Amy SanfordMD, is a hematologist/oncologist at Sanford Health who provides compassionate care to patients with cancer and blood disorders. Sanford Cancer Center It operates out of Sioux Falls, South Dakota and provides outreach services in Vermillion, South Dakota.
What are the main causes of lung cancer?
Dr. Sanford: Tobacco use, primarily cigarette smoking, is the greatest risk factor for lung cancer in developed countries. Developing countries are more affected by air pollution, but the majority of lung cancers in developed countries such as the United States are tobacco-related.
Do e-cigarettes cause lung cancer?
Dr. Sanford: Only time will tell, but it’s more likely to cause lung cancer. Research needs lag time to determine if anything is causing cancer.At this point, e-cigarettes are still too new , to say with certainty whether it causes cancer. Twenty years from now we will have more information about whether it causes lung cancer. Some of the aerosols in e-cigarettes are known carcinogens. Therefore, although we cannot say for certain at this time, we do expect that e-cigarettes will become associated with lung cancer in the future.
Does Radon Cause Lung Cancer?
Dr. Sanford: Radon exposure is known to contribute to the risk of developing lung cancer. Radon is a gas that is naturally present in soil, water, and rocks. It is a known carcinogen and risk factor for lung cancer. Older homes should be tested for radon exposure and, if present, have mitigation systems that can reduce that exposure. New homes tend to have these systems installed.
What are the warning signs of lung cancer?
Dr. Sanford: Many lung cancers are asymptomatic until very advanced. So many people don’t know they have cancer. The symptoms we see depend on where the cancer is located.
Coughing may occur if the cancer affects certain airways. Some people cough up blood. If the cancer is advanced and concentrated, some people will have shortness of breath and chest pain.
How can I get a lung cancer screening?
Dr. Sanford: Lung cancer screening is something that needs to be promoted and promoted. Of all the cancer screenings we do, lung cancer screening has the lowest mortality rate and can detect and save more lives than any other cancer screening. So for those in the community, it starts with talking to their primary care physician. Our Sanford Clinical Guidelines recommend screening people between the ages of 50 and 77 who are at high risk for lung cancer due to a history of smoking, even if they do not have lung cancer symptoms.
People whose smoking history includes 20 years of “pack years” are eligible to have a lung cancer screening CT (computed tomography) scan, which is a low-dose CT of the chest. It is something that qualified people should do once a year.
1 “1 pack-year” is equivalent to smoking an average of 20 cigarettes per day, or 1 pack for 1 year, or 2 packs per day for 10 years.
How does lung cancer usually start?
Dr. Sanford: Lung cancer starts like all cancers. A cell has acquired mutations that keep it alive forever — it is an immortal cell. These mutations occur in genes thought to stop growth or thought to promote growth. It may occur in certain genes. Lung cancer therefore begins with cellular mutations. For many tobacco-related lung cancer patients, tobacco acts as a carcinogen, driving mutations in their cells.
Does lung cancer spread quickly?
Dr. Sanford: There are two main categories of lung cancer. One of them spreads much faster than the others. For small cell lung cancer, for example, the cancer doubles in size in 4-6 weeks. The more common type of lung cancer, non-small cell lung cancer, spreads more slowly. Lung cancer has been present for more than a year and can progress slowly during that time.
How many types of lung cancer are there?
Dr. Sanford: There are several types of lung cancer, but they are divided into non-small cell lung cancer and small cell lung cancer. All lung cancers fall into one of these two umbrellas.
How is lung cancer treated?
Dr. Sanford: Treatment varies greatly depending on the type and stage of the patient’s lung cancer. For example, early-stage lung cancer detected on lung screening CT can often be cured with surgical resection or radiation therapy if the patient is not a candidate for surgery.
For more advanced disease, chemotherapy and radiation therapy are given at the same time. For patients with stage IV cancer, the main treatment is systemic therapy. That is, chemotherapy with or without systemic immunotherapy.
What would you say to people who may be reluctant to get screened because they don’t want to deal with their smoking habit?
Dr. Sanford: My message to the community is to get a screening CT of your lungs. I wish everyone would quit smoking. But if you still smoke, don’t let that get in your way when you talk to your doctor about getting screened for lung cancer. Cancers detected on screening CT are often found at an early stage. These are cancers that we often get a chance to treat, as opposed to cancers that are detected when someone has enough symptoms to present. There is often no effective treatment.
I hope everyone who still smokes gets a CT scan. I wish I had the opportunity to spend years talking to them about quitting smoking while tracking down early-stage lung cancer, rather than meeting them when they were terminally ill.
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