Lung cancer is the leading cause of cancer death and the second most common cancer among both men and women in the United States. Most lung cancers could be prevented by avoiding tobacco use and increasing participation in quit-smoking programs.

The American Cancer Society estimates that in 2017, more than 2,600 Arkansans will be diagnosed with lung and bronchus cancer; an estimated 2,160 Arkansans will die from it. The Centers for Disease Control and Prevention (CDC) ranks Arkansas third in the nation in the incidence of lung cancers and death from lung cancer. Lung cancer causes more deaths than breast, colorectal and prostate cancers combined.

Since the U.S. Surgeon General’s 1964 devastating report on the health costs of smoking tobacco, smoking rates have steadily dropped. Currently, 18 percent of U.S. adults are smokers. In Arkansas, the smoking rate exceeds 22 percent, ranking the state seventh worst in the nation, according to the CDC.  Arkansas’ lung cancer rates directly reflect Arkansans’ addiction to tobacco.

What causes lung cancer?

Smoking tobacco in any form is the most common risk factor for lung cancer. At least 85 percent of lung cancers occur in current or former smokers. Tobacco smoke includes more than 7,000 chemicals, most are poisons and at least 70 of them are known to cause cancer.

Smoking cigarettes will increase your chances of dying from lung cancer by 15 to 30 times that of a nonsmoker. The more you smoke per day and the earlier you started smoking, the greater your risk of lung cancer.

The National Institutes of Health says cigarette smoking can cause cancer almost anywhere in the body, including cancer of the mouth and throat, esophagus, stomach, colon, rectum, liver, pancreas, voice box (larynx), trachea, bronchus, kidney and renal pelvis, bladder, cervix, and causes acute myeloid leukemia.

Secondhand smoke is the smoke exhaled by a smoker and breathed in by a nonsmoker. The National Institutes of Health (NIH) says about 7,300 people a year, who never smoked, will die from lung cancer due to secondhand smoke.

 Other causes, in addition to secondhand smoke, include radon gas (radioactive breakdown of uranium rock found in soil and rock), asbestos, certain metals (chromium, cadmium, arsenic), history of tuberculosis and a family history of lung cancer, according to the Arkansas Department of Health’s 2017 Arkansas Cancer Facts & Figures.

Age. The risk of lung cancer increases with age. In Arkansas, the median age of lung cancer diagnosis is 69; the median age of death from lung cancer is 70.

Gender and race. Although lung cancer deaths are declining overall, men are much more likely to die from lung cancer than women are. While men’s death rates are declining, women’s death rates have remained almost the same from 2000-2013. Black males have a higher death rate than white males. At older ages, white women have a higher death rate than black women do. However, the rates for younger black or white women are about the same.

What are the symptoms?

In the earliest stages of lung cancer, there are rarely any symptoms. As the cancer progresses, symptoms can include a persistent cough that gets worse over time, chest pain, spit that’s steaked with blood, coughing up blood, voice changes, frequent bronchitis or pneumonia, fatigue, loss of appetite or weight loss, and shortness of breath, wheezing or hoarseness.

Diagnosis

Lung cancer develops silently. All too often, by the time lung cancer is found, it is too late for a cure. However, if found early, in Stage 1, the survival rate is 88-92 percent. If found at stage 4, the five-year survival rate is less than 5 percent.

The use of an effective screening program is essential to save lives. Screening means looking for, or testing for, a disease before there are any symptoms. When cancer is found early, it is easier to treat, you will often have more treatment options, and the treatment can be less drastic and shorter. Finding it early, through regular screening, also prevents the cancer from spreading to other parts of the body.

Lung cancer screening can save a significant amount of future health care costs. However, in 2015, less than 4 percent of current or former smokers were screened. The American Cancer Society estimates that 12,000 lung cancer deaths every year could be prevented if high-risk people were screened.

