World Lung Cancer Day Special: Know from the Expert
Published On: August 01, 2020
We hope this blog finds you in good health.
Are you keeping a track of the Covid-19 numbers? What’s the situation in your state, in your district, in your locality? Where are we in the battle against Covid-19? Where does India stand among all other countries affected by the Coronavirus outbreak? Amidst all these frequently asked questions on Covid-19, it is important to also address other important health related concerns that might not wait and pause for Corona to leave: the medical emergencies and critical illnesses can come calling unannounced at any time.
We, at ImpactGuru, get to see people fighting life battles daily on our platform. Some battle cancer, while some, organ failure. Some struggle to make it after a near-fatal accident, and some young ones, struggle to live after a premature birth. One thing that ties them all is the financial strain on the patient and his/her family/friends while having to get timely treatment and surgery for their ailment, illness or condition.
On one hand, we are doing all that we can to support them and raise funds for their cure from our vast network of donors, on the other, we also consider it our responsibility to educate the masses and help them with the right information from the right source. And that is precisely why, we get to you, Dr. M. Udaya Kumar Maiya, Senior Consultant Clinical Oncologist, to answer a few frequently asked questions on lung cancer, today August 1st being World Lung Cancer Day.
Let’s get started.
World Lung Cancer Day: Here are your FAQs, answered by our Expert
How common is lung cancer?
Lung cancer is the most common cancer diagnosed worldwide. There is a significant burden of lung cancer in India, contributing towards the cancer morbidity and mortality. About 70,000 cases of new lung cancer cases are diagnosed in Indian males (11% of all cancers) and about 26,000 cases of new lung cancer cases among Indian females (4%). Overall, lung cancer is ranked fourth among the various types of cancer after breast, cervical, and oral cavity cancer; in males it is ranked second and in females it is ranked sixth. Lung cancer is the foremost contributor to cancer-related mortality, resulting in 1.38 million cancer deaths per year worldwide. In other words, lung cancer accounts for more deaths than any other type of cancer.
In India, it is the third most common cause of cancer-related mortality after breast and cervical cancer. Among Indian males, lung cancer is the most common cause of cancer deaths and among Indian females it ranks seventh in terms of cancer-related mortality. Males predomination is seen with a male:female ratio of 4.5:1.
What are the signs/common symptoms of lung cancer?
Early disease has very few symptoms; most lung cancers do not cause any symptoms until they have become advanced or they have spread. The most common symptoms of lung cancer are:
A cough that does not go away, or gets worse
Coughing up blood or brown-coloured sputum
Chest pain that is often worse with deep breathing or coughing
Hoarseness of voice
Loss of appetite
Unexplained weight loss
Shortness of breath
Feeling tired or weak
Chest infections (Bronchitis and Pneumonia) difficult to treat, or repeated bouts.
If lung cancer spreads to other parts of the body, it may then cause:
Pain in the back or hips.
Headache, weakness or numbness of an arm or leg, dizziness, balance problems, or seizures, (cancer spread to the brain)
Jaundice (cancer spread to the liver)
What causes lung cancer? What are the risk factors leading to lung cancer?
The incidence of lung cancer has paralleled the trends of tobacco smoking. Smoking tobacco remains the overwhelmingly single most important risk factor in more than 85% of cases. A smaller proportion (15%) is attributed to occupational exposure, to various carcinogenic agents, pollution and other causes.
Some of the tobacco-related products smoked in India are beedis, cigarettes and hookah. Passive smoking and environmental tobacco smoke are known as lung carcinogens. Occupational exposure to various carcinogenic agents also contribute.
Can non-smokers get lung cancer?
Yes. It is a small percentage of lung cancer patients. These people are passive smokers, occupational workers working in hazardous workplaces, environmental exposure, etc.
Can you throw some light on what are the different stages of lung cancer? And what are the different types of lung cancer?
