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For years, more and more Canadians have been faced with the often fatal diagnosis of lung cancer. The condition can be difficult to detect, and therefore difficult to treat.
Nearly 100 people each day are expected to be diagnosed with lung cancer in Canada, which is a concerning statistic.
For Lung Cancer Awareness Month, which is recognized in November, Yahoo Canada spoke to Dr. Susanna Yee-Shan Cheng, a medical oncologist at Sunnybrook Health Sciences Center, about the disease and how you might be able to prevent it.
Read on to learn more about lung cancer, its causes, and its main warning signs.
What is lung cancer?
Cancer is a disease in which cells in the body grow out of control.
According to the Canadian Cancer Society, “lung cancer starts in the lung cells”, and when it starts in the lung cells, “it is called primary lung cancer”.
Lung cancers are generally grouped into two main types called small cell and non-small cell.
Non-small cell lung cancer usually starts in the gland cells in the outer part of the lung, and small cell lung cancer usually starts in the cells that line the bronchi in the center of the lungs. Non-small cell cells are more common.
According to Cheng, while lung cancer may not be as common as skin or breast cancer, for example, it’s the death rate that is of concern.
“Lung cancer is actually the number one cause of cancer death. It’s common, but it’s actually mortality that’s the biggest problem.”Dr. Susanna Cheng
“Lung cancer is actually the number one cause of cancer death,” Cheng says. “It’s common, but it’s actually mortality that’s the biggest problem. Lung cancer, step by step, has a worse prognosis than most cancers.”
What causes lung cancer?
Cheng says smoking is “the number one cause” of lung cancer. According to Lung Cancer Canada, the majority of lung cancer cases – about 85% – are directly linked to tobacco use, particularly cigarettes.
Smoking increases the risk of lung cancer by:
• Causing genetic changes in lung cells
• Damaging the normal cleansing process of the lungs by which they get rid of foreign and harmful particles
• Lodge carcinogenic particles in the mucus and turn into cancerous tumors
However, Cheng reveals that there are “a growing number of patients who do not smoke”.
“In particular, we are now seeing patients who have never smoked or been exposed to second-hand smoke developing lung cancer, which is interesting because smoking is usually a major cause,” Cheng says. “There are a number of patients who never smoke who may have no reason to have lung cancer, so that’s the most concerning part.”
Cheng says “we don’t know why” non-smokers develop lung cancer, so more research needs to be done. However, her best guess is that it’s “bound to certain hormones.”
That said, lung cancer screening focuses primarily on people with a history of smoking and between the ages of 55 and 70.
Unfortunately, Cheng adds, “the system does not allow non-smokers to be screened.”
“We are now seeing patients who have never smoked or been exposed to second-hand smoke developing lung cancer.”Dr. Susanna Cheng
What are the signs and symptoms of lung cancer?
In its early stages, lung cancer may cause no signs or symptoms. As the tumor grows and causes changes in the body, it usually causes coughing and shortness of breath.
However, if you have any of the below signs and symptoms related to lung cancer, it is important that you see a doctor or healthcare professional as soon as possible:
A cough that gets worse or doesn’t go away
Shortness of breath
Chest pain that you can still feel and that gets worse when breathing deeply or coughing
Blood in the mucus expelled from the lungs
Hoarseness or other changes in your voice
Swollen lymph nodes in the neck or above the collarbone
Cheng notes that she generally views “cough, infection, or pneumonia” as precursors to lung cancer.
However, she reveals that “COVID has put a pass on it.”
“Nowadays when someone has COVID, they can cough for weeks and weeks,” she says. “Some people can’t really tell what the symptoms are sometimes, which can make it difficult to diagnose at first.”
She adds that coughing, shortness of breath (especially when moving), unexplained weight loss, loss of appetite, chest pain and hoarse voice are other possible warning signs of lung cancer.
“In smokers, they may still have a chronic cough, but in non-smokers, they may never have a cough or develop it over time. This may delay the diagnosis of lung cancer,” adds Cheng. .
How is lung cancer diagnosed and treated?
Lung cancer is usually diagnosed after a visit to your family doctor, who will ask about your medical history, symptoms, and perform a physical exam. You may also have a blood test or have an X-ray, MRI, or CT scan.
If lung cancer is diagnosed, further tests are done to determine how far it has spread to the lungs, lymph nodes and the rest of the body. This process is called staging.
Lung cancer screening is another important step that can help detect the disease at an early stage. With lung cancer, early detection is vital. The earlier the disease is diagnosed, the better the chances of survival.
“It’s a shame that there isn’t really any screening yet for people who don’t smoke yet, but hopefully soon.”Dr. Susanna Cheng
“It’s a shame that there isn’t really screening for non-smokers yet, but hopefully soon,” Cheng said.
As for the treatment, Cheng thinks it’s going in a positive direction.
“Over the last 20 years things have changed dramatically. Before we only had chemotherapy, but now it’s based on their pathology and their genetic mutations, which predict the type of treatment they receive, like immunotherapy and targeted drugs,” says Cheng.
How can I prevent or reduce the risk of lung cancer?
Unfortunately, not all lung cancers can be prevented. However, there are things you can do to help prevent the disease from developing, such as changing the risk factors you can control.
Cheng says the first thing to do is avoid smoking.
“Really don’t smoke and try not to be around a loved one who smokes, because the risk of second-hand smoke is very real as well,” she says.
Cheng adds that there aren’t many risk factors related to diet or alcohol, but keep an eye out for “occupational exposure.”
“Monitor occupational exposure like in Ephesus. You can also check your home for radon, but other than that there’s not much you can do,” she explains.
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