- Lung cancer is usually a neglected entity in the universe of cancer
- Lung cancer is the biggest cause of cancer related deaths in the world
- Passive smoking, or secondhand smoke, is another risk for lung cancer
Lung cancer is usually a neglected entity in the universe of cancer management in India. It is not one of the first diagnosis in the mind of the primary doctors, neither is it one of the top priorities in the cancer treatment centres. Even when we talk about awareness we restrict ourselves to Breast and Gynaecological cancers and sometimes to head and neck cancers for males but conveniently forget lung cancers. One of the main reasons for this step motherly treatment of lung cancer is usually the dismal prognosis associated with it. Once the diagnosis of lung cancer is confirmed, everybody, including the treating doctors, condemn the patient to a life span of under a year and feel that there is not much point treating such patients.
But they are not wrong.
It is true that lung cancer is the biggest cause of cancer related deaths in the world. Infact in 2015, 1.38 million deaths across the globe were attributable to lung cancer alone. In India alone 48,000 patients died due to lung cancer in 2012.
But sometimes we have to read between the lines to understand the statistics.
It's important to understand that the large number of deaths that are associated with lung cancer are because they are usually detected in advanced stages. The difference in survival is such that an early stage lung cancer, if treated correctly and completely, has a survival of more than 5 years in most cases whereas Stage 4 lung cancer will survive for an average for 6 - 8 months only.
So it is important for us to understand the causative factors and early signs and symptoms of lung cancer to detect it early and also realize what is the best possible treatment for it.
Causes of lung cancer
1. Cigarette smoking is the most important cause of lung cancer. Cigarette smoke contains more than 4,000 chemicals, many of which have been identified as causing cancer. A person who smokes more than one pack of cigarettes per day has a 20-25 times greater risk of developing lung cancer than someone who has never smoked
2. Passive smoking, or secondhand smoke, presents another risk for lung cancer. An estimated 3,000 lung cancer deaths occur each year in the U.S. that are attributable to passive smoking.
3. Air pollution from motor vehicles, factories, and other sources probably increase the risk for lung cancer, and many experts believe that prolonged exposure to polluted air is similar to prolonged exposure to passive smoking in terms of risk for developing lung cancer.
4. Chemical exposure: Accidental or Occupational exposure to Asbestos or Radon also increases the risk of lung cancer. Asbestos is a commonly associated with cement industry
5. Lung diseases, such as tuberculosis (TB) and chronic obstructive pulmonary disease (COPD), also create a risk for lung cancer. A person with COPD has a four to six times greater risk of lung cancer even when the effect of cigarette smoking is excluded.
Symptoms and signs of lung cancer include
- difficulty breathing,
- spitting or coughing blood,
- chest pain,
- hoarseness or problems of swallowing.
Prevention and screening for early detection
Prevention is primarily focused on smoking cessation.
Smokers who wish to quit obtain benefit from many different strategies, including nicotine replacement therapy with patch or gum, counseling, and support groups. Smokers who do not wish to quit, but are told that they must, often will relapse if they can ever quit at all.
Screening recommendations have undergone some recent changes as regards this significant health problem. The U.S. Preventive Services Task Force (USPSTF) has recommended and the Centers for Medicare and Medicaid Services (CMS) has further agreed and amplified the following recommendation:
Adults between 55 and 77 years of age with a history of at least 30 pack years of cigarette smoking, either currently smoking, or who have quit in the past 15 years, and who have discussed the risks and benefits of CT screening with the ordering physician and have undergone documented smoking cessation counseling should undergo annual low-dose CT scan screening.
Such testing has been demonstrated to reduce the risk of dying from lung cancer by 15% to 20% as compared to those receiving only an annual chest X-ray
Remember, it is in our hands to prevent and detect lung cancer. The latter the lung cancer is detected, worse is the prognosis, shorter is the survival and less effective is the treatment.
(Dr. Shubham Garg is a Surgical Oncologist at Max Super Speciality Hospital, Vaishali)
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