Lung Cancer Awareness: Insights from a Medical Expert

 Lung Cancer Awareness: Insights from a Medical Expert

The American Cancer Society's new guidelines emphasize the importance of early detection for lung cancer, leading to expanded screening recommendations. These changes promote yearly screening through low-dose CT scans for individuals aged 50 to 80 with a 20-year or greater pack-year history, irrespective of their current smoking status or how long they've been smoke-free. (A pack-year involves smoking an average of one pack of cigarettes per day for one year.)

These updates highlight the significance of understanding lung cancer. How common is it? What are its different types? Besides smoking, what are the risk factors? Why is early detection crucial? What treatments are available? And what steps can individuals take to reduce their cancer risk?

To address these questions, we interviewed Dr. Leana Wen, our CNN wellness medical expert, an emergency physician, and a professor of health policy and management at the George Washington University Milken Institute School of Public Health.

Dr. Leana Wen: According to the US Centers for Disease Control and Prevention, lung cancer ranks as the third most common cancer in the United States, with skin cancer topping the list. Breast cancer is more prevalent among women, while prostate cancer is the primary concern for men. Despite gender differences, lung cancer claims more lives in the US than any other cancer type.

In 2023, the American Cancer Society anticipates approximately 238,000 lung cancer cases, resulting in around 127,000 deaths.

What are the different types of lung cancers?

Wen: There are two primary types of lung cancers: small-cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). They receive their names based on the size of cancer cells when examined microscopically, with SCLC cells appearing smaller than NSCLC cells. Each of these has further subtypes, with NSCLC encompassing adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.

SCLC tends to progress more rapidly throughout the body than NSCLC, and it is typically diagnosed after it has already spread beyond the lungs. The majority of SCLC cases involve current or former smokers.

NSCLC is more common, making up 80% to 85% of lung cancer diagnoses. These are also linked to smoking, although adenocarcinoma, the most prevalent NSCLC subtype, is found in non-smokers as well. It tends to affect younger individuals and is more common among women than men.

Lung cancers originating from other body parts can also spread to the lungs, such as breast cancer metastasizing to the lungs. These are distinct from lung cancers that originate in the lungs, like SCLC and NSCLC.

Other than smoking, what are the risk factors for lung cancer?

Wen: Smoking is the predominant risk factor for lung cancer, responsible for approximately 80% of lung cancer-related deaths. The risk increases with the duration and intensity of smoking; longer smoking histories and higher daily cigarette consumption elevate the risk.

It's essential to dispel the misconception that cigar or pipe smoking doesn't contribute to cancer risk; these habits do increase the risk. Smoking "light" or flavored cigarettes carries just as much risk as regular cigarettes.

Second-hand smoke is another major risk factor, putting individuals who live with smokers at risk of various adverse health outcomes, including lung cancer.

Additional risk factors include environmental exposures to substances like radon and asbestos, with the latter being associated with mesothelioma, a specific type of lung cancer. Individuals who have undergone chest radiation for other cancers are also at higher risk, like breast cancer patients who received post-mastectomy chest radiation. Having first-degree relatives with lung cancer may slightly elevate one's risk, although this is often challenging to separate from the effects of second-hand smoke. Furthermore, outdoor air pollution may contribute to 1% to 2% of lung cancer deaths in the US.

CNN: What are the symptoms of lung cancer?

Wen: Initial symptoms can be non-specific, including persistent cough, shortness of breath, fatigue, and vague chest discomfort. Some individuals may experience a hoarse voice, coughing up bloody mucus, loss of appetite, and unexplained weight loss. As the cancer spreads, additional symptoms may arise, such as bone pain, skin yellowing due to liver damage, or symptoms related to the tumor compressing blood vessels and other structures.

Why is early detection important?

Wen: Cancer screening is a lifesaver, applicable not only to lung cancer but various other cancer types. Cancers are more treatable when they are localized before they spread to lymph nodes and other organs. Survival rates significantly improve when cancers are detected in their early stages.

Screening, by definition, is conducted in asymptomatic individuals. The American Cancer Society has extended screening recommendations to include a broader population, as their research demonstrates the benefits outweigh the drawbacks when low-dose CT scans are employed.

Individuals experiencing symptoms like those described above should consult a physician promptly. This is not screening but rather an evaluation of the symptoms' underlying cause.

What treatments are available?

Wen: The specific treatment depends on the type of cancer, its stage at diagnosis, and the patient's overall health. Treatment options encompass radiation, chemotherapy, surgery, and immunotherapy. Surgery may be suitable for individuals with localized lung cancer. Patients with more advanced disease may receive treatments aimed at managing symptoms and extending life, even if they don't achieve a cure.

CNN: How can individuals reduce their risk of lung cancer and other cancers?

Wen: Smoking cessation is paramount for current smokers, as studies show that quitting can reduce lung cancer risk, even for heavy smokers. The risk will not reach the level of a non-smoker, but it can still prevent lung cancer. Numerous resources from organizations like the American Lung Association can assist smokers in quitting. Discussing this with a healthcare provider is also beneficial.

Reducing exposure to second-hand smoke, understanding occupational hazards, and assessing homes for harmful radon levels are steps individuals can take. Researchers are investigating protective factors like diet and exercise, although it's not yet clear how much these habits can reduce lung cancer risk. Nonetheless, these healthy behaviors can enhance overall health.