Many clinical trials have demonstrated the effectiveness of finding lung cancer by using low-dose helical computed tomography (LDCT). When compared to standard X-ray diagnosis, LDCT finds more cancers, shows fewer false positives and reduces lung cancer deaths.

  • The National Comprehensive Cancer Network (NCCN) guidelines recommend screening individuals ages 55-74, with a 30-pack-year history, who currently smoke or quit smoking less than 15 years ago.
  • The U. S. Preventive Services Task Force recommends a LDCT screening program for smokers ages 55-80.
  • Medicare currently provides coverage for screening at ages 55-77 with the same smoking and quit requirements as above. Medicare coverage requires patients to have no lung cancer symptoms, a life expectancy of at least 10 years and be able to undergo treatment.

Treatment options

Lung cancer treatment can include:

  • Surgery that removes cancer from your body
  • Radiation therapy that uses high doses of radiation to kill cancer cells or shrink tumors
  • Chemotherapy uses strong drugs to kill cancer cells
  • Immunotherapy to help your immune system fight cancer
  • Targeted therapy focuses on cancer cell changes that occur when cancer divides and spreads

More than one of these treatments is often used. Your treatment plan will depend on how far the cancer has advanced, your age and overall health status.

Side effects of lung cancer treatment vary from person to person, even if they have the same treatment. Side effects are affected by the strength of your treatments, how often and how long you have treatments, and your age and overall health status, according to the National Cancer Institute at NIH.

The most common side effects include loss of appetite and weight loss, vomiting, constipation and diarrhea, swelling, hair loss, infections, bleeding or bruising, memory or concentration problems, feeling tired (fatigue), sexual dysfunction, pain and sleep problems.

Your attitude and what you expect during treatment have a large impact on the intensity of side effects. For example, in a 2004 study, women who expected to have vomiting during treatment were five times more likely to do so than women who thought vomiting was unlikely.

The National Cancer Institute recommends these tips to lessen the chances of side-effect problems. Always tell your doctor about any symptoms you have during treatment and after it ends, including any change in your symptoms.

  • Maintain a positive attitude; try to be optimistic about your treatment
  • Eat smaller meals and avoid greasy, spicy, fried or salty foods
  • Eat balanced meals of high-nutrient foods and plenty of liquids to reduce fatigue
  • Eat foods that are easy to digest like bananas, applesauce and white rice; avoid raw foods and high-fiber foods because they can make diarrhea worse
  • Get extra rest; nap less than one hour during the day; reduce your workload
  • Get regular exercise – it will help with appetite, pain, fatigue and swelling
  • Use mild soap and fragrance-free lotion if skin is irritated
  • To reduce nail problems, ask for frozen mittens to keep hands very cold while receiving chemotherapy
  • If swelling (edema) is a problem, wear loose clothing and shoes; when you sit or lie down, put your feet up on a stool or pillows; avoid crossing your legs when you sit; ask about compression stockings or sleeves; reduce salt in your diet
  • Avoid infections with frequent handwashing; avoid sick people and crowds; keep teeth clean; disinfect all skin cuts
  • Treat your hair gently; avoid hairdryers and styling products; wash hair less frequently with a mild shampoo; many people use hats, scarves and wigs until hair grows back; hair will grow back within three to 10 months after the last treatment
  • Take pain medications exactly as your doctor tells you; keep track of when your pain is better or worse and give this information to your doctor
  • Always wear a condom during sex because some chemotherapy drugs can stay in semen and affect your partner

 Prevention tips

Quitting smoking will lower your risk of lung cancer, regardless of what age you quit. Nearly one out of every 15 homes in the United States has high radon levels. The EPA recommends testing homes for radon and using proven ways to lower high radon levels.

There are many tools to help you quit smoking, from setting goals and a quit date to medications and counseling. Ask your doctor about prescriptions that could help and other methods. Many smokers try to quit several times before they are successful, so don’t give up if previous attempts were not successful.