More than 90% of current lung cancer patients have a major cause from smoking, which is considered a very high statistic. But what is even more frightening is that many people who think they are safe because they do not smoke themselves may not be correct, as 30% of lung cancer patients are non-smokers who have been exposed to secondhand smoke from others.
This is why the recommendation is to have regular health check-ups every year because we can never be sure if “lung cancer” is developing in our body or not. Every day, we are inevitably exposed to cigarette smoke. To explain the process and chances of developing lung cancer more clearly, today we will talk with Dr. Winai Boveja, a respiratory medicine specialist, about the diagnosis process and current procedures for lung cancer.
Early Detection and Prompt Treatment Increase Survival Chances
Lung cancer is a serious and life-threatening disease. Therefore, to increase the patient’s survival chances, the most important role of the doctor at the first stage is to conduct a thorough and accurate diagnosis. It is necessary to determine whether the lung nodule seen on the X-ray is cancerous or not. If there is suspicion, diagnosis and treatment must be expedited because the golden rule of cancer is “early detection and prompt treatment increase survival chances.” Actually, the characteristics of X-ray or CT scan images can indicate which lung nodules “look like cancer” and which do not. There are white, black, and gray zones. If the image is black, the doctor can roughly tell from the image that this type of nodule is likely cancerous, having a higher chance than others. However, it still needs to be confirmed by endoscopy and biopsy.
What Types of X-ray Images Indicate a Risk of Lung Cancer?
In fact, CT scan images are more detailed than regular X-rays. Generally, nodules that may be cancerous include large nodules, cavities, clusters, star-shaped patterns, or many small nodules scattered throughout the lungs. However, to be certain whether it is lung cancer or not, endoscopy and biopsy are required. Some cases may not be cancer but only a suspicion. The diagnostic process also includes taking medical history, physical examination, and considering all information together.
Endoscopy and Biopsy Are Not Scary; If You Want Certainty, Get Tested Without Hesitation
As mentioned, to be sure whether it is lung cancer or not, endoscopy with biopsy is the most definitive answer. However, some patients hesitate, which prevents a clear diagnosis and may delay treatment. In the past, when a lung nodule was detected, open lung surgery was required to remove tissue for examination. Nowadays, this is no longer necessary because a small camera about the size of a pinky finger is inserted through the bronchus into the lung, directly to the nodule seen on the X-ray. There is no surgical wound and no pain. Once inside, a small forceps acts like a tiny knife to take tissue samples for examination. The procedure can be done in the morning, and the patient can go home in the afternoon. Results are available within three days, confirming the exact disease. This is a new technique that reduces risk, is less frightening, and provides accurate results, which is very important for treatment. As mentioned, the golden rule of cancer is early detection and prompt treatment to increase survival chances.
Pay Close Attention to Symptoms; If You Notice Warning Signs, See a Doctor Even If You Don’t Smoke
Since both smokers and those exposed to secondhand smoke have a chance of developing lung cancer, self-care and regular observation of symptoms are important. Lung symptoms that may signal abnormalities leading to lung cancer include chronic cough, coughing up blood, and persistent cough. Other symptoms include shortness of breath, chest tightness or pain, painful breathing, fatigue, weight loss, fever, and other unusual symptoms. If these are noticed, one should promptly see a doctor to check which part of the body is signaling a problem. After examination, the pulmonologist will know the cause. The pulmonologist is like a mechanic for a car; when we are sick, we bring the car to the garage. The doctor asks questions to determine the possible cause, then examines to find which part is abnormal, and diagnoses the condition. Once the cause is identified, treatment follows accordingly.
Dr. Winai Boveja
Internist, Respiratory Medicine Clinic
and Respiratory Critical Care
Phyathai 3 Hospital
