Liver Cancer | Liver Cancer Symptoms & Signs
cancer is the leading cause of cancer in
men and the second most common cancer in
women. One out of every five persons who
died from cancer had lung cancer. An
estimated 85% of lung cancer cases in
males and 75% in females are caused by
cigarette smoking. Less than 10% of lung
cancers occur among non-smokers. The
risk of lung cancer for the smoker is 15
to 25 times increased. When the smoker
stops smoking, the risk of lung cancer
dropped to 2 times the risk of a
non-smoker after 10 to 15 years. The
best safeguard against lung cancer is
never-smoke; and if you smoke stop now.
The air we breathe in enter the lungs
through the trachea and then the right
and left bronchi. The bronchi are
airways that branch into smaller airways
and finally the air sacs. Oxygen is
absorbed and carbon dioxide expelled via
the surface area of the air sacs. The
average lung has more than 300 million
of these air sacs.
Mucus produced by the cells in the
airways trap the foreign material that
enter the airway. Tiny hair-like
structures called cilia sweep the mucus
toward the throat where it can be
THE SMOKED-DAMAGED LUNG
Consistent insult eg. due to smoking, to
the cell lining of the airway will cause
an increase in the production of mucus.
The tiny-hair in the air passages become
worn away and are unable to sweep
foreign particles out of the throat.
Very often the smoker try to cough out
the mucus. Chronic smokers have been
heard to cough frequently in the
morning. In more advanced cases, the air
sacs become destroyed and abnormal
growth patterns leading to cancer may
THE CANCEROUS LUNG
Lung cancer can
take 10 to 30 years to develop.
Hence it is frequently seen in
middle-aged and elderly persons. In lung
cancer, the cells lining the airways
grow and divide without control so that
an abnormal mass is formed. The cancer
cells grow and spread to the other parts
of the body. Lung cancers tend to spread
more quickly because the lungs are
supplied richly by blood vessels and
lymphatic vessels. When the cancer
spreads through the lymph channels, it
can cause enlarged lymph glands. When it
spreads through the blood stream, the
cancer cells spread to the liver, bone,
brain or the other lung.
WHAT CAUSES LUNG CANCER?
CIGARETTE SMOKING is the main cause of
lung cancer. It is responsible for 90%
of lung cancer deaths. With the
increasing number of years of smoking,
the number of cigarettes smoked each day
and the tar and nicotine contents of the
cigarettes; the risks of developing lung
cancer will be increased.
PIPE AND CIGAR SMOKING - The risk of
lung cancer is also increased in pipes
and cigars smokers though less than
those who smoke cigarette.
INDUSTRIAL HAZARDS - Exposure to certain
workplace chemical and minerals increase
the risk of lung cancer eg. asbestos,
coal gas, chromates, nickel, arsenic,
vinyl chloride, mustard gas, radon
by-products of uranium mining and
processing. Asbestos workers who also
smoke increase their risks of developing
lung cancer 60 times.
PASSIVE SMOKING - Non-smoking wives who
inhale their husbands smoke have a 35%
higher risk of developing lung cancer.
Persistent cough and shortness of
breath. If you have a cough that does
not improve with treatment, a chest
x-ray should be done especially when
there is associated shortness of breath.
Blood in the sputum.
Chest pain - Chest pain may occur in
association with a chronic cough.
Recurrent chest infection, fever and
In many cases, the cancer has spread to
the other parts of the body causing
secondary changes such as liver
enlargement, pallor (lack of blood
causing the patient to look pale), lymph
node enlargement etc.
History and physical examination
As in any disease, before the doctor
diagnoses, he will first take the
medical history and exam the patient.
Subsequent investigations will be taken
to confirm the diagnosis.
Chest x-rays are valuable in the
diagnoses of lung cancer.
In some cases, examination of the sputum
under the microscope may reveal cancer
cells. Cancer cells may be coughed up
from the lungs or airways.
