Liver Cancer | Liver Cancer Symptoms & Signs

  • Lung 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 coughed out.

    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 develop.

    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.


    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 weight loss.
    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.

    Sputum cytology
    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.
    C.T. scans
    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 the cancer.

    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 normal life.

    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 stream.

    Q: How common is lung cancer in Singapore?

    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 are

    · Environmental tobacco smoke (or passive smoking)
    · Occupational exposure to asbestos & radiation
    · 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 following tests:

    · 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 lung cancer.

    Q: What are the methods of treatment available for lung cancer?

    Surgery, radiation therapy & chemotherapy

    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 cancer.

    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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