So much to learn about...Lung Cancer

By Debbie Kerr

There is a stigma associated with lung cancer. People, including me, have been under the misconception that only smokers develop lung cancer. Therefore, if people didn’t smoke, there wouldn’t be any lung cancer.  To me, it’s always seemed so clear. The truth is, there is nothing clear about lung cancer except that it is deadly.  

It wasn’t until I wrote this post, did some research, and talked to two people who were diagnosed with lung cancer, that I realized just how much I had to learn.  ​

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Types of lung cancer
There are two major types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Each of these types of cancer has sub-types, so it’s possible that you might hear lung cancer referred to by another name. NSCLC is the most-commonly diagnosed type of lung cancer, while SCLC is more deadly. However, given that 70% of lung cancers are diagnosed at Stage 3 or 4, both types of cancer can be deadly. 

Not so fun facts

• Excluding non-melanoma skin cancer, lung cancer is the second most-commonly diagnosed cancer in both Canada and the United States (second only to breast cancer in women and prostate cancer in men).
• In both countries, lung cancer has the highest mortality rate. In fact, more people die from lung cancer than breast cancer, prostate cancer, and colorectal cancer combined.
• The average survival rate (odds of living 5 years after a diagnosis) is estimated to be about 22% in Canada; however, factors like stage of diagnosis and type of lung cancer greatly affects this percentage. For example, the survival rate for a diagnosis at Stage 1 is much higher than a diagnosis at a later stage.
• In Canada, 20 to 30% of people diagnosed with lung cancer are non-smokers.
• In Canada and the United States, radon gas is the number one cause of lung cancer in non-smokers. In fact, Atlantic Canadians are among the most radon-exposed people in the world.
• Pollution is now considered an important risk factor for non-smokers.

Symptoms
There are a wide range of symptoms associated with lung cancer, which makes it hard to detect. There are the ones you would expect like a persistent cough, coughing up blood, wheezing, and difficulty breathing. Other symptoms of lung cancer can also be symptoms of so many other conditions that testing for lung cancer wouldn’t necessarily be the first test that would be performed. In fact, you might not even decide to see a doctor. For example, here are a “few” potential symptoms of lung cancer that you might not expect: fatigue, sudden weight loss, headaches, joint pain, muscle weakness, cramping, and vision issues. 

Real life stories (Angus and MaryAnn)
Of the two lung cancer patients I interviewed, both Angus and MaryAnn were diagnosed with lung cancer by accident. Neither one had symptoms that you might normally associate with lung cancer.

Angus was diagnosed with NSCLC while he was undergoing tests for breast cancer. He didn’t have any symptoms of lung cancer and had never smoked, although he was exposed to a lot of second-hand smoke (burning wood).  Like many lung cancer patients, Angus’s lung cancer was not discovered until it was Stage IIIC, which means it has been less treatable and more deadly.  To try and suppress the growth of the disease, Angus has had chemotherapy, radiation, and is undergoing immunotherapy and, while he was told he had only a 5% chance of living for 5 years after diagnosis, and I am happy to say that he recently reached that milestone. He is a runner and a lung cancer advocate.

MaryAnn had a pain in her carotid artery (side of her neck), so she was undergoing tests for potential heart issues.  Ironically, one of the tests showed a small lesion on her lung and she did not find any heart issues. She did not smoke. Her only previous experience with lung cancer was the death of her father who had SCLC (the more aggressive cancer). As a result of this experience, she believed that she would die too. Luckily, her cancer was NSCLC and was caught early at Stage 1a. She had surgery to remove the lesion and has not required any additional treatments. She is an example of what can be achieved with early detection. She, too, is a lung cancer advocate.
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Both advocate for greater awareness (for example, the causes and risks), more research, and earlier detection. As more discoveries and treatment options become available, they make sure they share that information so that those people undergoing treatment can advocate for themselves to see if new treatments will work for them.

Recommendations
The following are recommendations based on feedback from Angus and MaryAnn, as well as my own research:   

• If a cough lasts for more than three weeks and medications don’t resolve the issue, ask for a chest x-ray or, even better, a CT scan instead of just continuing to try other treatments.
• If you are diagnosed with lung cancer, ask to have your biomarkers checked. While being positive for lung cancer is bad, testing positive for any of the 7 or 8 biomarkers/mutations is good.  It means immunotherapy or targeted therapy can be used to “flag” a mutation so that the immune system recognizes it, attacks it, and kills it.
• Minimize your risk of developing lung cancer as follows:
  • Quit smoking.
  • Limit your exposure to second-hand smoke, which includes smoke from burning wood.
  • Test for radon gas in your home. While there are a variety of test kits available, Evictradon.org is the only organization that takes the test-kit results and uses them for research (spearheaded by Dr. A. Godarzzi in Calgary, Alberta).
  • Stay inside or wear a mask outside when the air quality is poor.
  • Protect yourself from toxic chemicals.
  • Eat a lot of fruit and vegetables.
  • Exercise. Exercise. Exercise. 

There’s hope

• The incidence of lung cancer is decreasing as more people quit smoking or never start smoking.
• Treatment options are improving.
• Studies are being done to find ways to detect cancer earlier, even before there are symptoms. 

Canadian Resources

• Canadian Cancer Society - lung cancer
• Lung Cancer Canada
• BC Cancer Article: Relationship between long-time exposure to air pollution and lung cancer
• CBC Article: Environmental Risks for lung cancer​

American Resources

• American Cancer Society
• LUNGevity