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n CME : Your SA Journal of CPD - Lung cancer : main article
Lung cancer is one of the most common cancers in men and has a rising incidence in the female population as well.
Smokers have a 16-fold increased risk of developing lung cancer compared with non-smokers. Asbestos and silica fibre exposure, diesel fumes, air pollution, industrial exposure to nickel and chromium, arsenic exposure, mine work and exposure to radon gas and uranium all increase the risk for lung cancer.
Lung cancers are divided into 2 main groups histologically: small-cell and non-small-cell lung cancer. Differences are on grounds of behaviour, features, treatment and prognosis.
NSCLC can be located either centrally or in the periphery of the lungs, and tends to metastasise a bit later than SCLC. Therefore surgery plays a much more important role in the management of NSCLC.
Nonspecific symptoms include weight loss, muscle weakness and clubbing of fingers and toes. Specific symptoms can include recurrent chest infections not responding to antibiotic treatment, dyspnoea, haemoptysis, chest pain due to chest wall infiltration or pleural effusion and hoarseness due to recurrent laryngeal nerve infiltration.
A simple chest X-ray with PA and lateral views is the first and probably the most important special investigation that should be done.
In SCLC the mainstay of treatment remains chemotherapy. In limited-stage disease chemotherapy is started with concurrent radiotherapy early in the treatment course.
In NSCLC the staging system is a bit more complicated and the choices of treatment depend on stage, co-morbid conditions and risk factors.
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