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Understanding Lung Cancer

Posted Aug 24 2008 1:49pm
ANNOUNCER: Lung cancer is the leading cancer killer in both men and women in the U.S. When it strikes, it can often be fatal. But it is also one of the most preventable cancers. So it's important to know the facts about this very serious disease.

DAVID JOHNSON, MD: Lung cancer is of course one of the more common cancers encountered in Canada and the United States. It's by far the leading cause of cancer-related death. About 150,000-160,000 Americans every year die of lung cancer, or roughly one American every 3½ minutes.

NASSER ALTORKI, MD: Somebody said it's the equivalent of a fully-loaded jumbo jet crashing every day of the year for 365 days. It has exceeded breast cancer in women as the leading cause of death from cancer-- so it's a big health problem.

What's the reason for that? 80 percent of patients present with an advanced stage; it's the cancer has metastasized to different organs, it's no longer operable, that sort of thing. Only 20 percent are candidates for surgery, with an expectation of cure.

ANNOUNCER: There are several risk factors for lung cancer, but one by far, stands out.

DAVID JOHNSON, MD: We know that 90 percent, or thereabouts, are caused by smoking, and therefore we want people to stop smoking first and foremost. However there is a percentage-- 10 percent maybe as high as 15 percent-- which is non-smoking related. That means around 25,000 cases of cancer of the lung each year are occurring in individuals who have never smoked.

ANNOUNCER: Aside from smoking other risk factors can include: air pollution from soot, sulfur dioxide, or the burning of fossil fuels. Exposure to radon gas, asbestos, or other airborne carcinogens, can also increase risk. Lung cancer, when diagnosed, falls into two main categories.

DAVID JOHNSON, MD: We tend to lump lung cancer into two broad categories. Small cell lung cancer, which represents somewhere around 15 percent to maybe maximally 20 percent of lung cancers. This is a very rapidly growing form of cancer, that is virtually always widely disseminated, that is spread or metastasized, as soon as it is diagnosed. And then there is a category called non-small cell lung cancer; this represents the majority of cancers of the lung. These cancers are sometimes confined to the chest when initially diagnosed, and can be removed with an operation. Unfortunately, in probably anywhere from 60-75 percent of cases, even the non-small cell cancers have already spread to other parts of the body, making surgery ineffective in and of itself as a treatment of this disease.

ANNOUNCER: The symptoms of lung cancer can include: a persistent cough, coughing up blood, shortness of breath, wheezing or hoarseness, loss of appetite or weight, fatigue, swelling of the face and neck, repeated bouts of bronchitis or pneumonia, and pain in the chest, shoulder or back. But pain can sometimes indicate that the cancer has already spread.

ROGER WALTZMAN, MD: Pain due to a cancer may or may not occur from a primary cancer. Often times primary cancers are not painful, which is why they're hard to detect for quite some time because people may not have symptoms at all. So for example primary lung cancer is not typically painful. The pain that they cause is usually from spread to other places.

ANNOUNCER: When lung cancer does spread, it can make an already serious disease, even worse.

ROGER WALTZMAN, MD: In a large percentage of times when lung cancer spread to other sites of the body, they die from the complications of the spread. So spread to the brain will obviously lead to tremendous complications. Spread to the liver may result in ultimately liver failure. Spread to the bone may lead to complications like fractures. Fractures then lead you to be immobile. When you're immobile, you're more likely to get blood clots. If you need surgery, you're more prone to infection. And so often times, people die of the complications of cancer having spread to other sites and trying to treat it, rather than for example, organ failure.

ANNOUNCER: Though lung cancer is often fatal, there is some good news for those living with this disease.

DAVID JOHNSON, MD: I suppose it's hard to say there's any good news for anyone who's diagnosed with the disease lung cancer. I think what we can say though is that patients with lung cancer today are living far longer than they were just a decade or so ago.

But we have a long way to go before we have really conquered this disease. It truly is a major scourge on our society.

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