Lung cancer happens when normal cells in the lungs change into abnormal cells and grow out of control. There are different types of lung cancer. Some types grow much faster than others.

In the developed countries, lung cancer is a biggest cause of deaths from cancer in both men and women, and its incidence is steadily increasing in developing countries.

Cigarette smoking is the biggest risk factor for lung cancer. As an example, smoking is estimated to cause 85 percent of all lung cancers. A smoker’s risk of developing lung cancer is 10 to 30 times greater than that of a nonsmoker. All forms of tobacco and smoking, including pipes, cigars, and chewing tobacco, are major risk factors for cancers of the mouth, throat, and lungs. The risk of lung cancer increases with the number of cigarettes smoked and the number of years of smoking.

The risk of cancer remains high for several years after quitting smoking but the risk does go down within 5 to 10 years after quitting. A former smoker’s risk of lung cancer is never as low as a nonsmoker’s risk.

Substances at work or in the environment can increase a person’s risk of developing lung cancer. In parts of the world where fuel such as wood or coal are widely used for cooking and heating, these may be important contributors to the risk of lung cancer. Other important factors include secondhand tobacco smoke, asbestos, arsenic, radiation, and some chemicals. Dust and fumes from nickel, chromium, and other metals may also increase the risk of lung cancer.

The risk of developing lung cancer increases with age. Lung cancer can occur in young people, although it is unusual in people younger than 40 years old. After age 40, the risk for developing lung cancer slowly increases every year.

Some people have a genetic risk or predisposition for lung cancer. Anyone with a first-degree relative (parent, brother, sister) with lung cancer has a higher risk of developing lung cancer themselves.

Most people with lung cancer have one or more symptoms. However, the symptoms of lung cancer are similar to the symptoms of other more common problems and hence the need for proper medical evaluation to detect lung cancer.

Common symptoms of lung cancer can include; cough, trouble breathing, or wheezing, spitting or coughing up blood, chest pain that can be dull, sharp, or stabbing, hoarse voice, headache and swelling of the face, arms, or neck. Arm, shoulder, and neck pain can be caused by a tumor in the top of the lungs. Other symptoms can include weakening of the hand muscles (due to pressure on the nerve that stimulates the arm), a droopy eyelid, blurred vision and loss of weight.

If one has symptoms that suggest lung cancer, the doctor will perform a physical examination, and if the examination findings are still concerning, more tests including blood work up and x-rays or scans will be ordered. If the chest X-ray or scans show an abnormal growth that could be a tumor, additional testing is performed to make a diagnosis. Usually, a piece of the growth will need to be removed and examined under a microscope to look out for cancer cells. This procedure is called a biopsy.

Once one has been diagnosed with lung cancer, the right treatment will depend, in part, on the stage of the lung cancer (Cancer staging is a way in which doctors find out how far a cancer has spread). The treatment will also depend on the type of lung cancer one has, age, and any other health problems.

There are a number of different treatment options for lung cancer. Standard treatment options include surgical resection (surgery to remove the cancer), chemotherapy (medicines that kills cancer cells), and radiation therapy (Radiation kills cancer cells). Newer lung cancer treatment approaches include photodynamic therapy, electrocautery, cryosurgery, laser surgery, targeted therapy and internal radiation. Each lung cancer treatment has its own specific ability to fight cancer and its own set of side effects and possible complications

For advanced cases of lung cancer, palliative care to alleviate pain and symptoms is offered

The most important factor in reducing the risks of lung cancer is to avoid smoking since cigarette smoking accounts for more than 85% of all lung cancer cases. For those individuals who are at increased risk of lung cancer because of smoking, screening with low dose computed tomography may be recommended by their physician.

Dr. Ian ShyakaResident in Surgery, Rwanda Military Hospital.