LUNG CANCER

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

Lung cancer is a type of cancer characterised by the uncontrolled growth of abnormal cells in the lung. It is a serious health issue that can cause severe harm and death – in fact, lung cancer is the leading cause of cancer-related deaths worldwide, accounting for more deaths each year than breast, prostate and stomach cancers combined.

There are two main forms of lung cancer, non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). These two types grow differently and are treated differently. Non-small cell lung cancer is the more common type.

Around 85% of lung cancer is caused by smoking, but even people who don’t smoke can develop the disease. Unfortunately, two thirds of lung cancer patients are diagnosed at a late stage, when it has already spread to other parts of the body, and when treatment options are limited. It is therefore essential to understand your risk, know the symptoms, and practice preventive behaviours to protect yourself from lung cancer.

LUNG CANCER IN SOUTH AFRICA

It’s difficult to provide accurate statistics on lung cancer in South Africa as we are waiting for the current and updated case reports to be released by the National Cancer Registry. Current estimates put South Africans as having a 1 in 241 lifetime risk of developing lung cancer – and it being the seventh most common cancer in South African women. There are no official screening programmes for lung cancer in South Africa, and the task of education around the disease falls largely to the Cancer Association of South Africa.

WOMEN AND LUNG CANCER

Unique effects of lung cancer for women:

Age of diagnosis: women are more likely to be diagnosed with lung cancer at a younger age.
Type of lung cancer: women are more likely to be diagnosed with adenocarcinoma, a type of non-small cell lung cancer which is a slower-growing type of lung cancer.
Survival: women generally have better survival rates than men for early-stage lung cancer.
Symptoms: women more commonly experience coughing, shortness of breath, fatigue, and pain in the back, chest, or shoulder. (Men are more likely to experience symptoms that affect the main airways, causing coughing and breathing difficulty.)
Risk factors: women have unique risk factors for lung cancer, including exposure to radon, secondhand smoke, and indoor cooking fumes, as well as genetic mutations and oestrogen exposure.
DNA repair: women with lung cancer have impaired DNA repair mechanisms, which are more frequent in younger women and those with a family history of impaired DNA repair mechanisms.
Increased danger from exposure to tobacco carcinogens: women are more susceptible to tobacco carcinogens than men. There is no doubt that quitting smoking is the most effective way to reduce your risk of lung cancer.

WHAT CAUSES LUNG CANCER?

Anyone can develop lung cancer, but certain factors increase your risk:

Smoking

Smoking is the biggest risk factor for lung cancer by far. Tobacco smoking causes about 9 out of 10 cases of lung cancer in men and about 8 out of 10 cases of lung cancer in women.

The more years you smoke and the more cigarettes you smoke each day, the more your risk goes up. Your risk is also greater if you smoke a lot and drink alcohol every day or take beta carotene supplements.

If you have quit smoking, your risk will be lower than if you had kept smoking. But you will still have a higher risk than people who have never smoked.

Secondhand smoke

Secondhand smoke is a combination of the smoke that comes from a cigarette and the smoke breathed out by a smoker. When you breathe in secondhand smoke, you are exposed to the same cancer-causing agents as smokers, although in smaller amounts.

This is especially dangerous for children because their bodies are still developing. Children exposed to secondhand smoke are at an increased risk of many health problems, including:

Respiratory problems like coughing, wheezing, shortness of breath, and respiratory infections like pneumonia and bronchitis
Asthma
Ear infections, fluid in their ears, and needing ear tubes
Slowed lung growth
Sudden infant death syndrome (SIDS)
Brain tumours and lung cancer
Other health problems like tooth decay, stuffy nose, headache, sore throat, and eye irritation

Genetics

A family history of lung cancer

Radiation

Being exposed to radiation moderately increases your risk of lung cancer, for example from:

Radiation therapy to the breast or chest
Radon in the home or workplace
Certain imaging tests such as CT scans

Air pollution

Evidence suggests that lung cancer rates are higher in cities than in rural settings, mainly due to higher levels of air pollution. Poor indoor air quality, caused by things such as open fires, certain building materials, cleaning products and cooling systems, have also been linked to lung cancer.

