If you have been diagnosed with lung cancer, you may wish to ask your physician these four additional questions:
1. What diagnostic tests am I to go through besides the MRI that I have taken?
Doctors can run a combination of diagnostic tests to confirm the size, location, malignancy, and spread of the lung tumor. The common diagnostic tests are:
• A run through the medical history records followed by a physical examination
• A chest radiograph (chest X-ray) to reveal the spread, collapse of lung or consolidation of cancerous mass.
• CAT scans (Computerised Axial Tomography) may be performed on the chest, abdomen, and/or brain to examine for both metastatic and lung tumors. This is a high resolution imaging procedure showing organs from different angles to a certain depth.
• Spiral CAT scan to help identify small lung cancers in smokers and former smokers.
• MRI (Magnetic resonance Imaging) is a non-radiation imaging procedure used to see contrasts and minute details that help decide the aging of the cancerous tumors.
• PET (Positron Emission Tomography) scanning. It helps determine whether a tumor tissue is actively growing and determines the type of cells within a tumor.
• Some other tests can be ordered after a confirmatory diagnosis has been made for lung cancer. They are:
o Bone scan helps determine if the lung cancer has metastasized to the bone.
o Sputum cytology shows the presence or absence of the malignant cancer cells in the sputum of the patient.
o Thoracentesis helps removes the pleural fluid from the chest for further testing to detect cancer cells.
o Thoracotomy may be performed to remove lymph nodes and other tissues in question.
o Bronchoscopy is done with a thin fiber optic probe to obtain samples of the tumor for further tests such as biopsy. It is also used to visualize the tumor.
o Fine Needle Aspiration or Needle Biopsy is done in cases where the tumor is located at the peripheries of the lung and not accessible by the bronchoscope.
o Blood tests help detect biochemical and metabolic changes in the body that accompany cancer development.
o Mediastinoscopy is done to remove lymph nodes and other tissues in question. By making an incision at the top of the breast bone.
2. What are my treatment options?
The treatment path will depend squarely on your medical history as well as factors such as symptoms, size of the tumor, malignancy, stage, whether non-small cell lung cancer or otherwise and metastases to multiple lymph nodes etc. However, some popular treatment options which are used in combination are:*
• For Non-Small Cell Lung Cancers (NSCLC) the options are:
o Stage 1 – Surgery and/or Chemotherapy
o Stage 2 – Surgery, Chemotherapy and Radiation
o Stage 3A – Combined Chemotherapy and Radiation
o Stage 3 B – Chemotherapy and Radiation if necessary
o Stage 4 - Chemotherapy, Targeted Drug Therapy, Clinical Trials, Supportive Care
• For Small Cell Lung Carcinomas (SCLC) the paths are:
o Limited – Combined Chemotherapy and Radiation, Surgery if necessary
o Extensive – Chemotherapy, clinical trials and Supportive Care
Surgery options include – Thoracotomy, Mediastinoscopy, Wedge (removal a section of a lobe of the lung) or Segmental resection, Lobectomy (removing a lobe of the lung) or Pneumonectomy (removal of one lung).
Radiation Therapy – High-energy X-rays are used to kill multiplying cancer cells. The radiation is either delivered externally or internally by placing radioactive substances in sealed containers within the body where the tumor is located. It can either shrink the tumor or halt its growth.
Chemotherapy – This achieves similar goals as radiation but is through drug or chemical delivery via pills and/or intravenous infusion. A combination of drugs is given in a series of treatments, called cycles, over a period of weeks with breaks in between cycles. Chemotherapy also kills normally dividing cells in the body, thus causing unpleasant side effects and reducing immunity.
Targeted Therapy – It is called so because the drug Erlotinib specifically targets the killing of cancer cells thus not damaging normal cells in the process. It does so by targeting epidermal growth factor receptors which are found in abundance on the surface of some cancer cells. This method is used in cases where chemotherapy is proving ineffective. Sometimes anti-angio-genesis drugs are also used.
Photodynamic Therapy – Here a photosynthesizing agent is injected into the person which is rapidly absorbed by the cancer cells. Later a light torch carrying a certain wavelength is shown on the cancer cells which then die as the photosynthesizing agent is activated in them producing toxins.
Radiofrequency Ablation – A CT scan aided needle is inserted to the place where cancer cells are located and then radiofrequency of desired magnitude is administered through the needle producing heat and destroying the cancer cells.
Clinical Trials or Experimental Therapies – Sometimes new drugs on which trials and experiments as well as research is on are tried on patients where other conventional therapies do not work as last resort and with the permission of the patient. Immunotherapy such as vaccine therapy is one such known therapy that uses the body’s immunity to fight cancer cells.
3. What are the steps to prevention?
Prevention is the best way to be free from cancer. This means avoiding exposure to second-hand smoke and quitting smoking if you do. It implies the cessation of any usage of tobacco products. Prevention also includes reducing the usage or all-together eliminating the usage of industrial and domestic carcinogens. Long term usage of Vitamin E increases the risk of lung cancers and need to be monitored by doctors if you have been prescribed such vitamins. Hazards such as inhalation of asbestos fibers, exposure to radon gas etc should be avoided or at least minimized. Usage of alcohol should be minimal to moderate to reduce your chances of getting lung cancer.
4. What is my prognosis?
Prognosis for non-small cell lung cancer depends upon the presence of pulmonary symptoms, size of the tumor, malignancy, stage and metastases to multiple lymph nodes, as well as vascular invasion. As per Mountain, CF (1997); "Revisions in the international system for staging lung cancer" (PDF); Chest (American College of Chest Physicians) 111 (6): 1710 –1717doi:10.1378/chest.111.6.1710. PMID 9187198, for non-small cell lung carcinoma (NSCLC), prognosis is generally poor. Following complete surgical resection of stage IA disease, five-year survival is 67 percent. With stage IB disease, five-year survival is 57 percent. As per, "Lung Carcinoma: Tumors of the Lungs"; Merck Manual Professional Edition, Online edition; Retrieved 2007-08-15, the five-year survival rate of patients with stage IV NSCLC is about 1 percent. For small cell lung carcinoma, prognosis is also generally poor. Patients with extensive-stage SCLC have an average five-year survival rate of less than 1 percent. The median survival time for limited-stage disease is 20 months, with a five-year survival rate of 20 percent.
*Benefits, side-effects, prior preparations, costs, duration of procedure, stay at the hospital, recovery and resumption of daily activities as well as support issues should be discussed with your doctor for each type of treatment option before starting on your treatment.
ALL INFORMATION GIVEN IN THIS ADVOCACY SHEET IS TO BE CHECKED WITH YOUR DOCTOR BEFORE IMPLEMENTING THEM OR TAKING THEM AS STANDARD OR VERIFIED.
Mamta Singh is a published author of the books Migraines for the Informed Woman (Publisher: Rupa & Co.), the upcoming Rev Up Your Life! (Publisher: Hay House India) and Mentor Your Mind (Publisher: Sterling Publishers). She is also a seasoned business, creative and academic writer. She is a certified fitness instructor, personal trainer & sports nutritionist through IFA, Florida USA. Mamta is an NCFE-certified Holistic Health Therapist SAC Dip U.K. She is the lead writer and holds Expert Author status in many well-received health, fitness and nutrition sites. She runs her own popular blogs on migraines in women and holistic health. Mamta holds a double Master's Degree in Commerce and Business. She is a registered practitioner with the UN recognised Art of Living Foundation. Link: http://www.migrainingjenny.wordpress.com and http://www.footstrike.wordpress.com