Lung cancer treated with low-dose CT scans.

• Lung cancer is a condition where cells in the lung tissue divide abnormally and uncontrollably, forming a malignant tumor that damages the lungs and can spread to other organs such as lymph nodes, the brain, and bones.
• Causes include smoking and secondhand smoke, along with other factors such as air pollution, PM 2.5, exposure to carcinogens, asbestos, radon gas, arsenic, certain chemicals/heavy metals, genetics, and previous radiation therapy to the chest.
• Symptoms to watch for include a persistent cough lasting more than 3-4 weeks, coughing up blood, shortness of breath, difficulty breathing, chest pain, hoarseness, rapid weight loss, loss of appetite, or recurrent pneumonia/bronchitis in the same lung.
• Low-dose CT scans are a type of computed tomography (CT) scan of the lungs using a low dose of radiation to detect small masses or abnormalities in the lungs before symptoms appear. This helps detect lung cancer in its early stages, increasing the chances of a cure and reducing the mortality rate.

Currently, lung health is a crucial issue that everyone should not overlook, as lung cancer remains one of the leading causes of death in Thailand. Many people mistakenly believe that this disease only affects heavy smokers, but in reality, environmental risk factors such as dust and smoke are significant triggers that can also affect non-smokers. Now, there is also the option of Low-Dose CT Scan, a new form of treatment. This article will explore this new treatment in more detail and examine other causes besides smoking.

What is Lung Cancer?

Lung cancer is a condition where cells in the lungs grow abnormally and divide rapidly and uncontrollably, forming tumors that can spread to nearby tissues or metastasize throughout the body through the bloodstream and lymphatic system. This disease has a high mortality rate and is one of the most common cancers because it often does not show clear symptoms in its early stages. As a result, it is usually detected when the disease has progressed to an advanced stage, making treatment difficult.

What are the symptoms of lung cancer?

Lung cancer often doesn't show obvious symptoms in its early stages. Symptoms only become apparent and persistent as the disease progresses. If you experience any of the following warning signs, you should see a doctor immediately for diagnosis

• Coughing problems Chronic coughing for several weeks, or a cough that is different from your usual pattern, including coughing up blood or blood-tinged sputum.
• Respiratory problems Difficulty breathing, wheezing, or chest pain when coughing and taking deep breaths.
• Weakness Rapid and unexplained weight loss, fatigue, easy tiredness, and loss of appetite.
• Frequent pneumonia or bronchitis; hoarseness or changes in voice.
• Other physical symptoms Swelling of the face or neck, which may be caused by blood vessel blockage in that area.

How many stages are there in lung cancer?

Small Cell Lung Cancer (SCLC)

This is a rare but fast-growing and rapidly invasive type. It is divided into two stages

• Landemic stage The cancer is confined to one lung and nearby lymph nodes. Treatment involves radiation therapy combined with chemotherapy.
• Metastatic stage The cancer has metastasized to one lung and nearby lymph nodes. Cancer spreads to the other lung or distant organs such as the brain or liver. Treatment focuses on chemotherapy and palliative care.

Non-Small Cell Lung Cancer (NSCLC)

This includes large cell lung cancer, which grows and spreads rapidly. According to international standards, lung cancer is classified into 4 stages

• Stage 1 The tumor is confined to the lung tissue and has not spread elsewhere.
• Stage 2 The cancer has grown larger or begun to spread to lymph nodes near the lung.
• Stage 3 The cancer has spread to lymph nodes in the chest or adjacent tissues, such as the chest wall.
• Stage 4 The cancer has spread through the bloodstream to other organs in the body, such as bones, liver, or brain.

Understanding Risk Factors Lung cancer is not caused solely by smoking.

The belief that "not smoking equals no risk" or "having smoked for a long time is okay means you're safe" is a misconception. While smoking is the primary cause, other factors can trigger the disease, such as air pollution, chemical residues, and genetics. Those exposed to secondhand smoke or continuously in toxic environments are at risk just as much as smokers themselves. Even those who smoke and show no symptoms are not at risk. Just because the disease hasn't shown symptoms or hasn't been detected yet doesn't mean your body is safe from lung cancer.

Lung cancer is caused by a combination of factors, both avoidable and difficult-to-control health factors, including

• Smoking Both traditional cigarettes and e-cigarettes are the primary cause, especially for those who smoke continuously for a long time.
• Secondhand smoke Regularly inhaling secondhand smoke from others increases the risk even if you don't smoke yourself.
• Toxic substances and chemicals Exposure to asbestos, radon gas, or hazardous chemicals from industrial factories.
• Air pollution Particulate matter (PM2.5) is a significant trigger for the disease today.
• Genetics Individuals with a family history of lung cancer have a higher risk than the general population.
• Lung health history A history of chronic lung diseases such as tuberculosis or chronic obstructive pulmonary disease (COPD).
• People who have previously received radiation therapy to the chest for other types of cancer have a higher chance of developing lung cancer, leading to more difficult treatment.

E-cigarettes vs. Regular Cigarettes: Which is More Dangerous?

E-cigarettes

• Toxic Substances and Carcinogens: E-cigarette liquid contains nicotine, volatile chemicals, and heavy metals. When heated, these substances create inflammation in the airways and can trigger cell mutations leading to cancer.
• Acute Dangers: There is a risk of severe epileptic malignancy (EVALI), which can result in respiratory failure and death shortly after starting to use.
• Cardiovascular Effects: The high nicotine content in e-cigarettes makes them highly addictive and increases the risk of ischemic heart disease, myocardial infarction, and stroke.
• Impact on Those Around You: The vapor is not just a mist; it contains toxins and fine dust particles that put those nearby at risk of asthma and chronic coughing, similar to secondhand smoke.

