How to Reduce Lung Cancer Deaths Starting Today

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Lung cancer is the leading cause of both men and women in the United States. You may be thinking smoking cessation immediately upon hearing these numbers, but lung cancer in never smokers is the 6th leading cause of cancer-related deaths in the United States.

Adding together both non-smokers with lung cancer and people who smoke that have other risk factors for lung cancer, it's worth taking a look at the lung cancer problem from a different angle.

How can we significantly reduce the number of lung cancer deaths without talking about quitting smoking? Let’s talk about ten ways we can begin reducing lung cancer deaths today aside from smoking cessation.

(For those who wish to instead learn more about cigarettes and lung cancer, check out this comprehensive article on smoking and lung cancer.)

Remember That Lung Cancer Isn’t a Smoker’s Disease

To talk about lung cancer without bringing up smoking cessation may seem almost heretical. It is true that smoking is responsible for many lung cancers. Smoking cessation is important and one of the best things we can do to decrease deaths is to help people kick the habit.

Yet, even if smoking were eliminated today entirely, we would still have lung cancer deaths.

There are several reasons why quitting smoking won't eliminate lung cancer deaths. One of the major reasons, of course, is that there are causes of lung cancer other than smoking.

Even among people who smoke there are additional factors that increase or decrease the chance they will develop lung cancer.

Another major reason is that the majority of people who develop lung cancer today do not smoke. Instead, over 50 percent of people who develop lung cancer are former smokers. For women, almost 20 percent have never smoked.

Talking about smoking cessation is commendable, but like most "positive" things in our lives, there can be a downside. That downside with lung cancer is that the studying the causes of lung cancer other than smoking, and spreading the word about these causes, has either been neglected or overshadowed by the massive amount of information on smoking. Whereas we continue to look for causes of other cancers—and in finding these risk factors help people lower their risk—it seems, in some ways, that we've pointed our fingers at smoking with lung cancer, wiped our hands, and moved on.

An example is worth a page of words, so let's start with one example of how focusing on smoking has decreased awareness of another very preventable cause of lung cancer.

The Problem of Dismissing Lung Cancer as a Smoker's Disease

For those who are still clinging to smoking cessation alone as the method of reducing lung cancer deaths, let's take a look at the example of radon and lung cancer.

Radon gas is an odorless, colorless gas, which is produced by the normal decay of uranium in the soil beneath our homes. Increased levels of this gas are found in 1 out of 15 homes in the United States, and around the world.

When the gas is released into outside air it quickly dissipates.The problem occurs when this gas becomes trapped in our homes.

We know that exposure to radon is the leading cause of lung cancer in non-smokers and the second leading cause in people who smoke. Exposure currently leads to around 27,000 lung cancer deaths each year in the U.S. alone.

To understand the significance of radon-induced lung cancer (a risk factor, we note, that is highest for women and children), let's compare this disease to breast cancer. There are roughly 40,000 breast cancer deaths each year in the U.S. If we knew of a way to screen for, and subsequently, eliminate the cause of 75 percent of breast cancers, do you suppose we would have heard?

Yet testing the radon level in your home, and incorporating radon mitigation if necessary, could eliminate this same number of deaths.

Order Lung Cancer Screening for Everyone Who Is Eligible

If you are a smoker or former smoker, make sure to check out the guidelines for lung cancer screening. If everyone who was eligible for screening was tested, it's thought that we could reduce the mortality rate from lung cancer by 20 percent. One in five people now destined to die from the disease could live.

Testing is recommended for:

  • People between the ages of 55 and 80
  • People who continue to smoke or have quit smoking in the past 15 years
  • People who have smoked a total of 30 pack-years or more
  • People who could tolerate surgery (or focused radiation) if an early lung cancer is found

Though this article is about ways to decrease deaths from lung cancer aside from smoking cessation, it's notable that one of the "side effects" of lung cancer screening is an increased rate of smoking cessation. Lung cancer screening provides a "teachable moment" and it's been found that those who have CT screening are more likely to quit smoking than those who do not have the screening.

Don’t Depend on Your Doctor to Learn About Lung Cancer Screening

Do you know the guidelines for lung cancer screening? If you don’t, you’re not alone. A 2016 study found that half of primary care physicians didn’t know these either. So if you’re depending on your internist or family doctor to educate you, your chances are 50:50 that you’ll even know about this.

We know that many people still smoke and that there are many former smokers out there. It's likely that most internists see at least a handful of former smokers each day. Yet less than half of doctors polled had referred one or more patients for lung cancer screening over the prior 12 months. There are many possible reasons for this. Some doctors expressed uncertainty regarding the benefit of lung cancer screening, wondering if it could really lengthen life expectancy. Other cited insurance coverage problems or possible harm related to screening. (Medicare now covers screening.)

Whatever the reason, this is another reminder for you to be your own advocate for your health care. Learn about the screening tests available so that you can decide if these are something which would be helpful for you as an individual, or not. Take the time to learn more about the controversy of lung cancer screening.

Understand That Lung Cancer Screening Guidelines Are a Work in Progress

The current guidelines we have for lung cancer screening are fairly new and continue to be studied.

A recent study found that only a third of people who had been scheduled to have lung cancer surgery met the guidelines for screening so that even if we screened everyone who was eligible, we would miss many cancers.

One area that is being researched (and guidelines may change) is that of people who quit smoking more than 15 years ago. We know that former smokers are at risk decades later and many people recall that Paul Newman died from lung cancer 30 years after quitting.

