Study of clinical presentations of lung cancer in tertiary level hospital
DOI:
https://doi.org/10.18203/2349-3933.ijam20220117Keywords:
Clinical presentations, Lung, cancerAbstract
Background: Lung cancer is the most common cancer diagnosed worldwide. It is also the leading contributor to cancer-related mortality, resulting in around 1.38 million cancer deaths per year worldwide. The aim and objective of the study was to study the clinical presentations including paraneoplastic manifestations and metastatic effects of lung cancer and to identify reasons for delay in diagnosis of lung cancer.
Methods: Hospital based observational study was conducted on 100 consecutive cases.
Results: Mean age of the cases with lung cancer was 56.36 years and 30% of the cases. Male predominance was seen with 63% males to 37% females. Tobacco smoking was present in 59% cases while exposure to second hand smoke and biomass fuel was seen in 11% and 9% patients. Most common presenting symptoms were cough (22.21%), chest pain (16.13%), fever (14.37%), dyspnea (11%) and hemoptysis (5.22%). Most common type of lung tumor was Adenocarcinoma (53%) followed by Small cell carcinoma (22%) and Squamous cell carcinoma (19%). Mutation analysis by molecular testing where possible in 76.66% NSCLC cases and showed with RAS (26.19%), EGFR (23.8%), ALK1 (11.9%) and ROS (4.7%) mutation. Stage I and II of lung cancer was seen in 17% cases while stage III and IV was seen in 39% and 44% cases respectively.
Conclusions: Present study shown tobacco smoking as the most common risk factor in the causation of lung cancer (59%) followed by passive smoking (11%) and biomass fuel exposure (9%). Mortality in the present study was 72% in 2 years of follow up and Median survival in the study was 11 months. We recommend high index of suspicion in the high-risk groups as smokers and those with chronic respiratory diseases to avoid delay in diagnosis.
References
Sethi T. Lung cancer Introduction, Review series. Thorax. 2002;57:992-3.
Khuri FR, Herbst RS, Fossells FV. Emerging therapies in non small-cell lung cancer. Ann Oncol. 2001;12:739-44.
West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Thorax. 2000;55:987-99.
Thankappan KR, Thresia CU. Tobacco use & social status in Kerala. Indian J Med Res. 2007;126:300-8.
Pai SA. Gutka banned in Indian states. Lancet Oncol. 2002;3:521.
Jindal SK, Behera D. Clinical spectrum of primary lung cancer – review of Chandigarh experience of 10 years. Lung India. 1990;8:94-8.
Kenfield SA, Wei EK, Stampfer MJ, Rosner BA, Colditz GA. Comparison of Aspects of Smoking Among Four Histologic Types of Lung Cancer. Tob Control. 2008;17:198-204.
Khurana S. Lung cancer. Available at: https://docs.google.com/viewer?a=v&q=cache:kcjOH8ZHPzMJ:sancd.org/upl oads/pdf/lungcancer-factsheet. Accessed on 20 June 2021.
Tobacco Free Initiative (TFI). World Health Organization. Available at: http://www.who.int/ tobacco/research/cancer/en/. Accessed on 26th November 2011.
Beckles AM, Spiro SG, Colice GL, Rudd RM. Initial evaluation of patients with lung cancer. Symptoms, signs, laboratory tests and paraneoplastic syndromes. Chest. 2003;123:975.
Wilker JD, Fidias, P, Veikers, L, Perer, R P. Malignancy related pericardial effusion. 127 cases from the Roswell Park cancer Institute. Cancer. 1995;76:1377.
Alberg AJ, Samet JM. Chapter 52: Epidemiology of lung cancer. 2016.
Dubey N, Julka A, Varudkar HG. A Clinicopathological profile of primary lung cancer patients presenting in a rural medical college of central India. Panacea J Med Sci. 2015;5:124-9.
Rawat J, Sindhwani G, Dushyant G. Clinico, a pathological profile of the lung cancer in Uttrakhand. Lung India. 2009;26:74-6.
Hyde L, Hyde CI. Clinical manifestations of lung cancer. Chest. 1974;65:299.
Chute CG, Greenberg ER, Baron J. Presenting conditions of 1539 population-based lung cancer patients by cell type and stage in New Hampshire and Vermont. Cancer. 1985;56:2107.
Kosmidis P, Krzakowski M, ECAS Investigators. Anemia profiles in patients with lung cancer: what have we learned from the European Cancer Anaemia Survey (ECAS)? Lung Cancer 2005;50:401.
Kasuga I, Makino S, Kiyokawa H. Tumor-related leukocytosis is linked with poor prognosis in patients with lung carcinoma. Cancer. 2001;92:2399.
Dasgupta D, Aggarwal A, Jindal S. Pulmonary effects of passive smoking: The Indian experience. Tob Induc Dis. 2002;1:129-36.
List AF, Hainsworth JD, Davis BW. The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in small-cell lung cancer. J Clin Oncol. 1986;4:1191.
