A Guide to Lung Cancer & How to Get a Second Opinion

Lung cancer occurs when lung cells begin to split and multiply at a rapid rate, and grow out of control.

Worldwide, lung cancer is the most common cancer in men and the third most common type of cancer in women.

It is often diagnosed late as there are no symptoms in the early stages. As symptoms begin to show in the later stages, this is when diagnoses are most commonly made. Approximately 1 in 3 people survive lung cancer for over one year, and around 1 in 20 live for at least ten years after their initial diagnosis. A swift and accurate diagnosis and effective treatment plan are key to ensuring the best quality of life and prognosis.

While your primary doctor can provide an initial diagnosis, seeking another view is more than acceptable to ensure the diagnosis you have been given is accurate and the most appropriate treatment options are recommended to you. Learn how a second opinion for lung cancer can help and how OncoloMed can facilitate this for you or a loved one.

What is Lung Cancer?

Lung cancer is a cancer of the lungs which most often starts in the lining of the lungs but can also occur in the windpipe or airways. Cancerous cells grow exponentially to form tumours, which may go undetected for some time as symptoms often do not present until the cancer has spread.

Lung cancer may be categorised as primary or secondary cancer, dependent on if the cancer first occurred in the lungs, or initially developed elsewhere and spread to the lungs. Cancer which began in the lung itself is called primary lung cancer. Cancer which developed elsewhere and spread to the lung is referred to as secondary lung cancer. This may also be referred to as metastatic lung cancer.

Types of Lung Cancer

There are two main forms of lung cancer, small cell and non-small cell.

Non-small cell lung cancer (NSCLC)

Around 80% of all lung cancers are NSCLC and describes a number of different types of lung cancer. NSCLC cancers include:

Adenocarcinoma – Adenocarcinoma accounts for around 42% of all lung cancers worldwide, including the majority of lung cancers in people under 40 years of age, and those who have never smoked. It occurs in the mucus gland cells in the lining of the airways.

Squamous cell carcinoma – Approximately 30% of all NSCLC diagnoses are squamous cell carcinoma. This type of lung cancer begins in the lining of the air passages, most often the large airways. This means squamous cell carcinoma of the lungs often presents symptoms earlier than some other forms of lung cancer, however the majority of diagnoses for this type of lung cancer will appear after it has spread.

Large cell carcinoma – So called because of its appearance under a microscope, large cell lung carcinoma is a more aggressive form of lung cancer which spreads more quickly than other types. Roughly 10% of all lung cancers are large cell carcinomas. LCLC develops on the edges of the lungs, and so presents different symptoms to other types of lung cancer, which can lead to late or missed diagnoses.

Small cell lung cancer (SCLC)

Small cell lung cancer is less common than non-small cell lung cancer, but is usually more aggressive and requires a fast diagnosis and treatment to limit the spread of cancerous cells. Around 15% of lung cancers are SCLC.

Causes of Lung Cancer

The exact cause of lung cancer is not always known.  It is widely accepted that the most common denominator is smoking, which is linked to over 70% of lung cancers, but there are a number of other factors which may contribute to an increased likelihood of developing primary lung cancer.

These include:

• Age – Lung cancer is uncommon in people aged 40 years or less
• Passive smoking
• Exposure to radon gas
• Exposure to asbestos
• Previous radiotherapy treatment
• Immunodeficiency disorders
• Family history
• Air quality and air pollution

The main symptoms of lung cancer

The main symptoms of lung cancer vary depending on the type of cancer, however there are some symptoms which are likely to be experienced with any form of lung cancer.

These include:

• Chest pain when laughing, coughing or deep breathing
• Shortness of breath
• Wheezing
• Persistent cough
• Coughing blood
• Weight loss
• Loss of appetite
• Fatigue

Other symptoms may include shoulder and arm pain, lumps around the neck, headaches, dizziness, effects of facial nerves, swelling of the upper body, muscle weakness, jaundice, nausea, vomiting, and a number of other symptoms.

Diagnosis of Lung Cancer

If you or a loved one are experiencing symptoms associated with lung cancer, it is important to seek a diagnosis immediately. Due to the wide range of symptoms which may be experienced, many people opt for a second opinion to help determine the exact type and stage of lung cancer they are experiencing. Having the right diagnoses from the outset helps to ensure the most effective treatment for you or your loved one.

The first step in the process is to book an appointment with your doctor. They will examine you, and ask a series of question about your lifestyle, family history, and exposure to certain elements which are known to pose an increased risk of lung cancer. They may take a blood test, and will refer you to a specialist or recommend scans such as a chest x-ray, CT scan, MRI scan or PET scan.

You may also be offered other procedures to assist in your diagnosis such as:

Brochoscopy – this is where a thin tube with a camera attachment is used to view your airways and obtain a biopsy. This procedure requires the tube to be passed through your mouth or nose, which can be uncomfortable, and you will be offered a sedative and local anaesthetic.

Endobronchial Ultrasound Scan (EBUS) – This procedure combines a bronchoscopy with an ultrasound scan to identify and obtain a biopsy form your lymph nodes.

Other less common types of biopsy procedures include:

Mediastinoscopy – This procedure requires a small cut to be made at the base of the neck for a thin tube with a camera attachment to be passed into the chest and take biopsies.

Percutaneous Needle Biopsy (PNB) – Where a needle is inserted into the affected area of the lung to obtain a biopsy.

Thoracoscopy - Where a thin tube with a camera attachment is used to view the area in the chest outside of the lungs.

Second Opinions for Lung Cancer

It’s widely encouraged for patients to get a second opinion about their diagnosis and/or treatment options for any form of cancer.  You may seek confirmation or your diagnosis and want a deeper understanding of the stage and type of your lung cancer. Whatever the reason, Oncolomed can help facilitate second opinions with lung cancer specialists from leading hospitals globally. Get in touch with our caring team to learn how we can help.

Treatment Options for Lung Cancer

There are a number of treatment options for lung cancer, and the best treatment plan for you or your loved one will depend on a number of factors such as location, size, stage, and type.

The most common forms of lung cancer treatment are:

• Chemotherapy
• Immunotherapy
• Tumour ablation
• Radiotherapy
• Surgery
• Laser therapy
• Targeted therapies – designed to help stop the spread of cancer

With ongoing research and developments in the field of lung cancer treatments, there are also more innovative methods of treatments that may be suitable too. These include:

• Regional Chemotherapy
• CyberKnife
• Tomotherapy
• NanoKnife
• Radio Frequency Ablation

It is likely that you will be recommended a combination of therapies and treatments, which will be discussed with you by your doctor or specialist.

Lung Cancer Treatment Abroad

You may wish to think about receiving your cancer treatment abroad. This may be due to long wait times in your own country, or forms of treatment are not yet available where you are. This may be due to advancements in research and treatment that your current specialist is not aware of. If you are considering cancer therapy abroad, there are a number of aspects to consider.

It is important to have a full understanding of how the process of receiving treatment works in the country you are considering, as well as the potential cost implications, travel regulations and recommendations, understanding the implications of travelling abroad and the aftercare procedures for when you return.

How OncoloMed Can Help

Oncolomed can guide and support you through your cancer treatment journey. Take a look at our cancer patient stories to find out how we have helped our clients or view our services page to learn more about what we do. If you have any questions or would like to speak to a specialist, get in touch with us.