Lung cancer are tumours arising from the respiratory epithelium and broadly divided into two major types:
- Small Cell Lung Cancer (SCLC)
- Non Small Cell Lung Cancer (NSCLC), which will include Adenocarcinoma, Squamous cell carcinoma, and Large-cell carcinoma.
SCLC tumours grow faster, spread earlier and are more sensitive to chemotherapy. They have a poorer outcome.
Though all types of lung cancer can be found in smokers, Squamous and Small-cell carcinomas are most commonly associated with heavy tobacco use.
In Non-smokers and women, Adenocarcinoma tends to be the dominant histology.
Let’s discuss the staging.
NSCLC stages can be categorised as Stage 0, I, II, III and IV. The lower the stage number, the less the cancer has spread, and with increase in stage, the more the cancer has progressed.
Another method of staging is the 2-stage system that divides lung cancer into
- limited stage
- extensive stage.
This is used commonly for SCLC.
For limited stage cancer, a person might benefit from more aggressive treatments such as chemotherapy combined with radiation therapy. For extensive stage disease, chemotherapy alone is more likely to control the cancer.
Is it curable, doctor? What are the survival chances in lung cancer?
Overall, the cure rates are low in lung cancer. Because the detection of the disease is usually in mid or late stages, the outcomes are poor. A good percentage of early cancers are probably curable. Oncologists usually talk about 5-year survival rates as an estimate of disease control.
Survival rates give us an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. They can’t tell you how long a patient will live, but can help you to better understand how likely a treatment will be successful.
For example, in early stages of NSCLC, one can expect a 5-year survival rate of about 50% but only about 5 % in late stages. These figures are poorer in SCLC, where in early stages a 25% 5-year survival rate is seen which drops to less than 3% in late stages.
What are the chances of relapse or recurrence in lung cancer, doctor?
Lung cancer is a difficult disease to treat, with low cure rates. The rates of residual disease and recurrent disease are high. Lung cancer deaths are also high. There are a variety of second level treatment options available like chemotherapy, immunotherapy and palliative radiotherapy but they are usually not as effective as the initial therapies.
Certain myths that you hear from patients on lung cancer which you would like to break and give clarity on.
Non-smokers and ex-smokers don’t get lung cancer
Majority of people that develop lung cancer are ex-smokers.
About 10 to 15% of people who get lung cancer are non-smokers!
Getting a health screen check for a smoker as normal will ensure that he/she will not get lung cancer
There is no guarantee that he/she will escape lung cancer subsequently; a normal health check is no visa to continue smoking.
Living in a polluted city is a greater risk than smoking
Being exposed to diesel exhausts and air pollution does raise the risk of lung cancer; however, the risk is small in comparison to smoking.
I am having advanced lung cancer. Why do I need treatment if I cannot get cured?
Even if lung cancer is not curable, it is still treatable. Cure is not the only end point in cancer treatment; controlling symptoms, improving quality of life and extending it, making the person useful to himself/herself and to society as long as they live is also important.
Cigars are safer than cigarettes when it comes to cancer causation
No. Cigar smoke, like cigarette smoke, contains toxic and cancer-causing chemicals that are harmful to both smokers and non-smokers. In fact, cigar smoke has a higher level of cancer-causing substances like nitrosamines than in cigarette smoke.
It has more tar: for every gram of tobacco smoked, there is more cancer-causing tar in cigars than in cigarettes.A higher level of toxins: cigar wrappers are less porous than cigarette wrappers. The non-porous cigar wrapper makes the burning of cigar tobacco less complete than the burning of cigarette tobacco. As a result, cigar smoke has higher concentrations of toxins than cigarette smoke.
The same is true for Pipes and E-cigarettes (Vaping).
(to be continued…)
Want to know more from Dr. Udaya Kumar Maiya? Have questions on treatment options and medical advancements available in lung cancer management? What are the costs like and how to fundraise for lung cancer treatment? All this and more, coming up in the Part 2 of this interview excerpt. Join us there.