Lung Cancer

Lung cancer is the leading cause of cancer death. In Illinois, between 1973 and 1992, the death rate from lung cancer rose more than the rate for all other cancers combined, including breast, prostate and colorectal cancers. In Illinois, projections for 2001 indicate that there will be more than 8,540 new cases of invasive lung cancer and more than 7,000 people will die. Experts predict that in the next four years, twice as many women will die from lung cancer as from breast cancer.

The lungs are large and cancer can grow in them for a long time, often for as long as 10 years or more, before symptoms occur. For this reason, by the time many people find out they have lung cancer, it has already become advanced and spread to other parts of the body.

Lung cancer is largely preventable by avoiding its risk factors.

Cigarette smoking is the direct cause of about 85 percent of all lung cancers. Other causes are exposure to secondhand smoke, radon, certain industrial substances such as asbestos and occupational radiation. Additionally, medical and environmental sources, air pollution, and tuberculosis or other lung diseases can also cause lung cancer.

About 20 percent of people who die from lung cancer have never smoked. People who quit smoking may still get lung cancer.

Persons who have smoked cigarettes have the largest risk of getting lung cancer. Pipe and cigar smokers have a higher risk of lung cancer than nonsmokers. The number of years a person smokes, the amount smoked per day and how deeply the person inhales all affect risk of developing lung cancer. Others at risk include those exposed to secondhand smoke, individuals who have had tuberculosis or other lung diseases such as emphysema, and people exposed to substances such as asbestos, chromium, radon and other industrial or environmental chemicals.

Early diagnosis of lung cancer is difficult because a lung tumor big enough to cause symptoms is usually advanced. Occasionally, lung cancer is detected as a shadow on a routine chest X-ray. If present the following symptoms should be discussed with a doctor.

• persistent cough
• coughing up blood
• change in the color of sputum
• chronic pain in back, chest, shoulder
• reoccurring bronchitis or pneumonia
• swelling of neck and face
• unusual tiredness
• shortness of breath or wheezing
• loss of appetite or weight
• hoarseness

If you smoke, quit. Stopping smoking, or never starting, greatly reduces a person's risk for developing lung cancer. Stay away from second-hand smoke.

Eliminate radon if it is present in your home. A kit available at most hardware stores allows homeowners to measure radon levels in their homes. The home radon test is easy to use and inexpensive. Once a radon problem is corrected, the hazard is gone for good.

Protect your lungs from inhaled particles that can lodge in the lungs, damage cells and increase the risk for lung cancer. Workers should use protective equipment, such as masks, and follow recommended work practices and safety procedures. Avoid asbestos exposure.

Lung cancer is the largest single cause of cancer deaths in Illinois women. For years, men were at higher risk for lung cancer because of their higher smoking rates. However, with the rising number of women who smoke, lung cancer surpassed breast cancer as the leading cause of cancer deaths among women. From 1975 to 1995, the number of Illinois women who died of lung cancer increased almost 180 percent compared to an increase of about 22 percent in Illinois men.

Smoking causes 87 percent of lung cancer, but what about the other 13 percent? There is evidence that exposure to tobacco smoke in the home, usually from a smoking spouse, may increase the risk of lung cancer in non-smoking women. Nearly nine out of 10 non-smoking Americans are exposed to "second-hand" smoke, as measured by levels of nicotine in their blood. The best scientific studies show that restrictions on second hand smoke reduce the risk of death and injury to non-smokers, including the hundreds of thousands of children with asthma and other respiratory illness. The U.S. Food and Drug Administration (FDA) has classified second-hand smoke as a group A carcinogen (known to cause cancer in humans). More studies are needed to determine how much exposure might be harmful in any of these settings.

The best way to avoid death from lung cancer is never to smoke, or to stop smoking. Once lung cancer is diagnosed, there are several treatment options, including radiation, various chemotherapies and surgery. Survival rates have improved for non-small cell lung cancer because of advances in combination radiation/chemotherapy treatment. However, small cell lung cancer is still very difficult to treat. Small cell is the most aggressive of lung cancers, and many patients have advanced disease at the time of diagnosis. Small cell lung cancer is responsive to both chemotherapy and radiation, yet nearly all these patients eventually relapse and need additional treatment.

There is a clear need for more effective treatments for lung cancer. New advances in research have recently led to new drugs that can protect normal cells from being destroyed from chemotherapy.

Early detection remains the key to successful therapy. If you have a history of chronic coughing, coughing up blood, chest pain or fever, you should be evaluated by your physician as soon as possible.

Lung cancer is not the only smoking- related cause of death in women. The World Health Organization states that at least 25 percent of women smokers will die of smoking-related disease such as cardiovascular disease and chronic obstructive pulmonary disease (COPD).

• American Cancer Society
• National Cancer Institute