Lung cancer is broadly categorized into two main types, each with different biological behavior and treatment approaches:

1. Non-Small Cell Lung Cancer (NSCLC)
   • Represents nearly 85% of all lung cancer cases.

   • Includes subtypes like adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.

   • Usually grows and spreads more slowly than small cell lung cancer.

2. Small Cell Lung Cancer (SCLC)
   • Accounts for about 10–15% of cases.

   • Strongly linked to smoking.

   • Tends to spread rapidly to other parts of the body.

In addition, rare forms of lung cancer, such as carcinoid tumors, can develop from neuroendocrine cells in the lungs.

Lung cancer develops due to genetic changes that disrupt the normal life cycle of lung cells, causing uncontrolled growth. Several risk factors increase the likelihood of these changes:

• Smoking: The number one cause, responsible for nearly 85–90% of cases. Both active smoking and exposure to secondhand smoke raise the risk significantly.

• Environmental exposure: Air pollution, asbestos, radon gas, and occupational hazards like chemical fumes contribute to lung cancer.

• Family history: Individuals with close relatives who had lung cancer are at higher risk.

• Chronic lung diseases: Conditions like COPD (chronic obstructive pulmonary disease) or pulmonary fibrosis increase vulnerability.

• Age and gender: Most cases occur in people over 50, but rising trends are seen among younger populations.

One of the biggest challenges in managing lung cancer is that early symptoms are often mild and nonspecific. Many patients assume they are related to infections, allergies, or aging.

Common Symptoms Include:

• Persistent cough that worsens over time

• Coughing up blood or rust-colored sputum

• Shortness of breath and wheezing

• Chest pain or discomfort while breathing, coughing, or laughing

• Repeated lung infections like bronchitis or pneumonia

Advanced Symptoms May Include:

• Hoarseness in voice

• Unexplained weight loss and fatigue

• Loss of appetite

• Swelling in the face or neck

Bone pain and headaches if cancer spreads to bones or brain

A proper diagnosis requires a combination of imaging, biopsy, and laboratory tests. Early detection improves treatment outcomes significantly.

1. Imaging Tests
   • Chest X-ray: Often the first test but may miss small tumors.

   • CT Scan: Provides detailed images of the lungs and helps detect small nodules.

   • PET Scan: Determines if cancer has spread to other parts of the body.

2. Sputum Cytology
   • Examining mucus from the lungs under a microscope to detect cancer cells.

3. Biopsy Techniques
   • Bronchoscopy: A flexible tube is inserted into the airways to collect samples.

   • Needle biopsy: Performed under CT guidance to extract tissue from suspicious areas.

   • Surgical biopsy: Used when less invasive methods are inconclusive.

4. Molecular Testing

Identifies genetic mutations (EGFR, ALK, ROS1, KRAS) that may guide targeted therapy.

Once diagnosed, lung cancer is staged to determine its spread and guide treatment:

• Stage I: Tumor confined to the lungs.

• Stage II: Cancer has spread to nearby lymph nodes.

• Stage III: Involvement of more distant lymph nodes or chest structures.

• Stage IV: Cancer has metastasized to other organs like the brain, bones, or liver.

Small cell lung cancer is usually classified as limited stage (confined to one lung and nearby nodes) or extensive stage (spread throughout the chest or body).

The treatment plan depends on the type, stage, genetic profile, and overall health of the patient. Often, a combination of therapies is used for the best outcome.

1. Surgery

• Lobectomy: Removal of one lobe of the lung.

• Pneumonectomy: Removal of an entire lung.

• Segmentectomy or wedge resection: Removal of part of a lobe, often for small tumors.
  Minimally invasive or robotic-assisted surgeries allow faster recovery in eligible patients.

2. Radiation Therapy

• High-energy beams are used to destroy cancer cells.

• Can be used as primary treatment in non-surgical candidates or combined with chemotherapy.

• Stereotactic body radiotherapy (SBRT) is an advanced method for early-stage patients unable to undergo surgery.

3. Chemotherapy

• Uses drugs to kill fast-growing cancer cells.

• Administered before surgery (neoadjuvant) to shrink tumors, after surgery (adjuvant) to eliminate remaining cells, or as primary treatment in advanced disease.

• Common agents include cisplatin, carboplatin, paclitaxel, and pemetrexed.

4. Targeted Therapy

• Focuses on specific genetic mutations driving cancer growth.

• Drugs like erlotinib, osimertinib (for EGFR mutations), crizotinib (ALK), or entrectinib (ROS1) are highly effective in selected patients.

5. Immunotherapy

• Harnesses the body’s immune system to fight cancer.

• Drugs such as pembrolizumab, nivolumab, and atezolizumab have revolutionized treatment for advanced lung cancer, offering durable responses in some patients.

6. Palliative Care

• For advanced stages, treatment may aim to relieve symptoms such as breathlessness, pain, or fatigue while improving quality of life.

Survival outcomes for lung cancer depend heavily on stage at diagnosis, tumor type, genetic profile, and response to treatment.

• Early-stage NSCLC: 5-year survival rate can exceed 50–60%.

• Advanced-stage NSCLC: Drops significantly, often to less than 20%.

• SCLC: Highly aggressive, with average survival of 1–2 years even with treatment.

However, recent progress in targeted therapy and immunotherapy is improving outcomes, offering many patients longer and better-quality lives.

While not all lung cancers can be prevented, significant risk reduction is possible through lifestyle and environmental changes:

• Quit smoking: The most effective step. Even quitting after years of smoking reduces risk.

• Avoid secondhand smoke: Exposure is dangerous, particularly for children and non-smokers.

• Reduce occupational exposure: Follow safety measures if working with asbestos, diesel exhaust, or chemical fumes.

• Test for radon gas: Especially in regions with higher natural radon levels.

• Adopt a healthy lifestyle: Balanced diet, regular exercise, and limited alcohol intake strengthen lung health.

• Air quality awareness: Minimizing exposure to outdoor and indoor pollution is increasingly important in urban environments.

emotionally and socially. Comprehensive care focuses on both medical treatment and supportive services.

• Nutritional care: Many patients experience weight loss and loss of appetite. Dietitians help plan high-calorie, protein-rich meals to maintain strength.

• Psychological support: Counseling, mindfulness, and support groups ease emotional stress.

• Rehabilitation: Pulmonary rehabilitation programs improve breathing capacity and physical stamina.

• Family and caregiver involvement: Strong social support plays a vital role in treatment adherence and recovery.

Lung cancer is one of the most serious health challenges of our time, yet modern medicine is transforming the outlook for patients. Awareness of risk factors, vigilance toward symptoms, and access to advanced diagnostics can lead to earlier detection and better survival chances. With breakthroughs in targeted therapies and immunotherapies, patients today have more treatment choices and hope than ever before. If you or someone you know experiences persistent cough, chest discomfort, or unexplained weight loss, consult a healthcare professional without delay. Early intervention remains the most powerful weapon against lung cancer.