E cigar was launched to replace cigarettes and to reduce side effects associated with smoking. These are usually thrown in different flavours to lure the young population. Although these vapes are introduced as a replacement for tobacco, are these without the associated risks? It was not cleared by any study.
E-cigs usually contain nicotine solution and a heating element that vaporizes the liquids and forms vapours. These vapours are typically inhaled to alleviate the harmful effects of smoking on the physiology of the body. But soon, it was known that sharing this led to the transmission of respiratory infections from one person to another. In addition, in covid pandemic times also leads to illness outbreaks.
E-cigs latest models are like USB sticks that can be charged with laptops and used at will. This is, in reality, an explicit abuse of technology. Moreover, these are not launched to target motivated persons who want to quit smoking. Instead, it was marketed everywhere. Different vibrant colours and flavours attract the juvenile population.
It is always argued by inventors that it will help smokers return to their everyday life, but the way it is being marketed, we can predict it’s like planting trojan horses in young minds. Very soon, if this practice is not curbed, it will affect the health of society. Vapes don’t lead to cancer. There is no precise data; there are few initial predicting papers that say it can lead to lung cancer.
Smoking is difficult to quit. In addition, it needs counselling, motivation, and medical support; otherwise, relapse is inevitable. It was initially approved to help smokers, but the main agenda of manufacturers is to bypass pharmacies and prescriptions to buy e-cig. The moment the manufacturer succeeds in its intentions, it will come to market as an alternative to smoking.
To stop this menace from coming to market and in reach of young people, Government should make stringent laws to control the supply chain.NGOs should come together to fight this menace. This monster that started in developed countries is now knocking at our door. There is a lot of advertising on social media, and it is regrettable to state that it is now available in Jammu and Kashmir too.
Parents should observe this menace as it is already creeping into their daily lives.
Lung cancer is the most typical cancer nowadays, and cases are rising. Soon it will become number one all over the world. It accounts for 11 to 15% of all new cancer cases and 19% of cancer-related deaths worldwide. There were two lakh new lung cancer cases estimated to occur in 2012. In India, lung cancer constitutes 7 per cent of all new cancer cases and 9.3 per cent of all cancer-related deaths in both sexes.
Lung cancer starts in the windpipe (trachea) and can involve the primary airway and the lung tissue. However, lung cancer may originate in any part of the lungs or airways. These are part of the breathing pathway.
The breathing system involves the nose and mouth, trachea, and airways to each lung (left and right bronchus) and lungs.
Risk factors for Lung Malignancy
Smoking tobacco is the most significant cause of lung cancer in India. Around seven out of ten lung cancers are caused by Smoking, including second-hand and Third-hand Smoke.
Even occasional Smoking leads to an increased risk of lung cancer. But the risk dramatically rises as the duration and no of pack years increases. So avoiding Smoking is the best thing you can do for your health. The sooner you stop, the better outcomes are.
Some heavy metal compounds and environmental factors also increase the risk of lung cancer. These include asbestos, silica, and diesel exhaust. People usually get exposed to these substances through their occupational work.
Asbestos was used in the construction industry and shipbuilding in the late sixties. Few workers in older buildings still get exposed to it. However, there are strict laws in foreign lands about work that involves asbestos: for example, when working in or repairing structures containing asbestos. Smoking also increases the risk of asbestos exposure.
Silica substances are used in some industrial materials, such as bricklaying and glass making. People who have worked and been exposed to silica have a slightly increased risk of lung cancer. It can lead to a condition known as silicosis, which increases the risk of lung cancer. Underlying lung diseases can rise your risk of lung cancer. These risks are usually higher in smokers.
Chronic obstructive pulmonary disease (COPD) is also chronic obstructive airways. It means long-term lung illnesses such as emphysema and chronic bronchitis. COPD usually develops after long-term damage to your lungs from breathing in a harmful substance, usually cigarette smoke or working in the polluted environment. The risk of lung cancer is higher if you have COPD or lung infection (pneumonia) compared to people who don’t have it.
