The human body needs oxygen to survive, and there is oxygen in the air. This oxygen enters the body through the nose to the lungs then into the whole body, they are a part of the respiratory system. The lungs exchanges oxygenated blood and deoxygenated blood through the capillaries in the alveoli, they are tiny important cells. An average adult takes 12 to 20 breaths per minute, more or less than that count is abnormal. Deformities in the structure of the lung will lead to jeopardizing the supply of oxygen, leading to death.

Lung Cancer is a silent aggressive disease, an increase growth of abnormal lung cells leading to destruction of the normal structure and functions. This growth forms a mass, tumor. The tumor forms an obstruction in the flow of oxygen to the body, which is essential for human survival.

The figure above shows how a mass is present within the lungs, and how it will block the supply of oxygen as it will grow larger eventually if not treated.

Lung cancer, a disease that does not discriminate between races. As the days goes by, more and more people are falling into the trap of this cancer. Every year about 1.76 million death occurs due to lung cancer all over the World. The combined death count of Prostate, Colorectal and Breast Cancer is less than Lung Cancer. As of 2018, in Bangladesh out of all cancer patients, 8.2 % is newly diagnosed with Lung Cancer, the number might seem insignificant but that is about 12,374 people.¹

Human body’s immune system is always giving warning signals when it is under attack. Yet in case of Lung Cancer it is slow, and can be ignored. Some symptoms which might be present are:

Having any of these symptoms does not mean the person is suffering from Lung Cancer but to consult a physician is advised for proper treatment.

• Tobacco- consumed in any form either smoked or chewed may cause Lung Cancer, about 80% of diagnosed Lung Cancer occurs due to tobacco smoking.
  Many people assume that they did not smoke, therefore, they might not suffer from Lung Cancer, which is not always the truth. The number one cause of Lung cancer is use of tobacco.

• Radiation- People being treated with radiation are also at risk of developing Lung Cancer.
• Occupational- hazardous ingredients such as asbestos and carcinogenic materials are handled without proper precaution by workers puts them at risk too.
• Urban air pollution- particles in busy city air rather than rural areas has had an effect on the lungs, leading to lung cancer.
• Indoor pollution- People are more prone to lung disease in houses with poor ventilation, where woods are burnt or anyone smokes.
• Other lung diseases- Such as Chronic Obstructive Pulmonary Disorder (COPD), Tuberculosis and Emphysema may increase the risk of lung cancer. If there has been a familial history of cancer, other family members should go for regular consultation with a physician and screening if necessary.

Mainly Lung cancer has been divided into two types, Non-Small Cell Lung Cancer (NSCLC), and Small Cell Lung Cancer (SCLC). Staging is used to describe the spread of lung cancer, whether it is local, all over the lungs or did the cancer spread to lymph nodes and other organs.

Non small cell lung cancer makes up 85% of all lung cancers^{6 &7} . People who smoke or breathe in a lot of smokes or work in polluted environment are most likely to get NSCLC.

Stages of non small cell cancer :

1. Stage I - The cancer is localized to the lung only.
2. Stage II- The cancer found in the lungs and nearby lymph nodes ( Lymph nodes: they are part of the immune system, it’s function is to filter the lymphatic fluid )
3. Stage III- The cancer has spread all over the lungs and nearby lymph nodes. The spread can be on the same side, described as stage IIIA, and if it involves the other side of lungs then it is called stage III B.
4. Stage IV - The most advantageous stage, where the lungs, and the lymph nodes including other organs to which the cancer has spread to.

Small Cell Lung Cancer is staged as limited stage and extended stage. The limited stage being it in on one side of the lungs and has spread to nearby lymph nodes. Extended stage means, it involves other parts of the body, meaning the cancer has metastasized.

Treatment will depend on the stage of cancer after diagnosis. It may be surgery, chemotherapy, radiotherapy, targeted therapy or immunotherapy. An oncologist will be able to do the diagnosis by going over the test results from sputum cytology or others such as CT, MRI, PET scan, needle biopsy even molecular testing. Every day physicians are pouring their knowledge into new studies to provide the best treatment for cancer patients.

During treatment a person goes through a whirlwind of emotions; anxiety, fear, panic, depression, insecurities. Aastha is there to help you on this.

Sadly, there is no vaccination or any other drugs against lung cancer. Even though there are some predominant behavior that increases the risk (as described above; tobacco, radiation......), there are also cases where we cannot explain the reasons. It will be in our own best interest to avoid the risk factors that put us in danger. Paying attention to health can take us a long way, whenever any symptoms arise a doctor should be consulted, we cannot ignore our precious self. After all, health is wealth.

1. What is Lung cancer?

When there is an increased number of abnormal cells in the lungs, that destroys the lung’s function and structure due to a mass is formed it is known as Lung cancer

2. Who can suffer from Lung Cancer? I never smoked, will I be a victim to this disease?

Mostly people who smoke, or who are around smokers or people living in a very polluted area have more risks of suffering from lung cancer than people who do not. Yet there have been cases that people can be diagnosed with Lung cancer without touching or smoking once in there life.

3. How will I know if I am suffering from Lung cancer?

If you are ailing from the symptoms such as, fatigue, persistent cough, breathlessness, blood with sputum, headache then it better to go to a physician for consultation.

4. Doctor asked me to do a CT scan, why is that?

CT scan is a diagnostic process to check for abnormality in the body, which is similar to an x-ray. Your doctor may ask furthermore diagnostic tests such as MRI, or Biopsy.

5. My doctor said I am in Stage II of Lung Cancer, he mentioned NSCLC. What does he mean by that?

NSCLC stands for Non-Small Cell Lung Cancer. In case of lung cancer it is the most common, and there are different stages of lung cancer. Stage 2 means the cancer is present in lungs and it may have spread to nearby lymph nodes.

6. What are my treatment options since I have been diagnosed as NSCLC, stage 2. My doctor said I will need radiation and then surgery. Why do I need both? Will radiation not be enough?

Your tumor size maybe a of a size that cannot be removed by surgery right away. Your doctor will give radiation or chemotherapy to shrink your tumor then remove it.

7. I have started my chemotherapy, how long will this treatment take?

Even though human bodies are similar yet unique, your doctor will go through some diagnostic test to see how the chemotherapy is working for you and how many chemos you will need.

8. I am scared, I saw how a cancer patient loses hair after chemotherapy, and they are always sick.

It is understandable that you are scared of the treatment. You will need to trust your doctor, for he/she will do all to help you fight this. If you wish to enroll into our Aastha program where a professional counselor will assist you on maintaining mental health. Call +8801730018943, we are always here for your call from 10:00 am to 8:00 pm ( Saturday to Thursday)

9. I have been diagnosed with lung cancer, and I have to take chemotherapy. Will I be able to do regular things, like driving and going to office?

While some people are able to drive, work etc, some people are asked by the doctor not to. It depends on the extensiveness of your cancer and how your body is reacting to the treatment. If you feel unwell it is better not to do these. Also, if you do drive, it is better to have someone with you.

10. I had lung cancer and I have been treated. Is there any chance I might suffer from lung cancer again?

Unfortunately, being treated for lung cancer once it does mean it will not happen again. People who have had lung cancer can still get the same types of cancer. In statistics, they might be at higher risk.