A fibre-optic tube is passed through the
nose or mouth into the trachea to the
airways or bronchi. Suspicious-looking
growth can be biopsied (a small piece of
tissue is taken for examination under
the microscope) to confirm cancer.
Computerized tomography scans are x-ray
beams that rotate around the body to
produce series of x-rays taken from
different angles. The information is
then processed by a computer to produce
a complete picture or a cross-section of
a part of the body.
Magnetic Resonance Imaging can build
composite 3-dimensional images of
sections of the body.
An operation is done when the surgeon
believes that the cancer is present and
investigations cannot locate the site of
Surgery, radiation and chemotherapy are
the three main methods of cancer
treatment. The type of treatment depends
on the size, extent of the disease, the
type of lung cancer and the general
health of the patient.
Part of the lung or the whole lung may
be removed in the treatment of lung
cancer. Before surgery, the patient will
undergo a lung function test to assess
the functional capacity of the existing
lung. After surgery, these patients may
require assisted ventilation for a short
period. Physical activities may also be
limited for a short period. If the
remaining lung function is good, the
patient will be able to continue a
Certain type of lung cancer are
sensitive to chemotherapy treatment.
This form of treatment is increasingly
being used in combination with surgery
or with radiation. As newer drugs are
discovered and their range of efficacy
increased, the use of chemotherapy will
increase. Side-effects of chemotherapy
such as nausea, vomiting and diarrhoea
can be overcome with medications.
Radiation or the use of x-rays to treat
lung cancer may be in conjunction with
surgery or as a palliative treatment to
relieve the pressure symptoms or pain
caused by the lung cancer. Side-effects
of radiation such as tiredness, skin
rash or sore throat are transient.
Lung cancer occurs when normal cells, as
a result of chronic irritation, become
abnormal and keeps on dividing, forming
more and more abnormal cells without
control or order. The malignant tumours
can invade & damage nearby tissues &
organs. It can spread to other parts of
the body such as bones, liver & brain
through the lymphatic system or blood
Q: How common is lung cancer in
Lung cancer is the most common cause of
death in Singaporean men & the 3rd most
common cancer in women.
Q: What causes lung cancer?
Cigarette smoking. This is the major
cause of lung cancer and accounts for
about 90% of all lung cancer. The risk
of lung cancer increases when one starts
smoking at an early age, or inhales
relighted half-smoked cigarettes. It
also increases with the number of
cigarettes smoked each day, and with the
number of years of smoking. Other causes
· Environmental tobacco smoke (or
· Occupational exposure to asbestos &
· Contact with the processing of steel,
nickel chrome & coal gas
· Atmospheric air pollution
Q: What are the symptoms of lung cancer?
They symptoms may be persistent cough,
shortness of breath, blood stained
sputum, chest pain, & repeated bouts of
bronchitis or pneumonia.
In later stages, people may experience
fatigue, weight loss, extreme shortness
of breath, difficulty in swallowing and
hoarseness of voice, clubbing of
fingers, & symptoms of fluid being built
up in the chest.
Sometimes, symptoms that seem unrelated
to the lungs may actually be caused by
the spread of a lung cancer.
Q: How is lung cancer diagnosed?
Lung cancer may be detected through the
· Chest x-rays
· CT scans
· Sputum test
· Removing lung tissue sample for
microscopic examination through a
bronchoscope or needle aspiration
· Removing fluid from the lung to check
for cancer cells
Sometimes surgery is needed to diagnose
Q: What are the methods of treatment
available for lung cancer?
Surgery, radiation therapy &
If the cancer is confined to the lung,
surgery gives the best chance of a cure
except for small cell lung cancer.
Depending on the size, location, extent
of the cancer, the general health of the
patient & other factors, different types
of surgery will be used. It is
unfortunate to note that 75% of all
patients are in either advanced stage or
have too poor lung function for surgery.
Radiotherapy, given in 5 days a week for
several weeks, is used to destroy cancer
cells and to relieve pain in advanced
Chemotherapy is the treatment of choice
for those with small cell lung cancer.
Unfortunately, recurrences are common
and only a small number are curable.
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