Smoking and lung cancer: The link

by Admin-Phmp

Text by Henrylito D. Tacio

Photo: Cleveland Clinic

Perhaps not too many Filipinos are aware that every month, we observe National Lung Cancer Awareness Month every November.

November is gone already but still many don’t know that we did observe it without much fanfare. The Department of Health led it with the theme: “Kalaaman sa Kanser sa Baga Palawakin, Pag-iwas at Lunas Ating Alamin.”

The health department strongly advised Filipinos, particularly the younger generation, to stop smoking as research disclosed that smoking and secondhand smoke continues to be the leading cause of lung cancer.

“Aside from lung cancer that one gets due to smoking, it weakens the immune system which is also a big factor for survival if one becomes infected with COVID-19,” Health Secretary Francisco T. Duque III said in a statement.

According to Duque, there are several risk factors that may increase the chances of getting lung cancer. These include smoking, secondhand smoke, and other substances found at workplaces like asbestos, arsenic, diesel exhaust, and some forms of silica and chromium.

Smoking is not the only cause of lung cancer. Family history (if a father or mother, or relatives has the disease, the next generation may also have it), radiation therapy to the chest, diet, and lifestyle may also contribute to acquiring the disease.

The Global Cancer Statistics 2020 said lung cancer is the most common cancer worldwide, affecting 2.2 million people in 2020. In the Philippines, lung cancer is the second leading cancer site and the leading cause of mortality among all types of cancer in Philippines.

“More and more Filipinos are dying of lung cancer,” deplores the Philippine Society of Medical Oncology (PSMO).

According to the PSMO, 8,143 men out of 100,000 men are diagnosed with lung cancer, and 6,473 die. Among women, 2,500 are diagnosed with lung cancer out of 100,000, and 2,043 die. “As more people smoke cigarettes, the number of Filipinos with lung cancer is most likely to rise,” it said.

Lung cancer claims 25 lives each day, according to the Cancer Facts and Estimates of the Philippine Cancer Society (PCS). Some 240 Filipinos die each day due to tobacco-related diseases, PCS said.

Many Filipinos think only ordinary people die of lung cancer. But what they don’t know is that many famous men and women in history died of it. To name a few: Desi Arnaz, Yul Brynner, Joe DiMaggio, George VI, Betty Grable, George Harrison, Bob Marley, Ray Milland, Claude Monet, Jesse Owens, Patricia Neal, Boris Pasternak, and Harry Vardon.

The lungs are two spongy organs found in the chest. They are responsible for delivering oxygen to the bloodstream. When you take a breath in, air moves into the lungs, causing them to expand.

“Most lung cancer originates in the cells of the lungs; however, cancer may also spread (metastasize) to the lung from other parts of the body,” explains Dr. Gary Sy in his column published in a national daily.

Metastatic cancers, according to The Merck Manual of Medical Information, spread to the lungs most commonly from the breast, colon, prostate, kidney, thyroid gland, stomach, cervix, rectum, testis, bone, and skin (melanoma).

“There are many different types of growth or tumor that can occur in the lungs,” Dr. Sy says. “It is conventional to divide growths into benign and malignant, and primary and secondary. A benign tumor is one that is unlikely to spread to become life threatening, whereas a malignant tumor grows rapidly, and spreads, thereby threatening life. This happens by direct invasion of surrounding structures or by spreading through the blood or lymphatic system.”

A primary tumor of the lungs is one that has arisen first within the lung tissue; a secondary tumor is one that has arisen elsewhere in the body but has then spread to the lungs.

The symptoms of lung cancer are very non-specific. “This is the reason many patients with lung cancer present at an advanced stage of the disease,” Dr. Sy writes. “One factor hindering or delaying the early diagnosis of lung cancer is that the symptoms, such as cough, are common to other conditions.”

The symptoms include breathlessness, cough, and chest pain, lethargy, and weight loss. All these symptoms are very common and are present in numerous other conditions. Even coughing up blood (hemoptysis), which is thought by many to be a defining symptom of the condition, is not present in the majority of patients diagnosed with lung cancer.

“Catching the disease early is the key to successful treatment,” Dr. Diana Edralin, country medical director of Roche (Philippines) Inc., told Manila Standard’s Alena Mae Flores. “Symptoms do not show up until the later stages of lung cancer, but yearly testing can help achieve earlier diagnosis. This is why yearly testing is recommended for smokers or ex-smokers older than 55 years of age, who are the most at-risk for lung cancer.

“It is best to consult your medical oncologist for more information on lung cancer, and learn more about the available and emerging treatment options,” she added.

According to Dr. Edralin, treatment options for patients with lung cancer vary, depending on how it has grown and spread in the body. The main treatment for early-stage lung cancer is surgery to remove the tumor itself or the area where cancer has developed.

Chemotherapy, sometimes coupled with radiation therapy, is another treatment of choice.  

Like other forms of cancer, lung cancer can also be prevented. “Lung cancer prevention involves proper diet and adequate exercise, avoiding pollution, and most importantly, avoiding smoking and secondhand smoke,” Dr. Edralin said.

But “there is no way to totally prevent lung cancer,” Dr. Edralin pointed out, “and the fight against it is challenging.” 

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