Beacon Hospital Hotline
Lung cancer is the most common cancer in the world. There were approximately 2.09 million new cases reported worldwide and 1.76 million deaths caused by lung cancer in 2018 (International Agency for Research on Cancer, World Health Organization). According to the Malaysian National Cancer Registry (2007 – 2011), there were 10,608 out of 103,507 lung cancer cases reported with 7,415 cases in male and 3,193 cases in females.
Lung cancer is caused by mutated cells in the lungs grow out of control, forming a tumour. In many cases, these altered cells die or are attacked by the immune system. But some cells escape the immune system and grow out of control, forming a tumour in the lung.
Types of Lung Cancer
There are two major types of lung cancer:
- Non-small cell lung cancer (NSCLC)
- Small cell lung cancer (SCLC)
Other types of cancer found in the lungs are:
Anybody can get lung cancer but most lung cancers are caused by:
- Smoking (90%) – active and second-hand smoke
Tobacco smoke contains more than 4,000 chemical substances, most of which have been identified to cause lung cancer. According to research, smoking 20 cigarettes per day increases the risk of lung cancer by 20-25 times compared to non-smokers.
Other causes of lung cancer include:
- Air pollution from vehicles and factories
- Exposure to asbestos
- Having lung diseases such as tuberculosis
- Chronic obstructive pulmonary disease
- Occupational exposure to arsenic, chromium, nickel, aromatic hydrocarbon and ether
Stages of Lung Cancer
Stage I : Cancer may be present in the underlying lung tissues, but the lymph nodes remain unaffected.
Stage II : The cancer may have spread to nearby lymph nodes or into the chest wall.
Stage III : The cancer is continuing to spread from the lungs to the lymph nodes or to nearby structures and organs, such as the heart, trachea and esophagus.
Stage IV : The cancer has metastasized, or spread, beyond the lungs into other areas of the body.
In the early stages, lung cancer doesn’t cause any symptoms but typically occur when the disease advanced. The common symptoms include:
- Chest pain
- Shortness of breath
- Hoarseness of voice
- Coughing out of the blood
- Loss of appetite and weight
- Excessive lethargy
- Recurrent chest infection
Cancer screening in lung cancer is still controversial, although early detection at an early stage of lung cancer can lead to a more effective treatment.
To diagnose lung cancer, a doctor could perform a combination of tests including:
- Blood investigations
- Sputum examination
- Chest X-ray
- Computerised tomography (CT) scan of the thorax
- Positron Emission Tomography (PET) scan (to detect cancer and metastases)
- Bone scan
- Lung function tests
Beacon Hospital offers comprehensive Cancer Screening packages that are tailored made for individuals depending on the patient’s needs.
Treatment of lung cancer depends on the type of cancer, stage of cancer and the key cause.
- Surgery – Surgery is typically used to treat non-small cell lung cancer.
But surgery might not be appropriate for you if your cancer is very near any of the following structures:
- The heart
- The windpipe
- The food pipe (oesophagus)
- Major blood vessels
In these circumstances, your doctor might recommend other cancer treatments as an alternative of surgery, such as radiotherapy, chemotherapy or a combination of both.
- Chemotherapy – using drugs to kill cancer cells. It works by distressing the growth of cancer cells.
Chemotherapy is the key treatment for small cell lung cancer. Doctors use it because:
- this type of cancer responds very well to chemotherapy
- small cell lung cancer tends to have spread beyond the lung when it is diagnosed
Chemotherapy drugs circulate in the bloodstream around the body. Thus, they can treat cells that have spread away from the lung tumour and spread to other parts of the body.
There are two primary types of radiation therapy for lung cancer:
- External beam radiation therapy (EBRT): Delivers high doses of radiation to lung cancer cells from outside the body to kill cancer cells.
- High-dose-rate (HDR) brachytherapy (internal radiation): Delivers high doses of radiation from implants placed close to, or inside, the tumour(s) in the body.
Halcyon Radiotherapy System at Beacon Hospital enables:
- Fast and precise X-ray dose delivered to each tumour with high accuracy over a minimum number of treatment sessions
- Reduces unwanted radiation dose, thus, minimising side effects
Unlike any other radiation delivery system, the Halcyon technology’s beam-on time could be as fast as 1-minute plus. Its gantry rotates 4 times faster than a standard linear accelerator and its multi-leaf collimator (MLC) can move twice faster than traditional MLCs. All of these features help in improving the time it takes to treat the patients.
- Immunotherapy – to stimulate the body’s immune system to attack and kill cancer cells. Immunotherapy may not be suggested for all patients, and responses to the treatment may vary widely. Immunotherapy may also be used in combination with other treatments such as surgery or chemotherapy.