Researchers are investigating at how our genes could affect our risk of lung cancer.
People at risk of Lung Tumours
Lung cancer is more common in the older population. More than 70 per cent of the time, it is associated with Smoking. Other risk factors include exposure to radon gas, exposure to certain chemicals in the workplace, a family history of lung cancer and cancer treatment for different types of cancer.
Investigations needed for Diagnosis
CT scan
A CT scan is a investigation that uses x-rays and a computer algorithm to create detailed pictures of the body. First, it takes pictures from different angles. Then, the computer puts them together to make a three-dimensional (3D) image.
Bronchoscopy and Biopsy
A bronchoscopy is a test to examine the inside of your lungs’ breathing tubes (airways). Your Doctor can see any abnormal areas and take samples (biopsies) to test. An endobronchial ultrasound can show if it’s lung cancer and the size of the tumour. It can also reveal if cancer has spread into other lung areas or outside the lung.
WBPETCT
PET/CT is a valuable modality in evaluating lung cancer (NSCLC and small cell lung cancer). One essential indication is evaluating a single, isolated pulmonary mass ( nodule) (less than or equal to three cm in length). These are usually detected incidentally on chest radiographs or chest CT scans. This will help in metastatic evaluation also.
Impact of Stage and grade
The cancer stage tells you how big it is and whether it has spread. The type tells which type of cell cancer started from, and the grade means how abnormal the cells look under the microscope.
Knowing the stage, type and grade of cancer can help doctors plan your treatment.
The staging systems used for lung cancer can seem complicated. But it can be easily understood with the help of your Doctor.
Types of lung cancer
After Biopsy, The pathologist tells you the type of cell cancer seen in microscopic slides. This information will help the Doctor to decide on the treatment.
Cancer that originates in the lung is called primary lung cancer or denovo lung cancer. If cancer spreads to lungs from somewhere else in your body, then this is metastatic/secondary lung cancer.
There are different types of primary lung cancer, and they are divided into two main groups:
Small cell lung cancer (SCLC)
Non-small cell lung cancer (NSCLC)
In this writeup, we will discuss mainly NSCLC
Non-Small Cell Carcinoma
Around 80 to 85 of 100 lung cancers are non-small cell (NSCLC). The three main types are adenocarcinoma, squamous cell carcinoma and large cell carcinoma. They are grouped because they behave similarly and respond similarly to treatment.
Treatment for non-small cell lung cancer (NSCLC)
A team of Physicians and other professionals( like medical Physicists) discuss the best treatment and care for you. They are known as multidisciplinary teams (MDT). Your treatment depends on the location of cancer, its stage, grade and body fitness level.
Treatment Overview
The main treatments are surgery, chemotherapy, Radiotherapy, chemotherapy with Radiotherapy, targeted cancer drugs, immunotherapy and symptom control treatment.
Treatment by stage
Early-stage cancer means your cancer is small and is contained inside the lung. It hasn’t spread to lymph nodes. Surgery is the primary treatment.
Sometimes we add chemotherapy after surgery to avoid cancer coming back. However, If you aren’t fit enough for surgery, you might have Radiotherapy. For advanced disease, chemoradiotherapy – chemotherapy with Radiotherapy is used. Multiple combinations of treatment are possible. Sometimes the aim is only to control cancer for as long as possible and help with symptoms. This can be possible with chemotherapy; Radiotherapy targeted cancer drugs and immunotherapy.
Screening
Screening means testing people for the early stages of a disease before they have any symptoms. For screening to be functional, the tests need to be reliable at picking up cancers and, overall, it should do more good than harm. It can be used by people who smoke or used to smoke. Nowadays, there is good evidence that screening saves lives. However, tests can also find lung changes that look like cancer. This leads to further tests such as a biopsy. These additional tests can also have risks.
Lung screening might also cause overdiagnosis. Overdiagnosis means that some lung cancers found through screening might never become life-threatening. Instead, they are likely to cause anxiety.