Passive smoking increases lung cancer risk by 20-30 percent

Among the causes of lung cancer, which is one of the most feared cancer types, smoking addiction and environmental factors take the first place. 85% of lung cancer cases are directly related to smoking, and  this disease is more common in countries with high smoking rates. Even passive smoking increases the risk of lung cancer by 20-30%. The incidence of lung cancer is decreasing in countries that are seriously struggling against smoking. Professor from Memorial Şişli Hospital Chest Diseases Department. Dr. Mustafa Yaman gave information about lung cancer and ways to prevent it.

Lung cancer is a disease that can be prevented

The most important symptom of lung cancer is chronic cough. For chronic coughs that last longer than three weeks and cannot be explained by reasons such as upper respiratory tract infection, a pulmonologist should be consulted. The pulmonologist will definitely want a chest x-ray for this patient and evaluate whether there is any sign of a tumor if the person is over 40 years old and has a history of smoking.  If the person is non-smoker, evaluation is made according to her/his professional status and environmental factors.

Radon gas causes lung cancer

There is a difference between smoking-related lung cancer and non-smoking-related lung cancer. Environmental factors can also cause lung cancer. Factors such as air pollution, coal fire, some fuels used for cooking, radon gas and asbestos also increase the risk of lung cancer. Radon gas, which rises to the surface from natural sources and accumulates in homes and is known to have a carcinogenic effect, is among the factors that cause lung cancer. Radon gas is odorless, tasteless and tends to accumulate in closed environments. The regions where radon gas is intensified in Turkey are indicated in the radon gas map made by the Turkish Atomic Energy Agency. One of the causes of lung cancer is asbestos. Asbestos is concentrated in certain regions of Anatolia. Lung cancer may occur as a result of people inhaling the fibers of asbestos due to environmental exposure to asbestos. Since small amounts of particles are inhaled, their effects appear later.

The disease can be diagnosed early with low-radiation computed tomography

People over the age of 50 who smoke and do not have any complaints should have a computed tomography scan once a year. Low-radiation computed tomography is one of the methods that provides the earliest diagnosis of lung cancer. There is a risk of lung cancer if a person has smoked one pack a day for 30 years or 2 packs a day for 15 years, has quit smoking but has not quit smoking for 15 years, and is between 55 and 75 years of age.  Especially if these patients are diagnosed with COPD, the risk of lung cancer is even higher. If people in this risk group have low-radiation computed tomography once a year, very early nodules can be noticed.

Not all nodules are cancer

Not every nodule seen on computed tomography is lung cancer. These nodules have some characteristics. The definitive diagnosis is made by cancer councils composed of pulmonologists, radiologists, pathologists and thoracic surgeons. In these cancer councils, patients are followed up. If necessary, PET-CT is performed. If the nodule is at a point that can be reached, a biopsy is taken from there by entering the trachea with a bronchoscope. Alternatively, a full diagnosis is made by entering through the chest wall and performing biopsies called needle biopsy under computed tomography.

Treatment is planned according to the type and stage of the cancer

Lung cancer is divided into two large groups as small cell and non-small-cell. And there are some genetic characteristics in this type of cancer. It should be diagnosed to which group it belongs to and the treatment should be programmed accordingly.  Lung cancer that is caught at an early stage is called 1st stage lung cancer and the cure rate is very high. If the lung cancer is in the first stage, it has not spread to the lymph and since it does not metastasize, surgery is the best treatment option. However, if the person has another lung problem or a serious cardiac problem, since she cannot receive general anesthesia, there is no chance for surgery and surgery cannot be performed.

Local radiotherapy can be applied for patients who do not have a surgical option. With the radiation rays the tumor in the lung is caught and cancer cells are destroyed right on the nail.

Successful results are obtained with immunotherapy …

Another treatment method is immunotherapy, that is, enabling the natural protection mechanism of body. Lymphocyte cells are responsible for immunity. Lymphocytes attack everything that enters the body with antigen properties, as well as attack cancer cells that go astray and try to eliminate them. The life expectancy of disseminated lung cancers, called 4th stage, can be extended by virtue of these treatment methods.

Blog 7: Choose a life without tobacco to avoid lung cancer

Lung cancer, which is in the first place in cancer deaths in the world, can cause symptoms such as cough, sputum, hoarseness, loss of appetite, pain of chest, back and shoulder. To prevent lung cancer, which can progress insidiously without showing any symptoms, one should first avoid smoking .  Professor from Memorial Ataşehir Hospital Chest Diseases Department. Dr. Atilla Saygı gave information about lung cancer.

Lung cancer threatens not only men but also women

Lung cancer, which is known to cause 1.8 million deaths every year, is in the firs place in the deaths due to lung cancer in the world. Lung cancer, which is the most common cancer in men with a rate of 25.7% in Turkey, ranks 5th with a rate of 4.8% in women. The disease is becoming widespread due to the increase in smoking in women and the difficulty in cessation.

