Treating - and preventing - lung cancer

The Baltimore Sun

Every year about 165,000 people in the United States die from lung cancer, and about 210,000 new cases are diagnosed each year. That means more people die from lung cancer annually than from breast, prostate and colon cancer combined, says Dr. Gavin Henry, chief of thoracic surgery at St. Agnes Hospital.

While most people are aware that smoking is a primary cause of lung cancer, about 10 percent - or about 2,100 cases - of new lung cancers occurs in nonsmokers.

How is lung cancer diagnosed?

The most common way is by basic chest X-ray or CAT scan. It is hard to detect in certain populations, because it grows within the lungs and isn't easily noticed [in its earliest stages] by the patients. A lot of times it is picked up by accident.

What are some of the symptoms?

The symptoms can be a variety of things: A basic cough, coughing up blood, some pneumonia symptoms.

And there are also patients who are not symptomatic, who go for a check-up or X-ray for a new job, perhaps, and it is discovered.

Most people know that smoking can cause lung cancer. What are other causes of lung cancer?

About 80 to 85 percent of lung cancers occur in people who smoked, so you can pretty much say smoking causes lung cancer. But there is another, smaller set of people who have not smoked who get lung cancer, and the majority of these are from secondary smoke.

And there is a still smaller set who have neither smoked nor been exposed to secondary smoke. It isn't known why those who haven't smoked or been exposed to smoking develop lung cancer - but there is a genetic component. There also are some environmental causes of lung cancer, and these include exposure to asbestos, radon and arsenic.

In my practice, we are noticing more of these patients who have not had a history of smoking or secondary smoke. It is unclear why there has been this increase.

You mentioned secondary smoke - what is that?

People who inhale the smoke that comes from a burning cigarette [or other tobacco product] are inhaling the same kind of cancer-causing agents as smokers, only in smaller amounts. There is an estimated 20 to 25 percent increase in risk of developing lung cancer for those exposed to second-hand smoke when compared to nonsmokers [or those not exposed to secondary smoke].

What can be done to prevent lung cancer?

Quit smoking - that is the No. 1 thing to do. If you have had a significant history of smoking and you stop, there is still a risk of getting lung cancer. But the risk goes significantly down if you quit smoking and there is a 10-year-gap without smoking.

What do you tell your patients who are diagnosed with lung cancer?

That it is not necessarily the end of the world. I am a chest surgeon, so my job is to try to take [the cancer] out. If they come to me, that usually means the primary doctor has sent them, and the cancer is in an earlier stage. If you are in my office, there is a good chance we can [remove the cancer] and the survival rate goes up. But it is hard to predict for people how they are going to do.

Lung cancer is one of the deadliest cancers we have, and it has a stigma because people often feel that they have done this to themselves by smoking. It is unlike other cancers in this regard.

Anything you want the public to know?

That this is the deadliest cancer and if you are smoking or have had significant secondary smoke [exposure], don't hesitate to call your primary care doctor to get screened. Especially if you have been smoking for a while. More and more hospitals are offering screenings just like they do for breast cancer or prostate cancer. And if it were my family, I would recommend it.

Holly Selby is a former reporter and editor for The Baltimore Sun.

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