Lung Cancer constitutes more than 9% of deaths caused by cancer and it can be daunting. It is the most common type of cancer. You may have family members with lung cancer and people might have told you that it is genetic. But in this world of misinformation, it is very difficult to find facts. So here is all you need to know about lung cancer genetic testing and genetic testing for lung cancer risk.
Causes of lung cancer
- Smoking
Smoking, as well as second-hand smoke inhalation, create about 80% of total lung cancer deaths. Air pollution can also cause lung cancer.
- Asbestos
Asbestos is a naturally occurring mineral that can be subjected to through the air. People who work in labour-intensive industries like plumbing, mechanical works or near the sea, etc have a risk of being exposed to asbestos. Prolonged asbestos exposure can cause lung cancer in the healthiest of people. If working in environments where such exposure is imminent, one should talk to the doctor and take appropriate precautionary measures.
- Chemicals
Other workplace substances that might cause lung cancer include diesel exhaust fumes, arsenic, nickel, silica, soot, coal, radon, etc.
- Radon poisoning
A person can be vulnerable to radon poisoning even if they have no workplace relationship with it. Radon is a radioactive gas that can occur from the natural breakdown of soil, rocks, water, etc. It can seep through homes from the ground, into the air, through cracks holes and sometimes just doors. It is impossible to check for radon without professional testing as it is a colourless and odourless gas.
Is it genetic?
About 8% of patients with lung cancer carry a genetic predisposition for it. At times even if the genes themselves don’t make you sick, they make you susceptible to developing lung cancer through other generic means like smoking and chemicals. Genes cause some specific types of mutations in cancer cells. Tumour suppressor genes with mutations permit cells to replicate without limit, which thus causes tumours.
Some other types of mutations limit your body’s abilities to expel toxic substances and chemicals from your body or prevent cells from self-repair. While lung cancer can largely be inherited, sometimes the risk factor might be environments that families are collectively exposed to, for example, radon infected homes.
Genetic testing for risk of lung cancer
While a lot of people test themselves for genes of lung cancer, it is not very likely that a person with these genes will develop cancer. Genes increase the risk of developing cancer through other means like smoking or eating tobacco, even in small quantities. However, this argument would be redundant because doctors recommend “no smoking” to all.
Genetic testing is more useful in deciding treatments after you develop lung cancer. Some people with NSCLC- non-small-cell-lung cancer have mutations in two prominent genes – the EGFR gene (10% people) and the KRAS gene (25% people). The treatments then target these specific genes to make them more effective.
Treatments – Is lung cancer curable?
Several things factor into the treatment a patient receives for lung cancer. For example –
1. Type – The kind of lung cancer you have , for eg.- small-cell or non-small-cell, etc and how you have developed the cancer, like smoking, genetics, etc.
2. Stage – How far along it is, how much it has developed, has it spread to other body parts, etc.
3. Malignant or Metastasised – Whether the cancer is limited to one portion of your lungs or if it is spreading or has spread to the rest of your body.
4. Side effects – Specific treatments can have different side effects on your body depending on your age and other comorbidities.
5. Budget – In India, complex medical treatments can cost a handsome fee and many people are unable to afford quality treatment. So, many patients at times opt to go through with the treatments and then hope for the best.
The kinds of treatments available are:
- Surgery: Doctors opt for surgery when cancer has not spread too far and in the case of NSCLCs. In times of need, they might choose to remove an entire lung. Your doctor may use a thoracoscope, which is a flexible tube inserted through a tiny incision, it examines the chest and gets rid of the tissue. It is generally not possible to remove small-cell lung cancer through surgeries.
- Bronchoscopy: Tumours can grow to block a patient’s airways and cause shortness of breath. Doctors attach lasers to a tube, this is called a bronchoscope, and burn away parts of the tumour that may be blocking your airways. It can be used to place stents that will keep your airways open and help in breathing.
- Thoracentesis: Pleural effusion, is the build-up of fluid in your chest cavity or lungs can cause similar symptoms like shortness of breath, coughing, and chest pain. This procedure places a small tube in your chest which drains the fluid, the doctor may choose to leave it there if the build-up doesn’t stop.
- Radiofrequency Ablation: A thin needle inserted through your skin that touches the tumour will pass an electric current that heats and kills the cancer cells.
- Immunotherapy: It stimulates the body’s immune system to fight cancer on its own.
- Radiation: High-energy X-rays are aimed at a tumour through machines to destroy it. This helps attain relief from symptoms like pain or bleeding. This is often used to decrease the size of the tumour before surgery.
- Chemotherapy: These are medicines given to a patient in intervals of time. You may receive a single drug or a mix of several different ones, based on the doctor’s prescription.
Author’s note
It is to be kept in mind that in most cases, doctors opt to use a combination of several different treatments. While not always successful, through the right approach, lung cancer is very much curable.
Dr Manish Singhal is a medical oncologist and is an ECMO Gold Medalist, from All India Institute of Medical Sciences (AIIMS). He is also the executive committee member of the Indian Society of Medical and Pediatric Oncology. In the times of COVID-19, he has been conducting special video consultations and his clinic has been taking special precautions as per the guidelines. If you are looking for a lung cancer doctor in Delhi NCR Dr Manish Singhal is popularly known to be the best Cancer specialist in Delhi.
