Pathophysiology of Lung Cancer

Lung cancer can be defined as a neoplasm in the lungs' cells, either small-cell or non-small cells. Also, the cancer can start in the lungs, or elsewhere in the body, and travel through the blood to the lungs. Lung cancer has one main protagonist that causes it; smoking. Undoubtedly, the numbers are high; is the third most common cancer in the United States (VanMeter & Hubert, 2015). Nevertheless, the recurrence has lowered, but the mortality is high. According to the American Cancer Society, by 2018, there would be around 234,030 new cases of lung cancer; 154,050 deaths from lung cancer, impacting almost equally women and men. (American Cancer Society, 2018). Furthermore, African-American men are more susceptible to develop this disease as well with around a 20% chance (American Cancer Society, 2018).

Etiology

Smoking is the main predisposing factor when it comes to lung cancer, which is around 90% the causative agent in developing it (Ridge, McErlean, & Ginsberg, 2013, p. 96). Additionally, being a passive inhaler can also be a major risk factor in developing lung cancer. The major culprit are the chemicals in cigarettes which cause changes in the lung tissues. For instance, chemicals like asbestos and radon are some of the major chemicals that when inhaled are detrimental for the lungs' tissues and cells (Ridge, McErlean, & Ginsberg, 2013, p. 96). When it comes to cells, genetic material can sometimes play a role in either developing lung cancer or being exempt from it. Nevertheless, a non-smoker and a smoker can both develop lung cancer. Also, all of the above factors contribute to developing chronic obstructive pulmonary disease, which also contributes to developing lung cancer as well. Once a person survives lung cancer, that survivor status places the individual at risk for recurring lung cancer as well. On the other hand, other risk factors for include age, gender, and lifestyle as well. The older a person is, the more likely he or she is to develop cancer which can also metastasized as lung cancer too. Lastly, it has always been proven that an active lifestyle is one of the major preventions of any type of diseases, but some risk factors cannot be change, like age.

Pathophysiology Process

There are three types of lung cancer: adenocarcinoma, squamous cell carcinoma and small-cell lung cancer. When it comes to causes like COPD and how it relates to lung cancer, it must be observed at a cellular level. COPD is known for the inflammation that forms in the lungs, this inflammation is the result of various irritants that were inhaled, and the body is reacting to them (Miao et al, 2018). Many cells are part of this inflammation in COPD like macrophages, epithelial cells, dendritic cells, neutrophils, eosinophils, and T and B lymphocytes. This prolonged edema causes emphysema in the lungs which is damage to the air sacs that enable the gas exchange during the breathing process. While this is happening, the body will try to compensate by coughing and showing hypertension. Since there is an obstruction in the lung tissues, there will be an inadequate oxygen and carbon dioxide exchange as well. In hindsight, all these cellular level degenerative problems happen as well in smoker's lungs; since cigarettes contained several carcinogenics and irritants.

Clinical Manifestations

The manner in which cancer manifest in the body happens in numerous ways, nevertheless signs do not show when the cancer is in its early stages. For instance, shortness of breath and cough are the main signs since there is a buildup of mucus in the bronchioles and the body compensates with coughing to excrete the mucus. Nevertheless, due to the immense edema and emphysema, the mucus remains in the lungs. Moreover, the signs stated above also cause shortness of breath since the alveolus cannot expand properly; the inspiration/expiration is incomplete. There is also coughing up blood (hemoptysis) which is a sign of major tissue damage in the lungs. As result of the excessive inflammation in the lungs, individuals will experience chest pain since the pleural is inflamed and irritated with the coughing and emphysema. Consequently, as the lung cancer progresses, the more pain and complications an individual will experience. If left untreated, lung cancer can metastasize to other regions in the body through the circulatory system. If it metastasizes, cancer will be fatal to the individual.

Diagnostic

There are a couple of diagnostic tests physicians employ to detect lung cancer. For instance, an imaging test like an X-ray of the chest portion, would show any abnormal growths on the lungs like nodules or masses. Also, others imaging tests that would give physicians a clearer image are CT scans which would show small lesions that would not be shown in a chest X-ray. Furthermore, a more specific or clearer test on a microcellular level would be a sputum cytology test. Samples taken from the lungs would be examined under a microscope to detect any abnormalities on a microscopy level. Also, a biopsy can be performed, which takes a collected portion of neoplasm to check for abnormal cells. Other test that would also aid in the diagnostic procedure would be testing the oxygen levels in the lungs and blood.

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