Close to a quarter-million Americans will be diagnosed this year with lung cancer. While many people who develop the disease have a history of smoking, nonsmokers also are at risk. Edward Garon, MD, a UCLA oncologist in Santa Monica, and Solomon Hamburg, MD, PhD, a UCLA oncologist in Beverly Hills, share four facts that everyone should know about this life-threatening disease.
“Cigarette smoking is, by far, the biggest contributor to lung cancer, accounting for 80-to-90 percent of all cases,” Dr. Garon says. That means anywhere from 10-to-20 percent of people with lung cancer never have inhaled a cigarette. While lung cancer generally is not inherited, specific noninherited mutations may cause some people to develop the disease. Other risk factors include exposure to secondhand smoke, radon and asbestos.
Most people do not experience any pain or discomfort during the disease’s early stages. “Lung-cancer symptoms are fairly easy to dismiss,” Dr. Hamburg says. “You might have a persistent cough, feel shortness of breath or lose weight without trying. Some people develop heart palpitations from the lungs putting pressure on the heart.” By the time more troubling symptoms appear, such as recurrent pneumonia or bronchitis, the disease has likely already spread.
A low-dose computed tomography (LDCT) scan helps detect signs of lung cancer, such as nodules or spots on the lung, early, when the disease is most treatable. “Depending on test findings, we may monitor the patient with more frequent LDCT scans or do a biopsy for a definitive diagnosis,” Dr. Garon says. He notes that lung nodules are common and not always cause for concern. Researchers at UCLA’s Jonsson Comprehensive Cancer Center led a national lung-cancer-screening study that showed a 20-percent reduction in lung-cancer deaths among smokers who underwent LDCT screenings instead of traditional chest X-rays. The U.S. Preventive Services Task Force recommends annual LDCT screenings if you are 55-to-80 years of age and have a 30 pack-year history of smoking (the equivalent of two or more packs of cigarettes a day for 15 years or one pack a day for 30 years) and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. Depending on test findings, your doctor may order more frequent
Regardless of your smoking past, you can still reduce your risk of lung cancer and other conditions like heart disease by kicking the habit now. Just five years of smoke-free living halves your risk of cancers of the mouth, throat, esophagus and bladder. In 10 years, your risk of dying from lung cancer is half the risk of someone who continues to light up. Giving up cigarettes is still beneficial even if you already have lung cancer. “Smoking makes some cancer treatments less effective,” Dr. Garon says. It also heightens treatment side effects. Says Dr. Hamburg, “Nicotine is a tough addiction to break. You really have to be motivated to quit.” Drs. Garon and Hamburg suggest that patients work with their doctors to find the best smokingcessation tool for their unique needs.
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