It may be that guidelines will be extended so that people who quit in the distant past are included, but for now, talk to your doctor if you quit more than 15 years ago but are concerned. Guidelines are meant for the general public, but you and your doctor may decide that you should be screened outside of those guidelines. For those with COPD, this discussion is even more important, as COPD is an independent risk factor for lung cancer.

Know the Symptoms of Lung Cancer – Even If You’ve Never Smoked!

Unless you meet the criteria for lung cancer screening, and if you don't believe you have special circumstances which would warrant screening outside of these guidelines, you only have one way of finding a lung cancer in the early stages: know the symptoms.

Studies tell us that even though most people are familiar with the most common symptoms of lung cancer, most cannot name the top three symptoms.

Part of this reason is that the most common types of lung cancer have been changing in recent years, and with that, the symptoms.

Currently, lung adenocarcinoma, a type of non-small cell lung cancer is the most common type of lung cancer. These cancers tend to grow in the periphery of the lungs away from the airways, and as such, are less likely to cause the classic persistent cough or coughing up blood.

With lung adenocarcinomas (incidentally the most common type of cancer in non-smokers, most common type in women, and most common type in young adults with lung cancer) the most common symptom is shortness of breath. This shortness of breath can come on slowly, at first only with vigorous exercise. It's easy to dismiss this symptom as a sign that you are out of shape or have aged a few years. If you experience any shortness of breath, even if you feel it's related to those 10 extra pounds you gained, visit your doctor.

The most common early signs and symptoms of lung cancer include:

There are other symptoms which are fairly common as well, such as fatigue, blood clots in the legs (deep vein thrombosis), and even depression.

Don't Delay If You Have Symptoms

Being familiar with the symptoms of lung cancer alone, however, is not enough. If you have any of the above symptoms you need to visit your doctor. That said, the average time between the onset of symptoms and the diagnosis of lung cancer is currently around 12 months. Given that the doubling time of lung cancer is much less than this, those 12 months could make the difference between a curable and incurable cancer.

If you don't have a clear explanation about any of the above symptoms, continue to talk to your doctor. You may also wish to get a second opinion.

Don't Trust a Negative Chest X-Ray

If your doctor ordered a chest x-ray and feels you are fine, continue to ask questions. We've learned that chest x-rays can miss lung cancers and often do. In one large study, it was found that over 25 percent of people diagnosed with lung cancer had been reassured that they had a normal chest x-ray in the year preceding diagnosis, and missed lung cancers are responsible for upwards of 40 percent of radiology malpractice lawsuits involving the chest.

Know Your Risk Factors

Did you know that having a family history of lung cancer raises your risk, even if you've never smoked? Did you know that having one of the breast cancer genes we’ve been hearing so much about, BRCA2 raises lung cancer risk too? Did you know that more women die from lung cancer than breast cancer and that 20 percent of these women have never touched a cigarette?

As we've learned with breast cancer, being aware of your risk factors can alert you to be on the lookout for symptoms. Many people, however, are less familiar with the risk factors for lung cancer than they are the risk factors for breast cancer, even though they are more likely to die from lung cancer.

Learn About How You Can Lower Your Lung Cancer Risk

We know that there are a number of ways in which people can reduce their risk of lung cancer that have nothing to do with smoking. Since lung cancer has been linked so strongly with smoking, many people are unaware of some of these steps—even those that are very simple.

  • Check your home for radon
  • Be cautious with chemicals used at home and at work. It's thought that up to 27 percent of lung cancers in men are at least partially related to occupational exposures (learn about occupational causes of lung cancer)
  • Exercise - Even small amounts of exercising, such as gardening twice a week, can reduce your risk of lung cancer
  • Eat a healthy diet - Check out these superfoods for reducing lung cancer risk

Support Lung Cancer Research or Become an Advocate

Advocacy for lung cancer is needed for a number of reasons. One is to simply to raise awareness. As noted above, too few people are familiar with the symptoms of lung cancer, and too few have heard about lung cancer screening. There is a huge need to simply spread the word about lung cancer.

Another reason to spread the word is that advances are being made. The general attitude towards lung cancer has been somewhat fatalistic, with both patients and their physicians wondering if it really makes a difference to diagnose the disease early. The treatments for lung cancer are getting better. The survival rates for lung cancer are improving. Perhaps, if the public were more aware of this, people would be more likely to visit their doctors with symptoms or consider screening.

A final reason for advocacy is that it is desperately needed for funding. Advocacy draws in funding, which in turn sponsors lung cancer research. Lung cancer is painfully underfunded relative to many other cancers on both a private and public level. In addition, there are simply too few survivors out there to walk and run to raise support. It is up to those of us without lung cancer to make a difference in the lives of those living with lung cancer today, and those who will live with lung cancer in the future.

Learn more about how to become a lung cancer advocate.

Sources:

Fintelmann, F., Bernheim, A., Digumarthy, S. et al. The 10 Pillars of Lung Cancer Screening: Rationale and Logistics of a Lung Cancer Screening Program. Radiographics. 2015. 35(7):1893-908.

Pass HI. Principles and Practice of Lung Cancer: The Official Reference Text of the IASLC. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2010. Print.

Pedersen, J., Tonnessen, P., and H. Ashraf. Smoking Cessation and Lung Cancer Screening. Annals of Translational Medicine. 2016. 4(8):157.

Raz, D., Wu, G., Consunji, M. et al. Perceptions and Utilization of Lung Cancer Screening Among Primary Care Physicians. Journal of Thoracic Oncology. 2016. 11(11):1856-1862.

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