Lung cancer, one of the most common cancers in the world, begins in the tissues in one or both lungs, and is divided into two main types: small cancer lung cancer (which tends to spread rapidly) and non-small cell lung cancer (the most common type, which is separated into subtypes). Here, we're looking at the similarities and differences between men and women, as well as the risk factors, latest statistics, and most common symptoms when it comes to this sometimes-misdiagnosed form of cancer.
“Generally speaking, the symptoms of lung cancer are similar in both men and women,” Bryan Payne Stanifer, M.D., M.P.H., assistant professor, thoracic surgeon, and director of the Women’s Lung Program at New York-Presbyterian/Columbia University Medical Center in New York says. The signs may vary from person to person, and from smokers to non-smokers, yet in some cases, symptoms may not arise until the cancer is in the later stages (stage III or stage IV) and has spread to other parts of the body.
While the physical features of lung cancer may be the same in men and women, the rates of incidences are not. According to a 2018 study published in The New England Journal of Medicine, the rates of lung cancer have decreased in both sexes, aged 30 to 54, among those of all races and ethnic groups over the last 20 years. However, the decline was more sharp in men.
This study, which was funded by the American Cancer Society, concluded that incidence rates of lung cancer have become “significantly higher” among young women than young men, where white and Hispanic women were more likely to be diagnosed with this disease. Smoking behaviors did not pay a role in these findings.
Dr. Stanifer explains this is a complete shift from a historical pattern. “It used to be 55% to 60% male smokers, but that has changed,” he says. “When most people think of lung cancer, they imagine a 72-year-old man who smoked for 40 years. Today, there is this huge population of never-smokers, who are mostly women and who skew younger. In fact, it’s to the point now where if you’re younger than 50, you’re more likely to be a woman, than a man, if you have lung cancer.”
“We’ve known for decades that if you were of East Asian origin, you were much more likely to get lung cancer if you were a non-smoker, and especially being a woman,” Dr. Stanifer continues. “But we’re now seeing in the United States that same sort of pattern in non-smoking women who are Hispanic and who identify as white. There is this racial or ethnic component that no one seems to understand.”
As scientists continue to search for answers, Jack F. Jacoub, M.D., medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, CA says doctors question if there’s a hormonal factor tied to these statistics. “Also, we wonder what is in the environment, which is another a big component,” he says. “For example, are cooking oils and fumes a factor?”
Overall, adults who are at the highest risk for lung cancer are smokers, states the Mayo Clinic. The length of time someone has smoked, along with the number of cigarettes, pipes, or cigars also factors into their likelihood of being diagnosed with this type of cancer. “Both former smokers and current smokers, as well as those who have other pre-existing lung diseases, need to recognize they are high-risk individuals,” Dr. Jacoub adds.
The National Cancer Institute offers a list of other possible lifestyle habits that may increase an individual’s chances of developing lung cancer. These risk factors include: being exposed to secondhand smoke, certain chemicals (such as asbestos and arsenic), radiation therapy, or air pollution, as well as being infected with the HIV virus.
According to the Centers for Disease Control and Prevention (CDC), lung cancer claims the lives of more men and women than any other form of cancer. “Around 150,000 people each year die of lung cancer — you would have to add up [the fatalities] from breast, prostate, and colorectal cancers to equal the deaths from lung cancer,” Dr. Stanifer says. While patients experiences differ, the following are the most commonly reported symptoms of lung disease:
“This could be a nagging, lingering cough or an unresolved cough from a cold of flu,” Dr. Jacoub says. For smokers who may live with “smoker’s cough,” he adds that this type of symptomatic cough would become more pronounced. And while lung cancer can be mistaken for the flu or pneumonia, Dr. Jacoub explains that flu-like illnesses tend to last between four to six weeks. “So anything that persists without an explanation needs to be looked at by your doctor.”
This discomfort tends to increase while coughing, laughing, or taking in a deep breath. “The chest pain may start from the back and radiate to the front,” Dr. Stanifer says. “Sometimes the tumor is invading the chest wall, which causes the pain. If not, the patient will have the pain in the area where the tumor is.”
Some people will find their voice becoming weaker and raspier. “There’s a nerve in the chest called the recurrent laryngeal nerve, which starts in your brain, goes all the way down into your chest and then comes back up — along with your trachea and esophagus — and innervates your vocal chords,” Dr. Stanifer explains.
If the cancer has spread from the lungs and to other parts of the body (also known as metastasized), patients may experience localized symptoms elsewhere in the body. “Commonly, lung cancer goes to the three areas outside of the chest: bone, liver, and the brain,” Dr. Stanifer says. According to CancerCare, a national non-profit organization, it may also spread to the lymph nodes and adrenal glands.
Frequent head pain, along with dizziness, could mean the cancer has spread to the brain. Both Dr. Jacoub and Dr. Stanifer add that seizures may also occur. It’s estimated that between 25% and 40% of lung cancer patients develop brain metastases, state the researchers from Medical Oncology study.