Lung Cancer Awareness Month

Lung Cancer has the most common Cancer-related and tobacco-related mortality worldwide (1.38 million patients i.e 18.2 % of the total cancer death). It is also one of the commonest cancers in Males in developing countries so much that it is going to be an epidemic of Lung cancer in near future. However, there have been advancements in medical science right from preventive strategies to therapeutic strategies which bring a ray of hope in such a dismal scenario The month of November is designated for Lung cancer awareness by various Cancer organizations across the world. 


Who are at Risk of Lung Cancer?

  • Smoking, including passive smoking, is the most important risk factor for lung cancer. By destroying the cells that line the lungs, smoking causes lung cancer. 

  • Other risk factors of lung cancer include daily exposure to radiation therapy, radon gas, asbestos and other carcinogens, family history, old age, obesity, alcohol abuse and viral infections, such as Human Papilloma Virus. 


What are the symptoms of Lung Cancer?

Symptoms associated with Lung Cancer are:

  • Continuous cough 

  • Chest and abdominal pain

  • Blood present in cough

  • Shortness of breath

  • Hoarseness

  • Sudden loss of weight

  • Bone pain

  • Headache


Prevention of Lung Cancer- How to do it

There is no specific method to prevent lung cancer. However, the risk can be lowered by carrying out the following practices:

  • It is advised to quit smoking. Try a nicotine patch or chew nicotine gum to help you quit smoking.

  • If you live with a friend who smokes, encourage him or her to avoid smoking or invite him or her to smoke outdoors. It's as unhealthy to smoke passively as overt smoking. Stop visiting smoking-prone areas, such as bars and nightclubs. Instead, search for smoke-free alternatives.

  • A person working in an industry and hazardous place should take necessary precautions not to inhale toxic substances. Wear a face mask in crowded areas and places related to industrial production.

  • Maintain a healthy lifestyle. Do cardio exercise daily and stay away from alcohol.

  • Maintain a balanced diet. The diet should be rich in fruits and green leafy vegetables. 

  • Do pranayama and meditation.

Initiatives like an increase in the size of warning pictures on cigarette packaging and launch of Mobile app support to Quit tobacco have been important initiatives by the health ministry.

Secondary Prevention or Screening – A low dose CT scan carried out as a screening program in smokers did show some benefit of catching lung cancer early and should be considered in heavy smokers.

What are the advancements in Therapeutic Strategies?

Biopsy in Lung Cancer- Its Importance

The core advancement is in understanding the whole cancer genome either by obtaining the cancer tissue bit by a conventional biopsy or by drawing patient’s blood and analyzing the cancer cells in the same (liquid biopsy). Better understanding regarding genetic changes in cancer cells have led to the development and introduction of medicines known as “targeted therapy” and Immunotherapy. Though these drugs are used to treat lung cancer, they work differently than the traditional“chemotherapy” agents. 

Targeted Therapy

This causes disruption of the process of carcinogenesis i.e. stops the conversion of a normal cell to the cancer cell. The major advantage of the targeted therapy is their ability to act more specifically on cancer cells resulting in lesser risk of damage to the normal cells. Targeted therapy helps to prevent growth and spread of the cancer cells. The examples of targeted therapy include cell receptor inhibitors (e.g. EGFR inhibitors and ALK inhibitors. These inhibit the culprit mutation and result in cancer cell death. Many of these agents are taken as a pill which is very relevant in COVID 19 times. Since they have a specific target to act upon these targeted therapies have lesser side effects as compared to chemotherapy and moreover, Cancer carrying the specific mutations respond better to these drug than to chemotherapy adding several years to the life of the patient.

Immunotherapy

Another ray of hope has been Immunotherapy which reactivates the patient’s own immune system and has much better effects in treating advance stage lung cancers. Combination of chemotherapy and Immunotherapy has improved the survival of a significant number of  Lung cancer patients.

Chemotherapy

The major therapeutic advances in the field of medical oncology are preventing and better managing of Side effects of chemotherapy drugs which still find an important place in the management of Lung Cancer management.

Surgery

Surgery is carried out by a surgeon to remove lung cancer and a margin of healthy tissue.  If the cancer is limited only to the lungs, surgery may be a choice. If the lung cancer has spread within the body to a larger region before surgery, the doctor may prescribe chemotherapy or radiation therapy to shrink the cancer. The doctor may prescribe chemotherapy or radiation therapy after surgery if there is a possibility of recurrence. 

Radiation Therapy

The combination of chemotherapy with radiation therapy becomes the primary treatment when surgery is not viable. Radiation therapy may help relieve symptoms, such as pain in the patient suffering from advanced lung cancer. 


What are some myths about Lung Cancer?

The common misconceptions about lung cancer are as follows:

Myth1: Lung cancer happens to only people who smoke

Reality: Although the majority of people who have lung cancer have a history of smoking. However, people who passively smoke can also get lung cancer.

Myth2: Young People do not have lung cancer

Reality: Lung cancer is more common in older people, but can occur in young people and even children. For example, bronchioloalveolar cancer (BAC), a form of lung cancer is common among young women with no history of smoking. 

Myth3: A polluted city holds more risk of getting lung cancer than smoking cigarette 

Reality: Getting exposed to exhausts from automobiles and air pollution increases the chance of getting lung cancer. However, the risk is too small when compared to smoking.  

Myth4: Women do not die from lung cancer as they die from breast cancer.

Reality: Lung cancer affects women equally similar to breast cancer.  Moreover, it has been found that women with breast cancer tend to live longer than women with lung cancer, and also breast cancer can get cured if diagnosed early. 

 

Frequently Asked Questions

How long can a person live with lung cancer?

About 1 in 3 people live for at least 1 year after being diagnosed with lung cancer and about 1 in 20 people live for at least 10 years. Survival rates largely depend upon the stage of cancer and also on the time of treatment. Early treatment is associated with improved survival rates.

What is stage 4 lung cancer? Is it dangerous?

Stage 4 lung cancer is the most advanced stage of the disease. In this stage, the disease has spread, or metastasized, from the lung in which it originated to the other areas of the body like the bones, liver, and/or brain. Of those diagnosed at stage 4, only 19 % survive more than 12 months. 

Do all patients with lung cancer show early symptoms?

Most lung cancers do not cause symptoms until the disease has advanced, in part because the lungs have few nerve endings. When lung cancer does cause signs in its early stages, it may vary from person to person.



Dr. Peush Bajpai

HOD and consultant - Medical Oncology Sciences

Manipal Hospitals, Dwarka, Delhi

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