29 September 2020 Author : Margarida Felizardo Lung cancer remains the leading cause of death dur to cancer worldwide and has a 5-year survival rate of about 18%. According to recent data, in Portugal the disease is responsible for just over 4000 deaths per year and its incidence, that is, the number of new cases, continues to increase. What are the risk factors? Tobacco The main risk factor is tobacco. The relationship between tobacco and lung cancer is indisputable. Tobacco has in its composition several carcinogenic chemical agents and nicotine, which is also a highly addictive substance. Between 85% and 90% of patients affected by lung cancer are or have been smokers. Tobacco is not just related to this cancer. It is also associated with other cancers such as esophagus, pharynx, larynx, bladder, pancreas or kidney, among others. There is a direct relationship between the risk of lung cancer and the number of cigarettes smoked per day and the number of years of smoking. All smokers, including patients with lung cancer, should be counseled and supported for smoking cessation, as they have higher mortality rates than non-smokers. Passive smokers also have an increased relative risk of developing lung cancer. Exposure to asbestos and radon, namely the inhalation of the particles of these carcinogenic substances is also a risk factor that increases the likelihood of getting lung cancer, especially in smoking patients. Other risk factors Chronic obstructive pulmonary disease Pulmonary emphysema Pulmonary fibrosis Sequelae of tuberculosis Chest irradiation to treat breast tumors or lymphomas Lung cancer cases in direct family members Previous history of lung cancer or other tobacco-related cancers Warning signs of lung cancer symptoms The main symptoms that should alert patients to see a physician are: Persistent cough or different from the usual morning cough; Persistent or different sputum (for example, sputum with whitish mucus that becomes streaked with blood or dark yellow); Hoarseness; Changes in voice characteristics; Shortness of breath; Unexplained or aggravated tiredness; Chest pain; Unexplained weight or appetite loss; Appearance of ganglia in the armpits or above the clavicles; Swelling or edema of the neck or face. Important: Patients who have daily symptoms of bronchitis should seek medical help in there are changes. Nos casos em que a doença já se encontra metastizada, os sintomas podem estar relacionados com os locais de metastização e manifestarem-se por: Persistent or severe bone pain; Unexplained fractures; Neurological complaints, such as headache or seizures. Diagnosis Low-dose computed tomography (CAT) integrated into a detailed and comprehensive risk assessment and early diagnosis plan is the first test to detect this disease. In at-risk and symptom-free patients, mortality can be reduced by 20% if this test is performed instead of the “normal” chest X-ray. In cases where the patient already has the symptoms mentioned above, the first test to be performed will be a CT scan, that will help to locate the disease and guide doctors towards the fastest and most effective diagnostic and therapeutic approach. After adequate staging, the diagnostic and therapeutic approach is discussed in a multidisciplinary meeting by a group of doctors from the various specialties involved. Often, the objective of the first approach is to make a histological diagnosis (knowing the type of tumor) and the stage (stage) of the disease, in a single exam, according to international and national guidelines. The multidisciplinary team integrates several medical speciatlties Pathologic anatomy Thoracic surgery Palliative care Nuclear Medicine Medical Oncology Pneumology Radiology Radiotherapy A correct and effective diagnosis is essential in lung cancer. Time is absolutely vital for the initiation of adequate therapy and obtain control of the disease. Treatment Treatment depends on a number of factors related to the tumor, such as the type of tumor, the location and staging, but it is also dependent on the general condition and the patient decision. Often the initial approach is surgical using, whenever possible, minimally invasive techniques. In some of them, like robotic lung surgery, Hospital da Luz was a pioneer in Portugal. When the tumor is diagnosed at an advanced stage, treatment is guided after a molecular study to a targeted therapy, which can be immunotherapy, target therapy or chemotherapy. There are also patients who can be included in clinical trials. Hospital da Luz has a unique capacity to treat patients with ling cancer. Meet the pulmonology team of Hospital da Luz network and book your consultation . The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
