Speakers stress lifestyle changes to reduce incidence of lung cancer

KARACHI: Lung Cancer Awareness Month is celebrated in November with the aim of achieving better results for patients by raising the noise level of awareness about lung cancer and its harms.

Dr Abdul Qayyum, consultant oncologist at the Ziauddin Hospital, highlighted the many risk factors to be aware of in order to detect lung cancer at the earliest stage possible.

“As the most common cancer type across the globe, lung cancer impacts approximately 2.1 million people and causes an estimated 1.8 million deaths each year,” Dr Qayyum said in a webinar organised by the M Hashim Memorial Trust.

“While most understand that smoking is the single greatest risk factor for lung cancer, other lesser known risk factors include environment and genetics. Environmental exposure to radon and other radioactive materials have all been linked to lung cancer,” he said.

“The risk of lung cancer also increases with a history of cancer in another part of the body, age, family history, radiation to the chest area and lung diseases like COPD.”Dr Qayyum said treatment options for lung cancer have significantly advanced over the past few years and survival rates are increasing, adding that treatment for lung cancer depends on the type, stage, as well as the overall health of the patient.

He said possible treatments include surgery, chemotherapy, radiation therapy, immunotherapy and targeted therapy. He advised that you must visit a doctor if you or anyone in your family shows any persistent symptoms of concern. Finding lung cancer earlier and getting the required treatment immediately can help improve the patient’s quality of life, he explained.

“Today treatment has become more personalised, which means that doctors today detect specific mutations within the tumour, based on which a treatment course is planned out,” he said.“Unlike chemotherapy, this treatment does not have any side-effects and has faster recovery. Patients can also take this treatment at home instead of visiting the hospital. Another example of treatment is immunotherapy, which has also been showing very good results in those patients who opt for it”.

Dr Qayyum said respiratory oncology is not only about medicines, as 50 per cent of lung cancers are preventable. “We should emphasise lifestyle changes that would reduce the incidence of cancer: stop smoking, reduce alcohol intake, have a balanced diet low in red meat, exercise and avoid exposure to substances that have been shown to be carcinogenic.’’

Dr Lubna Saleem, consultant medical oncologist at the Cancer Foundation Hospital, said lung cancer incidence has gone up and this has been noticed especially more so in females.“Lung cancer, once considered a man’s disease, is now the top cancer killer in women, claiming more lives every year than breast cancer, uterine cancer and ovarian cancer combined,” she said. “But did you know that lung cancer in women differs from lung cancer in men in many ways? Weight loss, fatigue, shortness of breath, chest pain, back and shoulder pain are a few of them. But, unfortunately, many women aren’t aware of all the symptoms, especially those specific to their gender.”

She said we don’t know the exact cause behind the increase, but some factors that could be contributing to the increase are indoor pollution, that is exposure to cooking gases within the kitchen as well as increase in smoking among young females.

She also said the primary causes of lung cancer are smoking, exposure to radon (second risk factor after smoking) and other hazardous materials, adding that the type of cancer that we have seen has also changed in the past 40 years because of the smoking pattern.

“We are using filter cigarettes and other things, which actually have not reduced the incidence of lung cancer. But these habits are changin“We are witnessing more of adenocarcinomas now than squamous cell carcinoma. These are the two sub-types of carcinomas. But the actual number has increased. Therefore, thinking that taking a filter, etc. might be safe is just a myth.”

Dr Lubna cautioned that a proper and well-thought strategy for documenting data, preventive screening, sustainable financing, quality treatment protocols and high standards of palliative care are required to be established to get safe and successful patient outcomes.

According to College of Family Medicine Pakistan General Secretary Dr Shehla Naseem, smokers should be regularly screened for lung cancer because the condition remains the deadliest form of the disease in Pakistan.

“If you really want to do something, the price of cigarette needs to be much more, like in many Western countries. We also know shisha is a very bad habit and it needs to change and be stopped completely.”

She said that comprehensive lung cancer care requires a multidisciplinary team of specialists who care for a significant number of patients on a regular basis.“Although recommended by scientific societies, multidisciplinary management is not yet uniformly available. Ideally, centres managing patients with lung malignancies should have a multidisciplinary specialised oncology board to make decisions on individualised management, based on evidence-based data.”She advised that what we can do is continue to educate people, doctors and health providers, and provide specialists who have expertise in dedicated diagnosis, evaluation, treatment and follow-up with psychological support.”