Q: I have an 87-year-old neighbor who has smoked for years and was just diagnosed with lung cancer. He’s very confused and I would like to help him through this but I must admit I don’t really understand what the condition is all about. He wants my support as he has no family, but where can I begin? Can you enlighten me?
A: While it is known that some individuals never smoke and are still diagnosed with this potentially deadly disease, cigarette smoking is known to cause most lung cancers. Other possibilities include asbestos and radiation exposure, as well as exposure to high levels of pollution in the workplace or at home. There are many forms of lung cancer and each form grows and spreads in different ways. Treatment depends on the advancement of the disease and may include chemotherapy, radiation and surgery.
Lungs are a part of the respiratory system. Air enters through the mouth or nose, passes through the trachea, on through the bronchus, and into the lungs. On inhalation, the lungs fill with air. On exhalation, air passes out of the lungs and rids the body of carbon dioxide. Cells,whether in the lungs or other areas of the body, grow and divide to form new cells when needed. When normal cells age or become damaged, they die and new cells take their place. That’s on a good day, because sometimes the process doesn’t work as planned. New cells may form when the body doesn’t really need them and old or damaged cells don’t always die as they should. The buildup of the new cells form a tissue mass, otherwise known as a tumor. Lung tumors can be benign (not malignant), or they can be malignant, indicating cancer. Benign tumors don’t spread, nor do they necessarily need to be surgically removed. Malignant tumors can spread to other areas of the body, may be surgically removed, but may grow back again, and may take a life. Lung cancer cells travel either through lymph vessels or through blood vessels and may attach to and grow to form new tissues.
Prior to a person being tested for possible lung cancer, he or she may have a CT scan, a form of X-ray, a PET scan that will provide a better view of the suspected tumor, an MRI that will provide confirmation or lack thereof that the cancer has spread to other areas, a bone scan that will use a minimal amount of radioactive substance that will collect in areas of the body where the cancer may be present, or lymph node samples to determine if the cancer has spread.
Small cell lung cancer is divided into stages numbered between 0 and IV. Stage zero indicates the abnormal cells are contained in the innermost lining of the lung and is referred to as in situ. Stage I indicates invasion because the tumor has grown through the lining but hasn’t invaded nearby tissue, nor has it reached the lymph nodes. Stage II indicates the tumor is smaller than 7 cm and that there is invasion of the lymph nodes. Stage III indicates the tumor(s) has grown and may have invaded nearby tissues. Stage IV implies malignant tumors are seen either in both lungs or in other parts of the body.
Fortunately, enormous advances have been made in the treatment of cancer, no matter what stage a person is in. Individuals with early lung cancer may opt for radiation which will help shrink the tumor rather than surgery. Advanced cases may be best treated with chemotherapy that may utilize radiation, as well. Chemotherapy will utilize drugs to kill cancerous cells and are commonly given intravenously. Non-small cell lung cancer that has metastasized may respond to targeted therapy that will block both the growth and spread of lung cancer cells. Targeted therapy may be administered orally or through an IV.
Before the next visit to his oncologist, sit down with him and make a list of all questions he may have that require answers. Ask if you can accompany him on his next visit with that list so you can be sure nothing is overlooked. Because of HIPAA laws, he will have to grant permission to allow you to sit in on the visit. Ask how far advanced his condition is and what changes the patient can expect. This will help both of you make appropriate decisions regarding his care. There is professional care available that can help him through and you will fill the gap simply by being a caring friend.
