Health
Dear Doctor: Should I be screened for lung cancer after living with indirect smoking throughout my life?
Dear Dr. Cockroach: For over 60 years I have lived with smokers. My parents smoked around their children in our family home and in family cars. After that, most of my brothers smoked. Family gatherings have always been smoky events. I also married a smoker who was smoking at home until his toddler’s grandson lived with us. My husband started smoking outside, but sometimes he continued to smoke in the car with the windows open. He finally quit last year because his lungs collapsed during a biopsy. He has COPD and is receiving full-time oxygen therapy.
Three maternal uncles died of lung cancer. All were heavy smokers and worked in mines in early adulthood. My paternal grandmother, also a smoker, died of complications from emphysema. All that was told to my doctor is wondering why he didn’t suggest a lung scan as a precaution when I had never smoked. I understand that the early stages of lung cancer are relatively asymptomatic and that indirect smoking breathing can be as dangerous as smoking. What do you think? Is it wise to request a prophylactic scan, even if I am healthy? Are there any early symptoms to look for? –LH
Answer: Lung cancer remains the only major cause of cancer death and accounts for about a quarter of all cancer deaths. In the early stages, there are no signs or symptoms, but cough (especially blood production), shortness of breath, and chest discomfort are one of the first signs that lung cancer is more advanced. Smoking is the greatest risk factor for developing lung cancer. It is true that indirect smoking increases the risk of developing lung cancer. Nonsmokers with smoking partners have a 25% to 35% increased risk of lung cancer when compared to nonsmokers who have never been exposed to indirect smoking. In contrast, one and a half days smokers have a 11,000% increased risk of lung cancer.
No studies have examined lung cancer screening in nonsmokers exposed to indirect smoking. Getting a scan may not seem like a downside, but there are at least two. The first is scan time, cost, and radiation dose. Second, the scan may detect anomalies that need further evaluation. These have usually proven to be clinically insignificant, but not before additional unnecessary tests or, in some cases, procedures have been performed.
Lung cancer screening is recommended for people at high risk of lung cancer, who have smoked the equivalent of one pack daily for 15 years, due to the potential drawbacks of screening. For those people, the advantages of being able to detect cancer early when it is curable outweigh the disadvantages.
Quitting smoking is the best way to reduce your own risk of lung cancer and reduce the risk of lung cancer, heart disease, COPD and other conditions in the people you live in.
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Dr. Roach regrets not being able to answer the individual letters, but incorporate them into the column as much as possible.Readers can email questions [email protected] Alternatively, send an email to 628 Virginia Dr., Orlando, FL32803.
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