached surgically. EBUS helps early diagnosis of many lung diseases, especially the lung cancer, and it also increases success rate of treatment.

Road map of the treatment is drawn in the light of EBUS data

When lung cancer is identified, the first step is to assess if the patient may receive benefit from the surgery. Tumor should not have spread too much for the surgery to be performed. At this point, biopsy results (of specimens obtained with EBUS) and PET/CT data dictate the route to be followed. Surgery is decided if the disease is at an early stage, as verified by these results, or alternative treatments are planned in case of an advanced-stage disease.

Treatment methods are tailored for each patient

The most effective treatment modality is surgery for the lung cancer. Most patients also have chronic diseases such as heart failure, diabetes and renal failure due to their advanced age. Even if the tumor is small, patients with advanced age who have additional diseases fall in the high-risk group regarding the surgical treatment. Positive results may be obtained in such cases for certain treatment modalities, such as local radiotherapy. Other than the surgical management, medical treatment, chemotherapy and radiotherapy methods can be combined or used alone. Moreover, supportive treatment methods are employed in some cases.

The first condition to avoid lung cancer is a tobacco-free life

It is necessary to modify lifestyle for prevention of lung cancer that is among the most common reasons of death worldwide. The precautions against lung cancer are listed below:

• Smoking and tobacco products are the most remarkable etiological factors for lung cancer. Smoking should be quit and tobacco products should not be used, but it is also necessary to avoid areas where these products are allowed.

• Mediterranean-type healthy eating habits should be gained and foods rich in fat, salt and sugar that are produced for fast consumption should be avoided.

• Sedentary lifestyle should be given up and age- and person-specific exercises should be done regularly.

• Precautions should be taken to decrease air pollution in the cities.