Exposure to toxic substances

Workers in certain occupations may come into contact with high-risk cancer-promoting substances such as asbestos, radon gas, silica and arsenic.

Lowered immunity

Your risk is higher if you have HIV. However, smoking rates are higher in people who have HIV, so it’s not clear whether the increased risk is from the HIV infection or from smoking. Taking immunosuppressant treatments following an organ transplant also increases your risk of lung cancer.

Age and other lung diseases

Lung cancer is more common among older people and is rare in people younger than 40. People with a history of lung diseases such as emphysema, tuberculosis, pneumonia or chronic obstructive pulmonary disorder are at increased risk of developing lung cancer.

WHAT ARE THE SYMPTOMS OF LUNG CANCER?

Lung cancer affects people in different ways and may not show any symptoms until the cancer is advanced; sometimes the cancer is found during a chest x-ray done for another condition.

The earlier lung cancer is diagnosed, the greater the chance that treatments will be effective. Common symptoms of include:

Persistent cough that doesn’t go away after three weeks
Chest pain or discomfort
Coughing up blood
Trouble breathing / wheezing / trouble swallowing
Getting out of breath doing things that didn’t affect you previously
Chest infections that keep returning or that don’t go away

HOW CAN I PROTECT MYSELF FROM LUNG CANCER?

There’s no sure way to prevent lung cancer, but you can reduce your risk if you:

Don’t smoke

If you’ve never smoked, don’t start. People who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke. Even smoking a few cigarettes a day or smoking occasionally increases the risk of lung cancer.

Talk to your children about not smoking so that they can understand how to avoid this major risk factor for lung cancer. Begin conversations about the dangers of smoking with your children early so that they know how to react to peer pressure.

Stop smoking

Stop smoking now. Quitting reduces your risk of lung cancer, even if you’ve smoked for years.

According to the American Cancer Society, there are benefits to stopping smoking at any age:

15 to 34 years: avoided up to 100% of the extra risk of dying from cancer compared with if they’d continued to smoke
35 to 44 years: avoided around 90% of the extra risk of dying from cancer compared with if they’d continued to smoke
45 to 54 years: avoided around 78% of the extra risk of dying from cancer compared with if they’d continued to smoke
55 to 64years: avoided around 56% of the extra risk of dying from cancer compared with if they’d continued to smoke

Talk to your healthcare team about strategies and aids that can help you quit. Options include nicotine replacement products, medicines and support groups. You can learn more about the Bonitas Stop Smoking Programme here.

Avoid secondhand smoke

If you live or work with a person who smokes, urge them to quit. At the very least, ask them to smoke outside. Avoid areas where people smoke, such as bars. Seek smoke-free entertainment options and make your home and car smoke-free.

Lower your exposure to radon

Radon tests can show whether your home has high levels of radon. You can buy a test kit yourself or hire a professional to do the test.

Avoid carcinogens at work

Take precautions to protect yourself from exposure to toxic chemicals at work. Follow your employer’s precautions. For instance, if you’re given a face mask for protection, always wear it. Ask your healthcare professional what more you can do to protect yourself at work. Your risk of lung damage from workplace carcinogens increases if you smoke.

Eat a diet full of fruits and vegetables

Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. Avoid taking large doses of vitamins in pill form, as they may be harmful. For instance, researchers hoping to reduce the risk of lung cancer in people who smoked heavily gave them beta carotene supplements. Results showed the supplements increased the risk of cancer in people who smoke.

Exercise most days of the week

If you don’t exercise regularly, start out slowly. Try to exercise most days of the week.

HOW IS LUNG CANCER TREATED?

For most patients with lung cancer, current treatments do not cure the cancer. Survival rates vary widely, depending on how far the cancer has spread at the time of diagnosis. Early diagnosis can make a significant difference, and screening is recommended if you’re at high risk.

LUNG CANCER

LUNG CANCER

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

LUNG CANCER IN SOUTH AFRICA

WOMEN AND LUNG CANCER

WHAT CAUSES LUNG CANCER?

WHAT ARE THE SYMPTOMS OF LUNG CANCER?

HOW CAN I PROTECT MYSELF FROM LUNG CANCER?

HOW IS LUNG CANCER TREATED?

FURTHER READING