Leading Cause of Death, Overcoming Lung Cancer
Lung cancer is a formidable adversary. Last year, it was the leading cause of death among cancers in the country, with the highest mortality rate among them. It claimed 36.5 lives per 100,000 people, surpassing liver cancer (19.8), colorectal cancer (18.3), and pancreatic cancer (15). However, there are ways to fight back. Early detection through regular check-ups, receiving appropriate treatment, and preventive efforts can help alleviate the fear. In recognition of “Lung Cancer Awareness Month” (November), designated by the Korean Lung Cancer Society, here are key points to help with lung cancer treatment and management.
1. High-Risk Group: Over 50 and Long-Term Smokers
The greatest risk factor for lung cancer is smoking. Direct smoking increases the risk up to 13 times, and long-term passive smoking can also increase the risk by about 1.5 times. Older individuals over the age of 55 have a higher risk compared to younger people. Professor Park Sae-min from the Department of Thoracic and Cardiovascular Surgery at Seoul National University Hospital explains, “Occupational exposure to carcinogens or underlying lung diseases are also risk factors for lung cancer. The importance of family history is relatively lower compared to other cancers.” For those at high risk of developing lung cancer, early screening, such as low-dose chest computed tomography (CT), is recommended. According to the national guidelines, men and women aged 54-74 with a smoking history of 30 pack-years (number of cigarette packs smoked per day × smoking years) or more should undergo low-dose chest CT every two years. This test can detect small nodules of 3-5mm that are difficult to identify with chest X-rays and can observe areas obscured by the heart, blood vessels, and bones. It is the most effective method for screening high-risk groups for lung cancer to date.
2. Air Pollution and Lung Diseases
There is a consistent increase in lung cancer cases among women with no history of smoking. It is assumed that factors like occupational and environmental influences apart from smoking contributed to cancer development. Air pollution, indoor air pollution, and radon exposure are typical examples. Having lung diseases like chronic obstructive pulmonary disease or pulmonary fibrosis is also known to be associated with the onset of lung cancer. Histologically, most of these are adenocarcinomas, with numerous genetic mutations unlike squamous cell carcinoma or small cell cancer commonly found in smoking men. In non-smoking female lung cancer patients with epidermal growth factor receptor (EGFR) mutations, targeted therapy is known to be effective. In such cases, molecular genetic testing to check for EGFR mutations can help select appropriate treatments.
3. Watch Out for Cough, Phlegm, Hemoptysis, Shortness of Breath, Chest Pain
Symptoms are rare in the early stages. As the cancer progresses from the early to later stages, symptoms are more likely to appear. Symptoms due to the lung cancer mass include cough, phlegm, hemoptysis, shortness of breath, and chest pain. Symptoms also appear when lung cancer has metastasized to other organs. When it spreads to the brain, it may cause headaches, weakness, or sensory changes in parts of the body; when it spreads to the bones, there may be localized pain or even fractures. If metastasized to the liver or adrenal glands, one might experience dull pain or generalized weakness. However, since these symptoms are not exclusive to lung cancer and can be observed in a variety of illnesses, it is better to consult with a specialist rather than self-diagnose.
4. Design a Treatment Plan According to the Condition
Stages 1 to early 3 are typically addressed with surgery. Stage 1 is particularly effective with surgery. By surgically removing the lung lesion and some lymph nodes, the exact stage can be determined through a pathological assessment of metastasis. For stages 2 and 3, chemotherapy or immunotherapy is often employed to shrink the cancer before surgery, reducing the risk of recurrence and increasing survival rates. Professor Park notes, “Recently, the number of patients undergoing three rounds of neoadjuvant chemotherapy before surgery has increased,” adding, “The applicability of neoadjuvant chemotherapy varies depending on the patient’s overall condition.” Long-term use of targeted therapy post-surgery can also help prevent recurrence. For stage 4, chemotherapy is the primary treatment, sometimes combined with radiation therapy. Transplant treatments are rarely done even in advanced stages since replacing only the affected area doesn’t solve the problem of metastasis to other organs, and immunosuppressants used post-transplant can increase the risk of recurrence.
5. Quit Smoking and Eat Vegetables and Fruits
To prevent lung cancer, quitting smoking is essential. Even current smokers should stop immediately. Since polluted air or fine dust can impact, it’s advisable to wear masks to prevent access to lung cancer-causing substances when going out or working outdoors. According to the Korean Lung Cancer Society, plant-based foods like leafy green vegetables and fruits slightly reduce the risk of lung cancer, while red meat, processed meats, and alcohol may increase the risk. It’s recommended to improve daily dietary habits rather than relying on nutritional supplements.