Early detection of lung cancer even without symptoms

A common misconception about lung cancer is that it only affects certain people, such as the elderly and those who have smoked.

But when it comes to lung cancer, it’s no longer just a question of “Do you smoke?”

The reality is that even non-smokers who lead a healthy lifestyle can be diagnosed with lung cancer.

Although smoking remains the most common cause of lung cancer in Malaysia, the experience of Malaysian practitioners shows that the number of non-smokers diagnosed with this cancer has increased in recent years.

“Up to a third of patients diagnosed with lung cancer are never or never smokers,” said Dr. Anand Sachitanandan, consultant cardiothoracic surgeon and president of Lung Cancer Network Malaysia (LCNM). I’m here.

For Dr. Tho Lye Mun, senior consultant clinical oncologist and LCNM vice president, half of his lung cancer patients are never or very light smokers, and surprisingly, most of them are women. is.

family and pollution

Apart from smoking, people with a family history of lung cancer are also at risk of lung cancer.

A clinical trial conducted in Taiwan between February 2015 and July 2019 found that an individual’s lung cancer risk increased with the number of first-degree relatives with lung cancer.

According to Dr. Toh, the environment we live in also poses risks.

If you are constantly exposed to secondhand smoke from smokers around you, or if you are frequently exposed to asbestos at work, you are more likely to be diagnosed with lung cancer.

In fact, the World Health Organization (WHO) recently confirmed a link between air pollution and lung cancer.

The International Agency for Research on Cancer (IARC) officially declared outdoor air pollution to be a Group 1 carcinogen in 2013.

A recent study by the UK’s renowned Francis Crick Institute found that very small pollutant particles (PM2.5) in the air, e.g. from vehicle exhaust and fossil fuel combustion, predispose to lung cancer. It has been suggested that it can cause inflammation. .

Dr. Anand believes that chronic air pollution can trigger an inflammatory response at the cellular level, “activating” pre-existing dormant oncogenes or driver mutations (such as EGFR and KRAS) and causing lung cancer in susceptible individuals. He points out that there is new evidence that he is a non-smoker.

This may explain the rising incidence of lung cancer detected among young people and nonsmokers in densely populated and polluted urban areas.

As a precautionary measure, Dr. Anand urges the general public to avoid or quit smoking because smoking is a preventable risk factor for lung cancer.

Unfortunately, we have little control over the air we breathe, but the LCNM is a vocal and strong supporter of the Ministry of Health’s proposed generational end-of-life tobacco ban to limit the dangers of secondhand smoke and protect future generations. He continues, he says.

Also read: Preparing for the end of the tobacco generation

often diagnosed late

Most people with lung cancer are usually only diagnosed at a later stage compared to other types of cancer such as breast and prostate cancer.

According to Dr Tho, the vast majority (over 90%) of the lung cancer patients he encounters develop at stages III and IV.

Stage IV lung cancer is considered incurable.

Diagnosis is delayed because symptoms of lung cancer can be difficult to spot.

They are usually vague or non-specific and can be easily dismissed as far less malicious.

“For example, it can be confused with a simple cold or chest infection,” says Dr. Toe.

He adds that if an individual is a smoker, suspicion of possible lung cancer may be further delayed because they may mistake symptoms from regular smoking, such as coughing, for symptoms.

Lung cancer can cause coughing, chest pain, weight loss, coughing up blood, and shortness of breath.

Do most of these symptoms sound familiar to you?

It may sound like a common symptom of Covid-19.

Dr Tho urges people not to ignore these symptoms.

“It’s essential to see a doctor and have your symptoms properly investigated,” he says.

early detection

Air pollution is associated with lung cancer, which may explain why young people and nonsmokers in polluted cities are increasingly being diagnosed with this cancer.— Lim Ben Tat/ The Star

The good news is that lung cancer can be detected early, even before symptoms appear.

Dr Tho said:

“Lung cancer can be curable if detected early.”

According to Dr. Anand, LDCT scans are the gold standard for lung cancer screening.

Compared to conventional CT scans, which require several hours of fasting before the scan and use contrast agents, LDCT scans are “quick, painless, needle-free, and have minimal, low-dose radiation.” .

He adds that you don’t need to fast or do blood tests before the scan.

This is a single-breath technique that takes pictures of the lungs very quickly and provides high-quality, detailed images.

An LDCT scan is recommended for men and women between the ages of 45 and 75 who have smoked for 20 years or more.

Meanwhile, there are now artificial intelligence (AI) screening programs to help detect early stage lung cancer for people who have never smoked.

“Our advanced AI machine technology, based on deep learning algorithms, automatically scans and quickly reads patient chest X-rays more accurately than the human eye can, to generate detailed reports,” says Dr. Anand. says.

This not only assists general practitioners (GPs) in detecting lung cancer at the community level, but also improves diagnostic accuracy and facilitates referral of suspected cases to relevant pulmonologists, thereby increasing the potential for lung cancer. “It’s a game changer,” he added.

If the AI ​​software detects anything abnormal in the x-ray, the patient is referred to a hospital where a more detailed LDCT scan can be performed.

If a person is confirmed to have early-stage lung cancer, they can receive treatment to effectively cure the cancer.

“With LDCT scans and AI chest x-ray screening, we hope to achieve real change and detect more cases in the early stages where the disease can be treated more effectively. is,” he says.

not the death penalty

Many people assume, or share a common misconception, that being diagnosed with lung cancer is akin to being sentenced to death, and as such there is no point in treating it.

According to Dr Tho, this has also been the case in the past when patients with stage IV lung cancer had an expected survival of about six months or less.

However, this situation has changed thanks to tremendous advances in lung cancer treatment such as immunotherapy and oral targeted therapy.

he said:

He and Dr. Anand share the story of how one of the youngest lung cancer patients battled the disease.

The then 30-year-old woman had no family history of smoking or cancer, and had never experienced lung cancer symptoms prior to her diagnosis.

Her cancer was an unexpected discovery from a routine checkup.

After screening, she was diagnosed with early stage IV lung cancer.

Tho said her medical team performed genetic testing and found that her tumor had mutations that could be targeted by available drugs.

They prescribed her this oral targeted therapy.

Following a good response to treatment, Dr. Anand performed her surgery and was able to safely remove the tumor completely.

Almost five years have passed, and doctors share that the patient is well, cancer-free, and alive and well.

But Dr. Anand points out that economic toxicity is a real concern, as lung cancer treatments can cost more than six figures depending on the stage of the disease.

Treatment costs are generally less if the disease is detected early.

The best results are achieved with a multidisciplinary approach, such as surgery combined with immunotherapy or oral targeted therapy, and input from various relevant specialists working closely together.

Vouchers for discounted LDCT scans (including doctor visits) to screen for lung cancer in conjunction with the New Normal, Same Cancer public service campaign by LCNM, National Cancer Society Malaysia (NCSM) and Pink Unity, supported by AstraZeneca can provide.downloaded hereAvailable at more than 20 participating private hospitals nationwide.