Lung cancer – a cancer always associated with smoking, and thus attached to a stigma. But it’s a killer.
And anyone who has been diagnosed with lung cancer suffers. So why is it associated with so much shame and blame? Yes, it is associated with cigarette smoking, but do you know that nearly a quarter of lung cancer occurs in men and women who have never smoked in their lives? In any case, cancer is cancer. Surely anyone going through such an ordeal deserves our compassion and sympathy.
Here are some myths that we’re going to bust open, as we try to improve public awareness around the hideousness of lung cancer, during this Lung Cancer Awareness Month of November:
- Lung cancer doesn’t just affect smokers. If you have lungs, you can get lung cancer. While smoking tobacco remains by far the biggest risk factor for developing lung cancer, it’s not the only cause. Globally, 20% of lung cancer patients have never smoked cigarettes.
- Lung cancer also affects younger people. Although the average age of lung cancer diagnosis is 70yo and it is rare in <60yo, it can occur in people younger than 40yo. Often lung cancer in younger people is associated with a single oncogene mutation, not an environmental / lifestyle factor, like tobacco. A 2020 study in the International Journal of Cancer found that women aged 30-49yo are being diagnosed with lung cancer at higher rates than men – and this is not explained by differences in smoking habits.
- Lung cancer has no widely available screening programs. Low-dose CT scans can detect early-stage lung cancer, 70% of which are curable, however, they’re currently not incorporated into any screening programs.
- Lung cancer screening is not infallible. Even if someone has had a clear low-dose CT scan, it doesn’t reduce the risk of developing lung cancer in the future.
- Lung cancer is not incurable. Even with stage 4 disease, there are life-extending treatments that increase survival and improve the symptoms of the disease.
- Lung cancer cannot spread with surgery. Surgery is sometimes an important part of treatment.
- Lung cancer is a stealth disease. It offers no clear symptoms, especially when it’s only contained to the lungs – it doesn’t always show telltale respiratory signs, like cough, shortness of breath, or chest pain.
- Lung cancer research is not stagnant. New genetic mutations are being identified, new therapies emerging (such as oral targeted therapies and immunotherapies), and new treatment protocols being tested.
- Lung cancer now has many effective therapies. Currently, targeted therapymedication that targets specific molecular features of cancer cells (which kills the specific cells with mutations, rather than also damaging healthy cells) is offering new hope for about 25% of all people with adenocarcinomacancer arising from mucus-producing glands in organs – the most common type of non-small cell lung cancer (NSCLC). Immunotherapya treatment that uses a person's immune system to fight cancer is another approach, using medications that help to activate the immune system into recognising and killing cancer cells. Currently, immunotherapy is used routinely for all patients with stage 3 and 4 lung cancer (approximately 60-70% of all lung cancer patients).
- Lung cancer risk might be increased with e-cigarettes – the jury is still out, which means that they are not yet known to be risk-free. They contain significant chemicals that can damage the lungs, and they have not yet been approved as safe quit-smoking products.
- Lung cancer can have a less complicated treatment pathway and better success rates if the smoking patient quits smoking. It’s never too late to quit – it helps to decrease the risk of secondary cancers, increase the quality of life, and generally reduce complications during treatment.
So if you’re worried about your likelihood of getting lung cancer, or you have concerning symptoms; if you’ve been exposed to long-term tobacco, asbestos or other inhaled chemicals or you have a family history, please see your GP. But even if you have none of these risk factors, please see your GP about any ongoing, concerning symptoms.
Finally, yes, smoking does increase the risk of lung cancer. But it is not the only factor, and as we now know, 1 in 5 people with lung cancer have never smoked a cigarette.
We extend the same empathy, support and respect to all patients with cancer, judgment-free.
Authored by Dr Emily Isham