Regular Cigarettes

• A Source of Carcinogens: Cigarette smoke contains over 7,000 toxic substances, including at least 70 carcinogens, and carbon monoxide, which interferes with oxygen transport in the blood.
• Damages the Respiratory System: A major cause of lung cancer and chronic obstructive pulmonary disease (COPD), and increases the risk of respiratory infections.
• Harms Every Body System: Increases the risk of stroke and sudden heart attack, and causes high blood pressure. It also leads to decreased sexual performance and faster organ deterioration.
• The Dangers of Secondhand Smoke: Cigarette smoke severely affects family members, especially children and the elderly, increasing the risk of allergies, asthma, and lung cancer even for those who don't smoke themselves.

What is a Low-Dose CT Scan?

A Low-Dose CT Scan (LDCT) is a chest X-ray that uses a much lower dose of radiation than normal, but provides high-resolution 3D images. It can accurately detect small nodules or tumors, just a few millimeters long, better than a standard chest X-ray. This method is quick, painless, and does not require contrast dye, making it an important standard for early lung cancer screening.

Advantages of Low-Dose CT Scans:

• Low and Safe Radiation: Reduces radiation accumulation in the body by using significantly less radiation than a normal CT scan, while maintaining clarity for diagnosis.
• Early Disease Detection: Discover abnormalities in their early stages, even before symptoms appear, increasing the chances of a cure and reducing mortality by 15–30% compared to conventional X-rays.
• High Accuracy: Provides clear 3D images showing the location, size, and shape of tumors, helping doctors plan treatment accurately. Convenient and fast. The process is simple, taking only 5–10 minutes. No fasting is required (for general screening), and you can return to your normal life immediately after the test.
• Ideal for high-risk groups. It's the best option for heavy smokers or those continuously exposed to carcinogens, allowing for proactive screening without waiting for symptoms to appear.

Who Should Undergo a Low-Dose CT Scan?

• Heavy smokers aged 50-80 with a cumulative smoking history of 20 packs/years or more (calculated as number of packs smoked per day × number of years) are considered a high-risk group and should be screened regularly.
• Former smokers, even if they have quit, but previously smoked heavily (more than 20 packs/year) and quit within the last 15 years, are still at high risk. Annual screening is recommended.
• People exposed to secondhand smoke, those who are in close proximity to smokers in their homes or workplaces for extended periods, should consider screening due to accumulated exposure to toxins.
• People living in highly polluted areas, especially those regularly exposed to PM 2.5, traffic pollution, or living near industrial factories.
• People exposed to carcinogens at work, such as asbestos, radon gas, arsenic, or chemicals in industrial and mining operations.
• People with a family history of lung cancer in a direct lineage. If a parent or sibling has had the disease, they have a higher than normal genetic risk and should be screened for abnormalities early on.
• People aged 50 and older with risk factors, even just one factor combined with age, are recommended to have an annual LDCT scan for safety.
• People with chronic symptoms such as a cough lasting more than a month, coughing up blood, weight loss, or unexplained fatigue may be ordered by their doctor for detailed diagnosis.

What are some current ways to observe lung cancer symptoms?

Although early symptoms can be difficult to detect, if you experience the following symptoms persistently, you should see a doctor for a thorough diagnosis:

• Chronic cough: A cough lasting more than 3-4 weeks, whether dry or with phlegm, and that doesn't improve after medication. For smokers, a change in the pattern of the cough, such as frequent coughing or a change in the sound of the cough, should be especially concerning.
• Coughing up blood: This is a dangerous sign that should not be ignored. Even a small amount of blood in the sputum requires immediate medical attention because it may be due to a tumor compressing blood vessels in the bronchi or lungs.
• Chest pain: A deep, dull or sharp pain in the chest that worsens with deep breathing, coughing, or laughing. This may be due to cancer spreading to the pleura or chest wall.
• Hoarseness: If hoarseness persists for more than 2 weeks without a clear cause, and is not due to a cold or excessive voice use, it may be due to a tumor compressing the nerves that control the larynx.
• Difficulty breathing or wheezing: When a tumor obstructs the airway, it causes shortness of breath. Easy fatigue even with light activity or wheezing during breathing due to airway narrowing.
• Recurring respiratory infections: Frequent pneumonia or bronchitis in the same area may be caused by a tumor obstructing mucus drainage, allowing pathogens to accumulate and making infections easier.
• General, nonspecific symptoms: Because fighting cancer requires a high level of energy, the body may experience other symptoms such as:
  Severe fatigue without a known cause.
  Rapid and unusual weight loss.
  Loss of appetite; not wanting to eat the usual foods.

Lung Cancer Treatment at Vibhavadi Hospital

Lung cancer often shows no symptoms in its early stages, making it difficult to detect. If you experience symptoms such as chronic coughing, coughing up blood, chest pain, or a sore throat even without a cold or straining your voice, you can get checked at Vibhavadi Hospital. We are equipped with expert physicians and state-of-the-art equipment to ensure timely and targeted treatment for long-term lung health.

Summary

Lung cancer is a condition where cells divide abnormally, forming a tumor. It is often detected in the metastatic stage because the early stages have no clear symptoms. Major risk factors include smoking (all types), secondhand smoke, PM 2.5 pollution, and genetics. Important warning signs to watch for include chronic coughing, coughing up blood, difficulty breathing, or unusual weight loss.

Those in high-risk groups, such as heavy smokers or those with a family history of lung cancer, should undergo screening with high-resolution, low-radiation Low-Dose CT Scan technology. This helps detect abnormalities in the early stages, significantly increasing the chances of a cure and reducing mortality. You can get screened at Vibhavadi Hospital. We are ready to provide consultation, self-care advice, and preparation for lung cancer screening with specialized physicians to help you maintain better health.