November is Lung Cancer Awareness Month. While not always in the spotlight, lung cancer is a serious disease that affects more people each year than you might think.
“Lung cancer is the second most common cancer in females after breast cancer, and the second most common in males, second to prostate cancer,” said Dr. Eduardo Celis, director of bronchoscopy and interventional pulmonology at Mercy Medical Center in Cedar Rapids.
Although it’s the second most common cancer for men and women, it is the most deadly cancer. “To have an idea of how deadly lung cancer is, people have to understand that mortality for lung cancer is higher than breast, prostate and colon cancer combined,” said Celis, who also is director of Mercy’s intensive and critical care unit.
Perhaps one of the reasons lung cancer is so deadly is the fact that it is hard to detect early. “Unfortunately, the signs and symptoms of lung cancer are very unspecific, and for this reason it is very hard to diagnose lung cancer in the early stages,” Celis said. “The most common symptoms are cough, weight loss, shortness of breath, persistent bronchitis or pneumonia, chest pain and coughing up blood, among others.”
Since many of these symptoms often mimic other lung issues, one of the best things you can do to prevent lung cancer is to identify whether you are at high risk so you can seek adequate professional help.
Smokers are at the highest risk to develop lung cancer, but there are other factors to be aware of, too.
“The most obvious risk factor is smoking — cigarettes, cigar or pipe. It is associated with up to 80 percent of lung cancer deaths. Other exposures or diseases may increase the risk of lung cancer, such as asbestos, radon, pollution, radiation, certain minerals and metals, family history of lung cancer and HIV/AIDS,” Celis said.
And while people of every age are diagnosed with lung cancer, your risk goes up as you age. It is most commonly diagnosed late in life.
“The majority of people diagnosed with lung cancer are 65 or older, with an average age at diagnosis of 70, although the incidence of lung cancer increases starting at age of 40,” Celis said.
If you do have one or more risk factors, there is help available.
“The U.S. Preventive Services Task Force recommends annual screening with a low-dose CT chest scan for people 55 to 80 who have a smoking history, are current smokers or have quit within the last 15 years,” Celis said. “This test can be requested by your primary care physician or by a pulmonologist.”
For those who are diagnosed, there are factors that determine the outlook of one’s diagnosis. Since there are several types of lung cancer, prognosis and treatment can vary greatly.
“The prognosis of lung cancer is based on the staging at the moment of diagnosis, which is based on the TNM score, where T stands for the size of the tumor and what associated structures are involved. The N stands for the number and location of lymph nodes, and the M refers to the presence or not of metastatic disease,” Celis said. “Based on these elements, lung cancer is classified as Stage I to Stage IV, with survivals rates ranging up to 92 percent.” This classification system ultimately allows physicians to direct treatment, including chemotherapy, radiation or surgery.
As with any serious disease, prevention and early intervention lead to better outcomes. “Stay away from cigarettes. Also avoid any exposures known to affect the lungs in any way, not just because of the risk of lung cancer, but also for other lung problems like COPD, asthma and the many types of lung scarring,” Celis said.
He also emphasizes that there is no shame in asking for help.
“People should not feel embarrassed or afraid to ask their family doctor or primary care physician for more information or about any concerns that they may have,” he said.
Understand the different types of lung cancer
● Small cell lung carcinomas (SCLC) make up approximately 10 percent of all lung cancers.
● “The SCLC are what most of people know as ‘fast growers,’ but this term is inaccurate and may lead one to think that other types of malignancy are not aggressive or might not progress, which is far away from being true,” said Dr. Eduardo Celis of Mercy Medical Center in Cedar Rapids.
● Non-small cell lung carcinomas (NSCLC) account for around 85 percent of cases.
● The NSCLC subclassify in three main subtypes: squamous cell carcinoma, adenocarcinoma and large cell carcinoma.
● Squamous cell carcinoma accounts for 25 percent of all lung cancers and is linked with significant history of smoking.
● Adenocarcinomas are the most common, with approximately 40 percent of all cases. These can also be present in smokers and non-smokers.
● Large cell carcinomas are less common, making up 5 to 10 percent of cases.
● Various infrequent types (like carcinoids) make up the last 5 percent of cases.