Choose a life without tobacco

The most important cause of lung cancer (with the rate of 90%) is smoking. In addition to cigarettes and other tobacco products, the other causes of lung cancer are asbestos exposure, radon gas, heavy metals, genetic factors and tissue disorders caused by previous lung diseases. Today, the most important anti-smoking methods are establishing effective public health policies to prevent smoking, keeping tobacco products (cigarettes, cigars, pipes, hookahs) under control, providing medical and social support to nicotine addicts, government coverage of smoking cessation treatment, and raising public awareness.

There is no effective medical method for prevention and avoiding of lung cancer

Substances such as herbal teas, inhaled steroids used to keep asthma under control, vitamin E, aspirin, beta carotene, metformin do not have a role in preventing lung cancer. In preventing lung cancer, it is known that screening with chest X-ray and sputum tests has no benefit. Screening of patients considered to be at high risk for lung cancer with low radiation dose drug-free thoracic computed tomography is included in the scope of international guidelines. However, the beneficial and harmful aspects of this high-cost method should be known and patients should be informed about this screening.

Persistent cough may be a sign of lung cancer

An insidious disease, lung cancer is one of the most important diseases that may cause death. In lung cancer, where early diagnosis is important, it is usually diagnosed in the late and advanced stages. In the diagnosis and staging of lung cancer, a multidisciplinary approach is of significant importance. The disease may present local and systemic symptoms depending on the histopathological type of the disease (tissue diagnosis), the stage at which the diagnosis is made, and the involvement area.

Locally, persistent cough, change in the character of cough in people with chronic cough, sputum, coughing up blood, chest, back and shoulder pains, shortness of breath, wheezing, hoarseness, recurrent respiratory tract infections, pneumonias and

Systemically; loss of appetite, weight loss, weakness, fatigue, reluctance can be seen.

Lung cancer most commonly metastasizes to the brain, bones and bone marrow, liver and adrenal glands. Symptoms such as headache, balance disorder, stroke, pain and weakness  in arm and shoulders, bone pain and  jaundice may be seen in patient depending of the location of these metastasizes. In addition, hormonal, which is not related to the direct dissemination of cancer; hematological; immunological; skeletal system and dermatological signs and symptoms may also be seen.

Early diagnose saves life

In the diagnosis and staging of lung cancer, surgical methods such as bronchoscopic, radiological and nuclear medical methods (Computed Tomography, PET-CT, MRI, USG, etc.),  mediastinoscopy, VAMS, VATS, thoracotomy are used depending on the region of the cancer. The most important thing is to diagnose tissue, to perform staging and to decide on treatment methods by using the least invasive, that is, the interventional method as soon as possible. 

Promising developments in treatment

A decision is made by a multidisciplinary council consisting of experienced doctors according to the tissue type and stage of the disease in the treatment of lung cancer.

Surgery: The type of surgical operation depends on the location of cancer in the lung. In surgical intervention, the whole, one or two lobes or a segment of a lung can be removed anatomically. Whether surgery can be performed is determined depending on the location of the tumor, its size, and the patient's condition. In early stage patients, robotic surgery methods can be performed in some centers.

Chemotherapy and radiotherapy: In small cell lung cancer, which progresses faster and metastasizes more quickly, chemotherapy and radiotherapy respond better. In non-small cell lung cancer, surgical treatment is performed first, chemotherapy and radiotherapy are applied according to the stage of the subject.

Radiosurgery: In recent years, radiosurgery methods (Whole Body Stereotactic RT, Siberknife RT) have been started to be used in patients who are at an early stage and cannot be operated on for medical reasons.

Smart drug treatment: In advanced stage and metastatic patients, especially in adenocarcinoma type and in some patient groups with gene mutations, smart drug therapy, that is, targeted therapy, is applied.

Immunological studies: Regarding metastatic advanced lung cancer, immunological studies (immune check point inhibitors) are still ongoing. The aim of immunotherapy is to help the body to fight cancer by strengthening the immune system. Especially in stage 4 metastatic patients for whom systemic therapy is not effective, immunotherapy can be applied.  Immunotherapy has less side effects than chemotherapy. There are also vaccine studies that prepare the immune system of the body against cancer.

Patients diagnosed with lung cancer should be warned that the disease will recur if they continue to smoke.

The most important factors in lung cancer are the fight against tobacco, early diagnosis and treatment. On this issue, public awareness should be increased. In the fight against the disease, a multidisciplinary approach to patients with lung cancer will increase the chance of success. 

Prepared by the Medical Editorial Board. Our health library contents have been prepared for informational purposes only and with the scientific content on the registration date. For all your questions, concerns, diagnosis or treatment about your health, please consult your doctor or health institution.