Lung cancer, as the name suggests, happens when the cells lining the airways grow and divide without control, leading to the formation of an abnormal mass. It is a cancer that can develop over months to years and patients may not see the warning signs until much later. There are two major types of lung cancer: small cell lung cancer and non-small cell lung cancer. About 85% to 90% of lung cancers are non-small cell lung cancers. The major differences between these two types of lung cancer are the size and shape of the cancer cell, forms of treatment and the speed at which the cancer spreads. Small cell lung cancer spreads more rapidly.
Lung cancer is the second most common cancer in males and third most common cancer in females in Singapore. During the five-year period from 2010-2014, 15% of all cancer incidences in men were lung cancer cases. For women, the figure is 7.6%. People who smoke have the greatest risk of lung cancer as they increase their risk with each cigarette they smoke as well as the number of years they smoke. Non-smokers may develop lung cancer as well due to their exposure to second-hand smoke.
There are a variety of factors that contribute to your risk of developing lung cancer. Certain factors can be suppressed by quitting smoking while other factors such as family history cannot be controlled.
In the early stages, lung cancer does not usually cause any signs and symptoms –they usually appear when the cancer has reached more advanced stages.
*A doctor should be consulted should the symptoms occur.
A chest X-ray may be conducted to reveal any abnormal mass or nodule. A Computed Tomography (CT) scan can reveal other lesions in your lungs that may not show up in an X-ray.
A sample of cells is usually taken to confirm the diagnosis. A biopsy sample may also be drawn from lymph nodes or other areas where the cancer has spread.
At NCIS, our patients are managed by a team of cancer specialists and health professionals from various disciplines. From pathologists and radiologists to medical oncologists and surgeons, we believe that a multidisciplinary approach will give our patients comprehensive and holistic care. A treatment plan will be developed to fit each patient's needs and may include one or a combination of the following treatments.
Surgery is the mainstay of treatment for early-stage lung cancer that remains within the lung. Surgeons would remove the lobe of the lung where the tumour is located, as well as the surrounding lymph nodes. Minimally invasive ‘keyhole’ surgery is increasingly performed in suitable patients which results in less pain and faster recovery. Other surgical options are also possible, such as pneumonectomy which removes the entire lung, lobectomy which removes a section of the lung and segmentectomy which removes part of a lobe. In general, lobectomy is the preferred surgical option for non-small cell lung cancer.
Cancer cells are killed using drugs in a process called chemotherapy. One or more drugs may be given via an injection through a vein. The drugs are administered in a series of treatments over a period of weeks or months, allowing you to rest in between with breaks. It can be used as a first line treatment for more advanced cancer, or for selected patients before or after surgery or in other patients combined with radiation therapy.
Targeted therapies are a form of medical treatment involving the use of drugs or other substances. These drugs block or interfere with specific molecules that help the tumour to grow. They are usually used for stage 3 and 4 cancer with tumours that are unresponsive to other treatments. Two commonly used drugs for lung cancer are: