Patients ask me, besides the obvious risk from smoking, what can cause lung cancer?
Smoking tobacco products is by far the leading cause of lung cancer, accounting for 90% of cases. Other main risk factors include:
- Second-hand tobacco smoke from exposure to smoke from others.
- Radon gas, an environmental gas without an odor that comes from the ground and can get trapped in basements. Testing is available.
- Asbestos exposure, especially working with asbestos material directly, such as cutting or tearing it.
- Exposure to diesel exhaust fumes, particularly common in miners working in closed spaces with diesel fueled equipment.
- Having had a prior lung cancer.
- Prior radiation therapy to the chest.
- Having several close relatives who have had lung cancer, especially if the diagnosis was made at an early age.
To reduce your risk of lung cancer, I advise strictly avoiding known carcinogens like those listed above, especially tobacco smoke. Also, have your home tested for radon gas.
Screening for Lung Cancer
Lung cancer screening with low dose CT scans in current or former smokers can be a life-saving intervention. It is unfortunate that it is not yet being covered by Medicare and many other health insurance companies. Such screening should be done for three years, and are advocated only for cigarette smokers who are between the ages of 55 and 74 years old, have been smoking for at least 30 pack-years (multiply packs of cigarettes smoked per day by the number of years smoked), and who continue to smoke or have quit within the past 15 years.
Breakthroughs in Treatment
Current research suggests that an immune response and inflammation may play a role in lung cancer. I agree. A novel drug that blocks a substance called PD-1 is showing considerable promise in treating lung cancer. This drug is thought to work by amplifying the immune response to lung cancer.
Two new drugs have been approved in the past few years, Erlotinib and Crizotinib. Both of these drugs target specific mutations that are found in a small subset of lung cancers. In patients whose tumors’ possess one of these mutations, these drugs produce amazing results with side-effects that are typically quite mild.
There also are a number of promising new drugs and treatment strategies under investigation. At Missouri Baptist, we have a large cancer research program and are able to offer a variety of clinical trials that are examining novel drugs or treatment strategies to patients with lung cancer.
In my opinion, and based on research done in breast cancer, the best way to improve your immune system and mitigate inflammation is with daily exercise (at least 30 minutes) and a healthy diet rich in fruits and vegetables, and low in fried and processed foods.
And please… if you are a smoker… quit smoking as soon as possible.
Bryan Faller, MD, is board-certified oncologist specializing in the diagnosis and treatment of cancer. He is on-staff at Missouri Baptist Medical Center. For an appointment call 314-996-LIFE.